Highlights
- •Children with cerebral palsy used a Knee-Hip in-phase gait strategy.
- •Cerebral palsy had lower variability at Ankle-Knee and Knee-Hip joint pairs.
- •Impaired coordination in cerebral palsy is noticeable at specific gait events.
- •A knee-Hip in-phase gait strategy is related to fewer gait deviations.
- •Inter-joint coordination metrics are pertinent to assess motor control impairment.
Abstract
Background
Children with cerebral palsy present with poor motor control, altering their ability
to perform tasks such as walking. Continuous relative phase analysis is a popular
method to quantify motor control impairments via inter-joint coordination and coordination
variability; however, it has not been explored in children with cerebral palsy.
Methods
45 children with cerebral palsy and 45 typically developing children walked while
fit with retroreflective markers. Continuous relative phase analysis for knee-hip
and ankle-knee joint pairs quantified inter-joint coordination and coordination variability.
The Gait Profile Score estimated gait pathology. Group differences were assessed with
unpaired t-tests for coordination amplitude and variability (knee-hip, ankle-knee) across gait
events. For the cerebral palsy group, correlations assessed the relation between the
gait profile score and coordination metrics.
Findings
The cerebral palsy group showed more in-phase patterns for knee-hip coupling compared
to the typically developing group (initial contact, loading response, mid-stance,
terminal swing) (p ≤ 0.03). The cerebral palsy group showed lower knee-hip coordination variability
(mid-stance, mid-swing) (p ≤ 0.037) and lower ankle-knee coordination variability (initial contact, loading
response, terminal swing) (p < 0.001). The gait profile score correlated weakly to moderately (r = [0.323–0.472]), and negatively with the knee-hip inter-joint coordination (initial
contact, loading response, mid-stance, terminal swing) (p ≤ 0.042).
Interpretation
Children with cerebral palsy showed a more in-phase gait strategy during challenging
transitional gait cycle phases (beginning and end) and less flexible and adaptable
motor behaviors. Moreover, the correlation between in-phase joint patterns and increased
gait deviations (gait profile score) reinforces the relevance of coordination analysis
to assess motor control impairment.
Keywords
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Article Info
Publication History
Published online: August 14, 2022
Accepted:
August 11,
2022
Received:
October 5,
2021
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
