Fatigue in cerebral palsy: A critical review

Brunton, Laura; Rice, Charles L.

doi:10.3109/17518423.2011.629633

Cited by 43 publications

(26 citation statements)

References 40 publications

(77 reference statements)

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“…Multiple repetitions of a task universally reflect variation or movement variability, and the latter can be classified as "bad" when it impairs performance, "good" when it enhances the outcome, or "neutral" when it neither helps nor hinders the outcome (30,31). We did not find any effects of increased speed on variability in the studied variables, which corroborates what is reported among able-bodied populations (32). Gait variability is often reported to be higher in CP compared to TD peers (5-7) and is often interpreted as reflective of impaired motor control ("bad" variability).…”

Section: Discussionsupporting

confidence: 88%

“…The data in this study are based on short walking trials in a laboratory setting and therefore do not necessarily reflect the children's everyday walking performance, which may include longer periods of walking and at different intensities. Considering that fatigue is a common complaint in the CP population (32), this might interfere with both asymmetry and variability during walking. Indeed, signs of muscular fatigue were recently reported in the calf muscles of the affected leg after as little as 5 min of comfortable walking (35).…”

Section: Discussionmentioning

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: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“…He would often report fatigue and pain after participation in these events. Fatigue and pain are known to affect the walking ability of individuals with CP, although the exact mechanisms are unknown (Brunton and Rice, 2012;Opheim, Jahnsen, Olsson, and Stanghelle, 2009). Additionally, the POMA-G showed a ceiling effect when used to determine the mobility status of older adults and was not as responsive to change as the total POMA score (Faber, Bosscher, and van Wieringen, 2006).…”

Section: Discussionmentioning

confidence: 97%

Examination of the use of a dual-channel functional electrical stimulation system on gait, balance and balance confidence of an adult with spastic diplegic cerebral palsy

Robinson

Williamson

Cook

et al. 2014

Physiotherapy Theory and Practice

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The purpose of this case report is to determine the effects of a dual-channel functional electrical stimulation (FES) system on gait and balance of a 57-year-old male diagnosed with spastic diplegic cerebral palsy (CP). Outcome measures included the: Activities-specific Balance Confidence Scale (ABC); Dynamic Gait Index (DGI); Observational Gait Scale (OGS) and Tinetti Performance Oriented Mobility Assessment (POMA). Assessments were completed with and without use of FES during the initial examination and after two, four and six weeks of intervention with FES. ABC Scale scores improved from 32.8 to 48.1% during the 6-week intervention. Scores on the DGI improved from 6/24 to 9/24 without FES and from 9/24 to 14/24 with FES. OGS scores improved on both legs with and without FES. Tinetti POMA scores improved from 12/28 to 15/28 without FES and decreased from 16/28 to 15/28 with FES. The patient demonstrated improvement in both objective and subjective measures. The use of FES facilitated improved gait and balance; however, the patient was still at increased risk for falls after the 6-week intervention despite improved scores on the ABC Scale, DGI, OGS and Tinetti POMA.

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“…• Fatigue. The experience of physical fatigue is significant in people with CP and it has an impact on the maintenance of functional skills and on the perception of life satisfaction (Brunton and Rice 2012;Jahnsen et al 2003;Opheim et al 2009). …”

Section: Other Comorbiditiesmentioning

confidence: 99%