No abstract

Objective:Walking assessment is an important aspect of rehabilitation practice; yet, clinicians have few psychometrically sound options for evaluating walking in highly ambulatory children. The purpose of this study was to evaluate the validity and reliability of two new measures of walking function—the Obstacles and Curb tests—relative to the 10-Meter Walk test and Timed Up and Go test in children with spina bifida or cerebral palsy.Methods:A total of 16 ambulatory children with spina bifida (n=9) or cerebral palsy (n=7) (9 boys; mean age 7years, 7months; standard deviation 3years, 4months) and 16 age- and gender-matched typically developing children participated. Children completed the walking tests, at both self-selected and fast speeds, twice. To evaluate discriminative validity, scores were compared between typically developing and spina bifida/cerebral palsy groups. Within the spina bifida/cerebral palsy group, inter-test correlations evaluated convergent validity and intraclass correlation coefficients evaluated within-session test–retest reliability.Results:At fast speeds, all tests showed discriminative validity (p<0.006 for typically developing and spina bifida/cerebral palsy comparisons) and convergent validity (rho=0.81–0.90, p⩽0.001, for inter-test correlations). At self-selected speeds, only the Obstacles test discriminated between groups (p=0.001). Moderately strong correlations (rho=0.73–0.78, p⩽0.001) were seen between the 10-Meter Walk test, Curb test, and Timed Up and Go test. Intraclass correlation coefficients ranged from 0.81 to 0.97, with higher test–retest reliability for tests performed at fast speeds rather than self-selected speeds.Conclusion:The Obstacles and Curb tests are promising measures for assessing walking in this population. Performing tests at fast walking speeds may improve their validity and test–retest reliability for children with spina bifida/cerebral palsy.

This study used electromyography to compare the frequency of anticipatory postural adjustments for three bilateral trunk muscles and unilateral tibialis anterior muscle between children with and without developmental coordination disorder (DCD; n = 22, ages 7 to 14 years) during three tasks (kicking a ball, stepping onto a step, standing on one foot). Between-group comparisons demonstrated significantly less frequent anticipatory activation of ipsilateral tibialis anterior, ipsilateral transversus abdominis/internal oblique, and bilateral external oblique muscles in children with DCD. Odds ratios indicated that children with DCD utilized anticipatory contractions of these muscles one half to one quarter as often as the typically developing children did, while performing the same tasks. These results suggest that the movement difficulties experienced by children with DCD may be associated with less frequent anticipatory adjustments. For these children, inconsistent preparatory activation may contribute to postural control difficulties, excessive movement variability and poor movement quality.