Journal article
Dynamic stability during walking in children with and without cerebral palsy
Gait & posture, v 72
Jul 2019
PMID: 31226600
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
•We compared the margin of stability during walking of children with and without CP.•We evaluated gait at preferred speeds, fast speeds, and with a cognitive task.•Children with CP had more lateral stability when on the non-dominant limb.•Children with CP were not more or less stable anteriorly.
Cerebral palsy (CP) is associated with a high risk of falling during walking. Many gait abnormalities associated with CP likely alter foot placement and center of mass (CoM) movement in a way that affects anterior or lateral dynamic stability, in turn influencing fall risk.
Do children with CP demonstrate altered anterior or lateral dynamic stability compared to typically-developing (TD) children?
In this case-control, observational study, we measured gait kinematics of two groups of children (15 CP, 11 GMFCS level I, 4 GMFCS level II; 14 TD; age 5–12) in walking conditions of a preferred speed, a fast speed, and a preferred speed while completing a cognitive task. For dominant and non-dominant limbs, the margin of stability (MoS), a spatial measure of dynamic stability, was calculated as the distance between the edge of the base of support and the CoM position after accounting for scaled velocity. Statistical comparisons of were made using mixed factorial ANOVAs. Post hoc comparisons were Sidak adjusted.
The anterior MoS before foot strike and at mid-swing differed between each condition but not between groups. Based on the minimum lateral MoS, children with CP had more stability when bearing weight on their non-dominant limb compared to TD children. These differences were not apparent when on the dominant limb.
This high-functioning group of children with CP exhibited a more conservative lateral stability strategy during walking when bearing weight with the non-dominant limb. This strategy may be protective against lateral falls. We observed no between-group differences in anterior stability. Because CP has been previously associated with impaired anterior balance reactions, and there was no observed compensation in anterior gait stability, this lack of group differences could contribute to a higher risk of falling in that direction.
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Details
- Title
- Dynamic stability during walking in children with and without cerebral palsy
- Creators
- James B. Tracy - University of DelawareDrew A. Petersen - Drexel UniversityJamie Pigman - University of DelawareBenjamin C. Conner - University of ArizonaHenry G. Wright - University of DelawareChristopher M. Modlesky - University of GeorgiaFreeman Miller - Alfred I. duPont Hospital for ChildrenCurtis L. Johnson - University of DelawareJeremy R. Crenshaw - University of Delaware
- Publication Details
- Gait & posture, v 72
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Physical Therapy (and Rehabilitation Sciences)
- Web of Science ID
- WOS:000478682600027
- Scopus ID
- 2-s2.0-85067357253
- Other Identifier
- 991019169551504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Neurosciences
- Orthopedics
- Sport Sciences