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Associations of Walk-and-Turn Spatiotemporal Gait Parameters With Functional Mobility in Children With Cerebral Palsy
1Department of Rehabilitation Center, National Health Insurance Ilsan Hospital, Ilsan, Republic of Korea; Graduate School of Sports Medicine, CHA University, Gyeonggi-do, Republic of Korea.
Insights
Hip extensor strength and gait cadence are linked to functional mobility in children with cerebral palsy (CP). Specific gait parameters and strength also correlate with the Gross Motor Function Classification System (GMFCS) levels.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Biomechanical Engineering
Background:
- Cerebral palsy (CP) affects motor function in children.
- Assessing functional mobility and Gross Motor Function Classification System (GMFCS) levels is crucial for CP management.
- Spatiotemporal gait parameters offer insights into motor control.
Purpose of the Study:
- To investigate the association between spatiotemporal gait parameters, lower extremity muscle strength, and limitations in motion (LOM).
- To determine the relationship of these factors with functional mobility and GMFCS levels in ambulatory children with CP.
Main Methods:
- A cross-sectional study involving 107 ambulatory children with CP (GMFCS levels I and II).
- Gait parameters were assessed during a 5-meter walk-and-turn task.
- Lower extremity muscle strength, LOM, GMFCS level, and functional mobility (using GMFM dimensions D-E) were measured.
Main Results:
- Children with GMFCS level II exhibited reduced stride length, slower walking speed, and lower cadence compared to GMFCS level I.
- Hip extensor strength and cadence were significantly associated with functional mobility scores (GMFM D-E).
- Hip extensor strength, stride length, walking speed, and cadence were associated with GMFCS level.
Conclusions:
- Hip extensor strength and gait cadence are key predictors of functional mobility in ambulatory children with CP.
- Gait parameters measured during a walk-and-turn task, along with hip extensor strength, are associated with GMFCS level.
- Quantitative gait analysis provides valuable information for assessing mobility across different GMFCS levels in children with CP.
Objective:
To examine whether spatiotemporal gait parameters assessed during a 5-m walk-and-turn task, together with lower extremity muscle strength and limitations of motion (LOM), are associated with functional mobility and Gross Motor Function Classification System (GMFCS) level in ambulatory children with cerebral palsy (CP).
Design:
Cross-sectional study.
Setting:
Public hospital-based rehabilitation center.
Participants:
A total of 107 ambulatory children with CP (GMFCS level I, n=40; level II, n=67).
Interventions:
Not applicable.
Main Outcome Measures:
Spatiotemporal gait parameters assessed during a 5-m walk-and-turn task, lower extremity muscle strength, LOM, GMFCS level, and functional mobility measured using the Gross Motor Function Measure (GMFM) dimensions D-E.
Results:
The GMFCS level II group showed shorter stride length, slower walking speed, and lower cadence than the GMFCS level I group (all P<.05). Linear regression analyses showed that hip extensor strength (B=15.61) and cadence (B=0.12) were significantly associated with GMFM D-E scores (both P<.05). Logistic regression analyses showed that hip extensor strength (OR=0.18), stride length (OR=0.97), walking speed (OR=0.01), and cadence (OR=0.96) were significantly associated with GMFCS level (all P<.05). In complementary cutoff-based analyses, values below the receiver operating characteristic-derived cutoffs for walking speed, cadence, and stride length were associated with relative risks of GMFCS level II ranging from 2.00 to 2.68 (all P<.001).
Conclusions:
Hip extensor strength and cadence were associated with functional mobility, whereas hip extensor strength and selected spatiotemporal gait parameters assessed during a walk-and-turn task were associated with GMFCS level in ambulatory children with CP. Cutoff-based analyses further suggest that quantitative gait assessment may provide complementary information regarding mobility performance across GMFCS levels I and II.
