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Locomotion patterns in cerebral palsy syndromes
M Bottos1, M L Puato, A Vianello
1Servizio di Recupero e Rieducazione Funzionale, Bologna, Italy.
Insights
This study identified 10 distinct locomotion patterns in children with cerebral palsy (CP). The specific pattern, age of onset, and severity of impairment significantly influence a child's prognosis for walking independently.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) presents with diverse motor impairments affecting locomotion.
- Understanding distinct movement patterns is crucial for predicting functional outcomes in children with CP.
Purpose of the Study:
- To classify and analyze the various locomotion patterns observed in children with cerebral palsy.
- To investigate the relationship between specific locomotion patterns, impairment type, and prognosis for independent walking.
Main Methods:
- A study involving 160 children diagnosed with cerebral palsy.
- Classification of observed locomotion into ten distinct patterns based on motor impairment type and severity.
- Analysis of factors influencing the prognosis for walking, including locomotion pattern, age at onset, and physical deformity.
Main Results:
- Ten distinct locomotion patterns were identified and associated with specific types and severities of cerebral palsy.
- Factors such as locomotion pattern, age at onset, and manner of execution significantly impacted walking prognosis.
- Severe deformities influenced the chosen locomotion pattern.
Conclusions:
- Locomotion patterns in children with cerebral palsy are indicative of impairment type and prognosis.
- While physiotherapy may not alter established patterns, early intervention can help mitigate deformities and potentially improve outcomes.
Abstract:
Locomotion patterns were studied in 160 children with cerebral palsy. Ten patterns were distinguished, which were typical of the type of impairment: (1) crawling--mildly impaired children who will achieve independent walking; (2) creeping and crawling--diplegic children with moderate motor impairment; (3) creeping, never leading to independent walking--children with severe diplegia or tetraplegia; (4) bottom shuffling--children with hemiplegia and ataxia and minimal or mild motor impairment; (5) bunny-hopping--dyskinetic children with marked motor impairment but generally not mentally retarded; (6) rolling--severely diplegic and dyskinetic children; (7) other forms of locomotion, such as bridging or grub-type creeping, rare and typical of children with ataxic elements; (8) just walk--children with hemiplegia, diplegia, ataxic diplegia or ataxia, generally in cases of mild motor impairment but mental retardation; (9) just walk with aids--children with severe diplegia; and (10) no mobility. The locomotion pattern, age at onset and even manner of execution all influenced prognosis for walking. Severe deformity affected the choice of locomotion pattern. Though physiotherapy probably would not greatly influence the adoption of a particular locomotion pattern, early intervention might help prevent deformities.