Comparison of lower extremity range of motion during walking between children with cerebral palsy and normal children

Authors

  • Parinnapak Mahasup Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
  • Siriluck Kanchanomai Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand

Keywords:

Cerebral palsy, walking, computerized motion analysis, gait analysis

Abstract

Background: Walking is very important for children with cerebral palsy but they lack voluntary coordination of muscle movements. Moreover, affected children have their own pattern of walking which is different from normal walking. Thus, gait analysis is a great tool for diagnosis with the aim to rehabilitate the children as best as possible.

Objective: To compare lower extremity range of motion during walking between children with cerebral palsy and normal children.

Methods: The participants were 15 children with cerebral palsy (5 - 15 years of age). Their motor abilities were classified at level 1 - 3 on the Gross Motor Function Classification System. The control group comprised 15 age matched normal children. Walking movement was investigated by computerized motion analysis.

Results: There were statistically significant differences in the range of motion of right hip abduction/adduction, knee flexion/extension, and pelvic upward tilt/downward tilt (P = 0.020, 0.006, and < 0.001, respectively) during right foot strike. Likewise, statistically significant differences were observed in the range of motion of knee flexion/ extension and pelvic upward tilt/downward tilt (P < 0.001 and 0.001, respectively) during left foot strike. Concerning foot off, statistically significant differences were observed for right hip flexion/extension, right knee flexion/ extension, and pelvic upward tilt/downward tilt (P < 0.001, 0.001, and 0.014, respectively) for right foot off. When analyzing left foot off, statistically significant difference were observed for left hip flexion/extension, left abduction/ adduction, pelvic forward tilt/backward tilt, and pelvic upward tilt/downward tilt (P = 0.003, 0.006, 0.045, and < 0.001, respectively).

Conclusion: Gait analysis should be included in holistic diagnosis which is not often seen in present medication.

Downloads

Download data is not yet available.

References

Rosenbloom L. Definition and classification of cerebral palsy. Definition, classification, and the clinician. Dev Med Child Neurol Suppl 2007;109:43. https://doi.org/10.1111/j.1469-8749.2007.tb12629.x

Eek MN, Beckung E. Walking ability is related to muscle strength in children with cerebral palsy. Gait Posture 2008; 28:366-71. https://doi.org/10.1016/j.gaitpost.2008.05.004

Van Wely L, Dallmeijer AJ, Balemans AC, Zhou C, Becher JG, Bjornson KF. Walking activity of children with cerebral palsy and children developing typically: a comparison between the Netherlands and the United States. Disabil Rehabil 2014;36:2136-42. https://doi.org/10.3109/09638288.2014.892639

Wolf SI, Mikut R, Kranzl A, Dreher T. Which functional impairments are the main contributors to pelvic anterior tilt during gait in individuals with cerebral palsy? Gait Posture 2014;39:359-64.

https://doi.org/10.1016/j.gaitpost.2013.08.014

Van Campenhout A, Bar-On L, Aertbelien E, Huenaerts C, Molenaers G, Desloovere K. Can we unmask features of spasticity during gait in children with cerebral palsy by increasing their walking velocity? Gait Posture 2014;39:953-7. https://doi.org/10.1016/j.gaitpost.2013.12.024

Rattanatharn R, Siriphaosuwankul W. Back and hip muscles with EMG biofeedback training in diplegic cerebral palsy to improve balance and gait: A randomized control trial. Chula Med J 2019; 63:31-9.

Wallard L, Dietrich G, Kerlirzin Y, Bredin J. Balance control in gait children with cerebral palsy. Gait Posture 2014; 40:43-7. https://doi.org/10.1016/j.gaitpost.2014.02.009

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;41:489-506. https://doi.org/10.1016/j.ocl.2010.06.009

Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH. Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol 2008; 50:744-50.

https://doi.org/10.1111/j.1469-8749.2008.03089.x

Theis N, Korff T, Mohagheghi AA. Does long-term passive stretching alter muscle-tendon unit mechanics in children with spastic cerebral palsy? Clin Biomech (Bristol, Avon) 2015; 30:1071-6.

https://doi.org/10.1016/j.clinbiomech.2015.09.004

Houglum PA, Bertoti DB. Emphasis on functional movement. In: Houglum PA, Bertoti DB, editors. Brunnstrom's clinical kinesiology. 6th ed. Philadelphia: F.A. Davis; 2011, p. 543-61.

Perry J, Burnfield JM. Gait analysis: normal and pathological function. 2nd ed. SLACK Incorporated; 2010, p. 51-119.

O'Sullivan R, Walsh M, Kiernan D, O'Brien T. The knee kinematic pattern associated with disruption of the knee extensor mechanism in ambulant patients with diplegic cerebral palsy. Clin Anat 2010; 23:586-92. https://doi.org/10.1002/ca.20976

Cooney KM, Sanders JO, Concha MC, Buczek FL. Novel biomechanics demonstrate gait dysfunction due to hamstring tightness. Clin Biomech (Bristol, Avon) 2006;21:59-66.

https://doi.org/10.1016/j.clinbiomech.2005.08.014

Kim CJ, Kim YM, Kim DD. Comparison of children with joint angles in spastic diplegia with those of normal children. J Phys Ther Sci 2014;26:1475-9. https://doi.org/10.1589/jpts.26.1475

Krautwurst BK, Wolf SI, Heitzmann DW, Gantz S, Braatz F, Dreher T. The influence of hip abductor weakness on frontal plane motion of the trunk and pelvis in patients with cerebral palsy. Res Dev Disabil 2013; 34:1198-203. https://doi.org/10.1016/j.ridd.2012.12.018

Shin HI, Sung KH, Chung CY, Lee KM, Lee SY, Lee IH, et al. Relationships between isometric muscle strength, gait parameters, and gross motor function measure in patients with cerebral palsy. Yonsei Med J 2016;57:217-24. https://doi.org/10.3349/ymj.2016.57.1.217

Eek MN, Tranberg R, Zugner R, Alkema K, Beckung E. Muscle strength training to improve gait function in children with cerebral palsy. Dev Med Child Neurol 2008; 50:759-64.

https://doi.org/10.1111/j.1469-8749.2008.03045.x

Maas JC, Huijing PA, Dallmeijer AJ, Harlaar J, Jaspers RT, Becher JG. Decrease in ankle-foot dorsiflexion range of motion is related to increased knee flexion during gait in children with spastic cerebral palsy. J Electromyogr Kinesiol 2015;25:339-46. https://doi.org/10.1016/j.jelekin.2014.10.015

Wren TA, Lening C, Rethlefsen SA, Kay RM. Impact of gait analysis on correction of excessive hip internal rotation in ambulatory children with cerebral palsy: a randomized controlled trial. Dev Med Child Neurol 2013; 55:919-25. https://doi.org/10.1111/dmcn.12184

Ounpuu S. Gait analysis is a viable tool for the assessment of transverse plane motion in children with cerebral palsy. Dev Med Child Neurol 2013;55:878-9. https://doi.org/10.1111/dmcn.12227

Wolf SI, Braatz F, Metaxiotis D, Armbrust P, Dreher T, Doderlein L, et al. Gait analysis may help to distinguish hereditary spastic paraplegia from cerebral palsy. Gait Posture 2011;33:556-61.

https://doi.org/10.1016/j.gaitpost.2011.01.009

Downloads

Published

2023-08-15

How to Cite

1.
Mahasup P, Kanchanomai S. Comparison of lower extremity range of motion during walking between children with cerebral palsy and normal children. Chula Med J [Internet]. 2023 Aug. 15 [cited 2024 Oct. 12];63(3). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/295