The relationship between clinical measurements and gait analysis data in children with cerebral palsy

Domagalska, Małgorzata; Szopa, Andrzej; Syczewska, Małgorzata; Pietraszek, S.; Kidoń, Z.; Onik, Grzegorz

doi:10.1016/j.gaitpost.2013.05.031

Cited by 38 publications

(25 citation statements)

References 24 publications

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“…Three-dimensional gait analysis25 , 26 and stabilometry26 , 27 are considered fundamental assessment tools for the adequate quantification of the effects of interventions aimed at improvements in gait and static balance. These sensitive methods allow the identification of small changes within a short span of time and were therefore selected for the present study.…”

Section: Discussionmentioning

confidence: 99%

Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study

Grecco¹,

Duarte²,

Zanon³

et al. 2014

Braz. J. Phys. Ther.

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Background: Transcranial direct-current stimulation (tDCS) has been widely studied with the aim of enhancing local synaptic efficacy and modulating the electrical activity of the cortex in patients with neurological disorders. Objective: The purpose of the present study was to determine the effect of a single session of tDCS regarding immediate changes in spatiotemporal gait and oscillations of the center of pressure (30 seconds) in children with cerebral palsy (CP). Method:A randomized controlled trial with a blinded evaluator was conducted involving 20 children with CP between six and ten years of age. Gait and balance were evaluated three times: Evaluation 1 (before the stimulation), Evaluation 2 (immediately after stimulation), and Evaluation 3 (20 minutes after the stimulation). The protocol consisted of a 20-minute session of tDCS applied to the primary motor cortex at an intensity of 1 mA. The participants were randomly allocated to two groups: experimental group - anodal stimulation of the primary motor cortex; and control group - placebo transcranial stimulation. Results: Significant reductions were found in the experimental group regarding oscillations during standing in the anteroposterior and mediolateral directions with eyes open and eyes closed in comparison with the control group (p<0.05). In the intra-group analysis, the experimental group exhibited significant improvements in gait velocity, cadence, and oscillation in the center of pressure during standing (p<0.05). No significant differences were found in the control group among the different evaluations. Conclusion: A single session of tDCS applied to the primary motor cortex promotes positive changes in static balance and gait velocity in children with cerebral palsy.

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Section: Discussionmentioning

confidence: 99%

Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study

Grecco¹,

Duarte²,

Zanon³

et al. 2014

Braz. J. Phys. Ther.

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“…Three-dimensional instrumented gait analysis (3DGA) was performed using the Compact Measuring System for 3D Real-Time Motion Analysis (CMS-HS 3D) based on 15 active ultrasonic markers (5 triplicate ultrasound markers) with WinGait software (Zebris Medizintechnik GmbH, Germany) [17], [18].…”

Section: Methodsmentioning

confidence: 99%

Gait Pattern Differences between Children with Mild Scoliosis and Children with Unilateral Cerebral Palsy

Domagalska-Szopa

Szopa

2014

PLoS ONE

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This study was conducted to investigate the effects of asymmetrical body posture alone, i.e., the effects seen in children with mild scoliosis, vs. the effects of body posture control impairment, i.e., those seen in children with unilateral cerebral palsy on gait patterns. Three-dimensional instrumented gait analysis (3DGA) was conducted in 45 children with hemiplegia and 51 children with mild scoliosis. All the children were able to walk without assistance devices. A set of 35 selected spatiotemporal gait and kinematics parameters were evaluated when subjects walked on a treadmill. A cluster analysis revealed 3 different gait patterns: a scoliotic gait pattern and 2 different hemiplegic gait patterns. The results showed that the discrepancy in gait patterns was not simply a lower limb kinematic deviation in the sagittal plane, as expected. Additional altered kinematics, such as pelvic misorientation in the coronal plane in both the stance and swing phases and inadequate stance phase hip ad/abduction, which resulted from postural pattern features, were distinguished between the 3 gait patterns. Our study provides evidence for a strong correlation between postural and gait patterns in children with unilateral cerebral palsy. Information on differences in gait patterns may be used to improve the guidelines for early therapy for children with hemiplegia before abnormal gait patterns are fully established. The gait pathology characteristic of scoliotic children is a potential new direction for treating scoliosis that complements the standard posture and walking control therapy exercises with the use of biofeedback.

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“…Previous research has already shown the relevance of establishing the relation between specific gait features and other variables such as topographical classification, age, preceding treatments, and clinical measurements (Wren et al, 2005; Domagalska et al, 2013). Further, Rozumalski et al (Rozumalski and Schwartz, 2009) investigated how different crouch gait patterns, which were determined via k-means cluster analysis, were characterized by range of motion, muscle strength, and spasticity.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Joint Gait Patterns Defined by a Delphi Consensus Study Is Related to Gross Motor Function, Topographical Classification, Weakness, and Spasticity, in Children with Cerebral Palsy

Nieuwenhuys

Papageorgiou

Schless

et al. 2017

Front. Hum. Neurosci.

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During a Delphi consensus study, a new joint gait classification system was developed for children with cerebral palsy (CP). This system, whose reliability and content validity have previously been established, identified 49 distinct joint patterns. The present study aims to provide a first insight toward the construct validity and clinical relevance of this classification system. The retrospective sample of convenience consisted of 286 patients with spastic CP (3–18 years old, GMFCS levels I–III, 166 with bilateral CP). Kinematic and kinetic trials from three-dimensional gait analysis were classified according to the definitions of the Delphi study, and one classified trial was randomly selected for each included limb (n = 446). Muscle weakness and spasticity were assessed for different muscle groups acting around the hip, knee, and ankle. Subsequently, Pearson Chi square tests, Cramer's V, and adjusted standardized residuals were calculated to explore the strength and direction of the associations between the joint patterns, and the different patient-specific characteristics (i.e., age, GMFCS level, and topographical classification) or clinical symptoms (muscle weakness and spasticity). Patient-specific characteristics showed several significant associations with the patterns of different joints, but the strength of most identified associations was weak. Apart from the knee during stance phase and the pelvis in the sagittal plane, the results systematically showed that the patterns with “minor gait deviations” were the most frequently observed. These minor deviations were found significantly more often in limbs with a lower level of spasticity and good muscle strength. Several other pathological joint patterns were moderately associated with weakness or spasticity, including but not limited to “outtoeing” for weakness and “intoeing” for spasticity. For the joints in the sagittal plane, significantly stronger associations were found with muscle weakness and spasticity, possibly because most of the evaluated muscles in this study mainly perform sagittal plane motions. Remarkably, the hip patterns in the coronal plane did not associate significantly with any of the investigated variables. Although further validation is warranted, this study contributes to the construct validity of the joint patterns of the Delphi consensus study, by demonstrating their ability to distinguish between clinically relevant subgroups in CP.

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The relationship between clinical measurements and gait analysis data in children with cerebral palsy

Cited by 38 publications

References 24 publications

Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study

Effect of a single session of transcranial direct-current stimulation on balance and spatiotemporal gait variables in children with cerebral palsy: A randomized sham-controlled study

Gait Pattern Differences between Children with Mild Scoliosis and Children with Unilateral Cerebral Palsy

Prevalence of Joint Gait Patterns Defined by a Delphi Consensus Study Is Related to Gross Motor Function, Topographical Classification, Weakness, and Spasticity, in Children with Cerebral Palsy

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