Effect of additional load on angular parameters during gait and balance in children with hemiparesis – Cross sectional study

Abstract

Study aim: To study the effect of additional load over ankle and knee joints on angular parameters during gait and balance in children with hemiparesis. Material and methods: 10 children with hemiparesis were recruited and stratified into 2 chronological age groups: group A (4–8 years) and group B (9–12 years). Additional loads of 0.7 kg and 1.1 kg were placed on the affected and non-affected lower limb at the ankle and knee joint for group A and group B respectively. Angular parameters during gait were assessed using Kinovea software (version 0.8.15) and balance using the Pediatric Balance Scale. Results: Application of additional load of 0.7 kg over the non-affected leg knee joint is able to produce significant changes in ankle joint angles (p < 0.05) at initial contact and knee joint angles at heel-off (p < 0.05), toe-off (p < 0.001), acceleration (p < 0.05) and deceleration (p < 0.05) phases of gait and balance in group A, whereas on application of additional load of 1.1 kg over the affected leg at the ankle joint significant improvement in knee joint angles at initial contact (p < 0.001) and the deceleration (p < 0.05) phase of gait in group B was observed. There was significant improvement in the Pediatric Balance Scale score in both groups (p < 0.05). Conclusions: Additional load over knee and ankle joints of the affected and non-affected leg showed more improvement in angular parameters during gait and balance in younger children with hemiparesis than older children, as they present an immature form of gait that can be modified, corrected and brought back to a normal angle.

Using the TUG Test for the Functional Assessment of Patients with Selected Disorders

“…In the observations of Hoffman [34], patients after brain tumor surgery performed the TUG test within 5.1 s, and their recorded test time was very similar to the time obtained in the group of healthy children. On the other hand, in the group of children after stroke, Berkner et al [35] observed a slower gait, shorter stride and increased walking cadence which results from difficulties with tasks requiring greater coordination [36,37]. A study by Rahman et al [38] in patients after TBI with the TUG test demonstrated a significantly reduced walking speed (11.5 s) and frequency of steps, when compared to healthy children.…”