Abstract
Children with Cerebral Palsy (CP) show the postural constraints while standing, and gait disorders, resulting from both primary and secondary impairments of brain injury. In our previous studies, several characteristic postural and gait patterns in children with unilateral as well as with bilateral CP were defined, and the relationship between these patterns was demonstrated. The purpose of present study was to identify which features of body posture deviation during standing were strongly related to gait deviations in independently ambulatory children with CP. For this aim we explored the cross—relationship between features of body posture while standing examined by surface topography and the selected gait parameters from three-dimensional instrumented gait analysis in one hundred twenty children with cerebral palsy, aged between 7 and 13 years, who were able to walk independently. First, our study documented that that sagittal misalignment of the spine curvature was significantly related to kinematic deviations such as deviations of pelvic tilt, inadequate swing phase and knee flexion, and peak dorsiflexion in stance. Second, the study shows that the static asymmetry of pelvis and trunk was significantly associated with kinematic deviations during gait cycle such as pelvic rotation, hip abduction in swing, ROM of knee flexion, peak dorsiflexion in stance. Based on obtained results and referring to our previous findings it can be assumed that the first model of the relationship between postural deviation and gait disturbances, called ‘postural and gait complex of disorders in sagittal plane’, is related to children with bilateral CP, whereas the second model ‘postural and gait complex of disorders in coronal plane’ to children with unilateral CP. The clinical applications of this study relate to the early recognition of particular features of postural deviation using surface topography, instead of more difficult and demanding expensive tools 3-D gait analysis.
Highlights
Cerebral palsy (CP) is an impairment of postural control and manifestation of motor dysfunction of non-progressive brain damage; CP occurs early in life [1]
the sagittal A-P plane (TT) is the angle contained between two adjacent lines situated within the coronal plane and a line connecting the spinous processes from C7 through S1
If C7 is anterior to S1, TT value ranges from -180 ̊ to 0 ̊; the TT value ranges from 180 ̊ to 0 ̊ in the opposite case
Summary
Cerebral palsy (CP) is an impairment of postural control and manifestation of motor dysfunction of non-progressive brain damage; CP occurs early in life [1]. Correlation between body-posture deviations and gait disorders in children with cerebral palsy is fixed and non-progressive, the primary impairments caused by the upper motor neuron syndrome can lead to the development of secondary impairments. These include inadequate growth of muscles, which can cause contractures (shortening) of muscles and tendons, bone deformities, misalignment of joints, and excessive fatigue upon movement and walking [1]. Such primary and secondary impairments are often complex, resulting in a set of persistent disorders of posture and gait [1,2,3]. Children at GMFCS level I–III can walk without assistance
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