Improving Trunk Postural Control Facilitates Walking in Children With Cerebral Palsy

Abstract

Objective The aim of this study is to determine the effects of bilateral trunk support during walking on trunk and leg kinematics and neuromuscular responses in children with cerebral palsy. Design Fourteen children with spastic cerebral palsy (Gross Motor Function Classification System level I to III) participated in this study. Children walked on a treadmill under four different conditions, that is, without support (Baseline), with bilateral support applied to the upper trunk (upper trunk support), the lower trunk (lower trunk support), and combined upper and lower trunk (combined trunk support). The trunk and leg kinematics and muscle activity were recorded. Results Providing bilateral support to the trunk had a significant impact on the displacement of the pelvis and trunk (P < 0.003) during walking. Children’s weaker leg showed greater step length (P = 0.032) and step height (P = 0.012) in combined trunk support compared with baseline and greater step length in upper trunk support (P = 0.02) and combined trunk support (P = 0.022) compared with lower trunk support. Changes in soleus electromyographic activity during stance phase of gait mirrored the changes in step length across all conditions. Conclusions Providing bilateral upper or combined upper and lower trunk support during walking may induce improvements in gait performance, which may be due to improved pelvis kinematics. Improving trunk postural control may facilitate walking in children with cerebral palsy.