The Effect of Foot-Ankle Condition on Physical Performance in Cerebral Palsy with Spastic Equinus Deformity

The severity of foot disability in children with cerebral palsy (CP) should be examined with both objective and subjective assessment tools. This cross-sectional study investigated the effect of foot-ankle function on physical performance in CP with spastic equinus deformity.

A cross-sectional prospective study was performed on 61 children with CP. Participants were evaluated by the Gross Motor Function Classification System (GMFCS), Oxford Ankle Foot Questionnaire for Children (OxAFQ-C), Timed Up and Go Test (TUG), single-leg stance test (SLST), 3-Meter Backward Walk Test (3MBWT), and Functional Reach Test.

The mean ± SD age of the children with CP (28 girls and 33 boys) included in the study was 11.3 ± 4.4 years. Individuals with higher foot-ankle function had better TUG, 3MBWT, and SLST performances (P < .005). The OxAFQ-C physical scale was moderately correlated with TUG (r = -0.474) and SLST (right extremity-eyes open) (r = 0.386) (P < .01). In addition, there was a low significant correlation between 3MBWT, SLST (right extremity-eyes closed), SLST (left extremity-eyes open), and SLST (left extremity-eyes closed) with the OxAFQ-C physical scale (P < .05). The OxAFQ-C school and play scale had a moderate-to-weak correlation coefficient (r = 0.257-0.439) with all of the physical performance tests (P < .05). In addition, there were moderate and low correlations of the OxAFQ-C emotional scale with TUG (r = -0.495) and 3MBWT (r = -0.298).

These results show that foot-ankle performance influenced physical performance in time-based physical tasks but not in better performance-based physical conditions. It was concluded that foot-ankle condition was most strongly associated with sit-to-stand and walking performance.