Evaluating interventions to improve gait in cerebral palsy: a meta‐analysis of spatiotemporal measures

Paul, Scott M.; Siegel, Karen Lohmann; Malley, James D.; Jaeger, Robert J.

doi:10.1111/j.1469-8749.2007.00542.x

Cited by 25 publications

(12 citation statements)

References 78 publications

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“…Gait impairments are common in people with cerebral palsy (CP) (1). Children and adolescents with CP often walk slower than age-matched controls, although this is not consistently reported (2)(3)(4)(5). Compared to typically developing (TD) peers, the gait pattern of children and adolescents with CP is often characterized by increased variability (5)(6)(7) and asymmetry (2,8).…”

Section: Introductionmentioning

confidence: 99%

“…Gait speed affects nearly all gait variables (11). Since a change in walking speed often is observed following treatment (4), it is important to assess which changes arise as a direct result of treatment and which from a change in gait speed. Nevertheless, there are no studies that explicitly investigate the effect of walking speed on asymmetry and variability in CP.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Increased Gait Speed on Asymmetry and Variability in Children With Cerebral Palsy

et al. 2020

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Gait of children and adolescents with cerebral palsy (CP) is often reported to be more asymmetric and variable than gait of typically developing (TD) peers. As this may lead to less stable and less efficient gait, a relevant clinical question is how asymmetry may be improved and variability reduced in this population. The main objective of the current study was to investigate whether higher walking speed would affect gait symmetry and gait variability in children and adolescents with CP. Data from clinical gait analyses of 43 children and adolescents (29 males and 14 females) with unilateral (n = 28) or bilateral (n = 15) CP were included. Mean age was 11.3 ± 3.4 years, with level I (n = 26) or level II (n = 17) according to the Gross Motor Function Classification System (GMFCS). Corresponding data from 20 TD peers, matched in age and gender, were included as reference.Step time, step length, single support, and stance phase were studied at two different gait speeds: preferred and fast walking speed. Symmetry index and coefficient of variation were used as measures of asymmetry and variability, respectively. Results indicated that all participants managed to increase gait speed when instructed to do so. Overall, increased speed did not result in a more asymmetrical or variable gait, except for an increase in step length asymmetry and a difference in response between GMFCS levels I and II in variability. This implies that manipulation of gait speed may be useful clinically without necessarily making gait more unstable. However, some increase in step length asymmetry may be inevitable when gait speed is increased in people with CP.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effect of Increased Gait Speed on Asymmetry and Variability in Children With Cerebral Palsy

et al. 2020

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“…Movement impairments specific to walking have been reported in numerous studies in individuals with CP 2-4. However, there has been no investigation that has specifically reported the gait impairments that are present during the early years of walking in CP.…”

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confidence: 99%

Variability and symmetry of gait in early walkers with and without bilateral cerebral palsy

et al. 2010

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Purpose-Investigating gait characteristics during the early stages of walking in CP may contribute to the understanding of the development of impaired gait. The objective of this study was to investigate differences in the variability and symmetry of spatiotemporal gait characteristics during the early years of walking in children with bilateral spastic CP compared to children with similar amounts of walking experience and typical development (TD).Methods-The spatiotemporal gait parameters of 31 children (15 with spastic CP, 16 with TD) who had an average of 28.5 (18.1 SD) months of walking experience were collected using an instrumented walkway.Results-All primary spatiotemporal parameters were reduced in the CP group, who also demonstrated greater stride-to-stride variability, compared to the TD group. There were no statistically significant differences in side-to-side symmetry between groups. Ankle dorsiflexion range of motion was related to several of the gait measures.Implications-Clinical trials investigating gait interventions during the early years of walking in children with CP should be conducted to determine if treatment can reduce the functional limitations that are present during the emergence of walking skills. Further investigation should examine variability and symmetry in the kinematics, kinetics, and muscle activity patterns of early walkers with CP, and the effect of treatment on the variability and symmetry of walking characteristics.Corresponding author: Laura A. Prosser, National Institutes of Health, Building 10-CRC, 1-1469, 10 Center Drive, Bethesda, MD 20892, Telephone: 301-451-7534, Fax: 301-451-7536, laura.prosser@nih.gov. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. However, there has been no investigation that has specifically reported the gait impairments that are present during the early years of walking in CP. NIH Public AccessTo aid development of appropriate treatment programs for young children, it is important to examine gait patterns during the development of impaired walking patterns. Measurement of the characteristics of gait during the early years of walking may provide insight into potential strategies to treat or prevent gait impairments in CP. The majority of gait research in CP includes participants who are between the ages of five years and adolescence, which are many years after the onset of walking. Young children are rarely included as research participants, in part because of limited attention, cognition, and tolerance to the instrumentation involved in gait analysis.The immaturity of movement patterns in early ...

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“…76 In a systematic review of different interventions to improve gait, these interventions did have a statistically signifi cant effect on the spatiotemporal parameters of gait. 85 This was true for specifi c orthopedic procedures as well, when the analysis was stratifi ed based on the type of intervention. However, the authors were unable to make any clinical recommendations about relative effi cacy of different interventions.…”

Section: Evidence For Specifi C Orthopedic Procedures and Techniquesmentioning

confidence: 99%

What Is the Best Treatment for Ambulatory Cerebral Palsy?

Narayanan¹

2009

Evidence-Based Orthopaedics

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Evaluating interventions to improve gait in cerebral palsy: a meta‐analysis of spatiotemporal measures

Cited by 25 publications

References 78 publications

The Effect of Increased Gait Speed on Asymmetry and Variability in Children With Cerebral Palsy

The Effect of Increased Gait Speed on Asymmetry and Variability in Children With Cerebral Palsy

Variability and symmetry of gait in early walkers with and without bilateral cerebral palsy

What Is the Best Treatment for Ambulatory Cerebral Palsy?

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