Assessment of relation between gait and static balance in children with cerebral palsy

Authors

  • Joanna Majewska Institute of Physiotherapy, University of Rzeszow, Poland https://orcid.org/0000-0001-7698-0381
  • Magdalena Szczepanik Institute of Physiotherapy, University of Rzeszow, Poland https://orcid.org/0000-0003-2560-4436
  • Mariusz Drużbicki Institute of Physiotherapy, University of Rzeszow, Poland https://orcid.org/0000-0003-4511-8419
  • Sławomir Snela Institute of Physiotherapy, University of Rzeszow, Poland; Clinical Department of Orthopaedics and Traumatology, Regional Hospital No. 2 in Rzeszow, Rzeszow, Poland https://orcid.org/0000-0003-2410-9820
  • Wojciech Rusek Institute of Physiotherapy, University of Rzeszow, Poland
  • Grzegorz Sobota Department of Biomechanics, Academy of Physical Education in Katowice, Poland
  • Ewelina Nowak Outpatient Clinic of Physiotherapy ‚Neurorehabilitation of children and adults’, Katowice, Poland
  • Jacek Durmała Department of Rehabilitation, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
  • Marcin Bonikowski Department of Pediatric Neurology and Rehabilitation, Psychiatry Center, Zagorze, Poland

DOI:

https://doi.org/10.15584/ejcem.2017.1.4

Keywords:

spatiotemporal gait parameters, postural stability, asymmetry

Abstract

Introduction. Cancer, after cardiovascular disease, is the second most common cause of death both in Poland anIntroduction. In children with cerebral palsy, gait and balance assessment allows for an objective gait pattern evaluation as well as for therapy planning and assessment. It was hypothesised that asymmetry of the lower limbs load in a standing position causes asymmetry of spatiotemporal gait parameters.

Material and methods. 19 children with spastic diplegia and 20 healthy children participated in this study. 3D gait analysis was performed using the BTS Smart optoelectronic system. Stabilometric evaluation was performed using the Zebris Force Plate. Additionally, the Symmetry Index for selected gait and balance parameters was calculated.

Results and conclusion. It was shown that symmetry of gait parameters and lower limb load in standing position differs significantly between the study and control groups. There was no correlation confirmed between lower limbs symmetry in standing position and symmetry of gait parameters. It was shown that 80% of children with cerebral palsy had asymmetrical gait patterns. It has also been shown that asymmetry of lower limbs load in a standing position correlates with an asymmetry of spatiotemporal gait parameters. The majority of children with spastic diplegia present asymmetrical gait patterns and asymmetrical balance parameters, but it has no influence on gait symmetry.

Downloads

Download data is not yet available.

References

Lamontagne A, De Serres J, Fung S, Paquet JN. Stroke affects the coordination and stabilization of head, thorax and pelvis during voluntary horizontal head motions performed in walking. Clin Neurophysiol. 2005;116:101–11.

Böhm H, Döderlein L. Gait asymmetries in children with cerebral palsy: do they deteriorate with running? Gait Posture. 2012;35(2):322–27.

Patterson KK, Gage WH, Brooks D, Black SE, McIlroy WE. Evaluation of gait symmetry after stroke: a comparison of current methods and recommendations for standardization. Gait Posture. 2010;31(2):241–46.

Hsue BJ, Miller F, Su FC. The dynamic balance of the children with cerebral palsy and typical developing during gait. Part I: Spatial relationship between COM and COP trajectories. Gait Posture. 2009;29(3):465-70.

De Kegel A, Dhooge I, Peersman W, et al. Construct validity of the assessment of balance in children who are developing typically and in children with hearing impairments. Phys Ther. 2010;90(12):1783-94.

Woollacott M, Shumway-Cook A. Postural dysfunction during standing and walking in children with cerebral palsy: What are the underlying problems and what new therapies might improve balance? Neur Plast. 2005;12:211-19.

Saxena S, Rao BK, Kumaran S. Analysis of postural stability in children with cerebral palsy and children with typical development: An observational study. Pediatr Phys Ther. 2014;26(3):325–30.

Wallard L, Dietrich G, Kerlirzin Y, Bredin J. Balance control in gait children with cerebral palsy. Gait Posture. 2014;40(1):43-47.

Chang FM, Rhodes JT, Flynn KM, Carollo JJ. The role of gait analysis in treating gait abnormalities in cerebral palsy. Orthop Clin North Am. 2010;41(4):489–506.

Cimolin V, Galli M, Tenore N, Albertini G, Crivellini M. Gait strategy of uninvolved limb in children with spastic hemiplegia. Eura Medicophys.2007;43,303–10.

Ferreira LA, Cimolin V, Costici PF, Albertini G, Oliveira CS, Galli M. Effects of gastrocnemius fascia lengthening on gait pattern in children with cerebral palsy using the Gait Profile Score. Res Dev Disabil. 2014;35(5):1137–43.

Gage, J. R. In J. R. Gage (Ed.), The treatment of gait problems in cerebral palsy. London: Cambridge University Press 2004.

Galli M, Cimolin V, Valente EM, Crivellini M, Ialongo T, Albertini G. Computerized gait analysis of botulinum toxin treatment in children with cerebral palsy. Disabil Rehabil. 2007;29(8):659–64.

Galli M, Cimolin V, Rigoldi C, Tenore N, Albertini G. Gait patterns in hemiplegic children with cerebral palsy: Comparison of right and left hemiplegia. Res Dev Disabil. 2010;31(6):1340–45.

Piccinini L, Cimolin V, Galli M, Berti M, Crivellini M, Turconi, AC. Quantification of energy expenditure during gait in children affected by cerebral palsy. Eura Medicophys. 2007;43(1):7–12.

Rojas VG, Rebolledo GM, Muňoz EG, Cortés NI, Gaete CB, Delgado CM. Differences in standing balance between patients with diplegic and hemiplegic cerebral palsy. Neural Regen Res. 2013;8(26):2478–83.

Davis RB, Ounpuu S, Tyburski D, Gage JR. A gait analysis data collection and reduction technique. Hum Mov Science.1991;10:575–87.

Bjornson K, Hays R, Graubert C. Botulinun toxin for spasticity in children with cerebral palsy: A comprehensive evaluation. Pediatrics. 2007:120:49-58.

Eek MN, Tranberg R, Beckung E. Muscle strength and kinetic gait pattern in children with bilateral spastic CP. Gait Posture. 2011;33:333-37.

Liao HF, Jeng SF, Lai JS, Cheng CK, Hu MH. The relation between standing balance and walking function in children with spastic diplegic cerebral palsy. Dev Med Child Neurol. 1997;39(2):106-12.

Katz-Leurer M, Rotem H, Keren O, et al. Balance abilities and gait characteristics in post-traumatic brain injury, cerebral palsy and typically developed children. Dev Neurorehabil. 2009;12:100-105.

Bax M, Goldstein M, Rosenbaum P, et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol. 2005;47(8):571–76.

Liao SF, Yang TF, Hsu TC, et al. Differences in seated postural control in children with spastic cerebral palsy and children who are typically developing. Am J Phys Med Rehabil. 2003;82(8):622–26.

Cherng RJ, Lin HC, Ju YH, et al. Effect of seat surface inclination on postural stability and forward reaching efficiency in children with spastic cerebral palsy. Res Dev Disabil. 2009;30(6):1420–27.

Kyvelidou A, Harbourne RT, Shostrom VK, et al. Reliability of center of pressure measures for assessing the development of sitting postural control in infants with or at risk of cerebral palsy. Arch Phys Med Rehabil. 2010;91(10):1593–601.

Donker SF, Ledebt A, Roerdink M, et al. Children with cerebral palsy exhibit greater and more regular postural sway than typically developing children. Exp Brain Res. 2008;184(3):363–70.

Lin D, Seol H, Nussbaum M, et al. Reliability of COP-based postural sway measures and age-related differences. Gait Posture. 2008;28(2):337–42.

Lafond D, Corriveau H, Hébert R, et al. Intrasession reliability of center of pressure measures of postural steadiness in healthy elderly people. Arch Phys Med Rehabil. 2004;85(6):896–901.

Ioffe ME, Ustinova KI, Chernikova LA, et al. Supervised learning of postural tasks in patients with poststroke hemiparesis, Parkinson's disease or cerebellar ataxia. Exp Brain Res. 2006;168(3):384–94.

Rocchi L, Chiari L, Horak FB. Effects of deep brain stimulation and levodopa on postural sway in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2002;73(3):267–74.

Rocchi L, Chiari L, Cappello A, et al. Identification of distinct characteristics of postural sway in Parkinson's disease: a feature selection procedure based on principal component analysis. Neurosci Lett. 2006;394(2):140–45.

Riach CL, Hayes KC. Maturation of postural sway in young children. Dev Med Child Neurol. 1987;29(5):650–58.

Liao HF, Mao PJ, Hwang AW. Test-retest reliability of balance tests in children with cerebral palsy. Dev Med Child Neurol. 2001;43(3):180–86.

Cherng RJ, Su FC, Chen JJ, et al. Performance of static standing balance in children with spastic diplegic cerebral palsy under altered sensory environments. Am J Phys Med Rehabil. 2007;78(4):336–43.

Chang CF, Wang TM, Wang WC, et al. Balance control during level walking in children with spastic diplegic cerebral palsy. Biomed Eng. 2011;23:509-17.

Kim CJ, Son SM. Comparison of Spatiotemporal Gait Parameters between Children with Normal Development and Children with Diplegic Cerebral Palsy. J Phys Ther Sci. 2014;26(9):1317-9.

Johnson DC, Damiano DL, Abel MF. The evolution of gait in childhood and adolescent cerebral palsy. J Pediatr Orthop. 1997;17: 392–96.

Abel MF, Damiano DL. Strategies for increasing walking speed in diplegic cerebral palsy. J Pediatr Orthop. 1996;16: 753–758.

Kurz MJ, Arpin DJ, Corr B. Differences in the dynamic gait stability of children with cerebral palsy and typically developing children. Gait Posture. 2012;36: 600–04.

Diop M, Rahmani A, Calmels P, et al. Influence of speed variation and age on the intrasubject variability of ground reaction forces and spatiotemporal parameters of children’s normal gait. Ann Readapt Med Phys. 2004;47(2):72–80.

Hausdorff JM, Zemany L, Peng C, Goldberger AL. Maturation of gait dynamics: stride-to-stride variability and its temporal organization in children. J Appl Physiol. 1999;86(3):1040–47.

Prosser LA, Lauer RT, VanSant AF, Barbe MF, Lee SC. Variability and symmetry of gait in early walkers with and without bilateral cerebral palsy. Gait Posture. 2010;31(4):522–526.

Downloads

Published

2017-03-31

How to Cite

Majewska, J., Szczepanik, M., Drużbicki, M., Snela, S., Rusek, W., Sobota, G., Nowak, E., Durmała, J., & Bonikowski, M. (2017). Assessment of relation between gait and static balance in children with cerebral palsy. European Journal of Clinical and Experimental Medicine, 15(1), 24–31. https://doi.org/10.15584/ejcem.2017.1.4

Most read articles by the same author(s)