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Mélo T.R.1,2,3, Guimarães A.T.B.4, Israel V.L.1
1Federal University of Paraná, Physical Education, Curitiba, Brazil, 2Campos de Andrade University, Curitiba, Brazil, 3Brazilian Institute of Education and Therapias (IBRATE), Curitiba, Brazil, 4State University of West Parana, Cascavel, Brazil
Background: Children with cerebral palsy (CP), specialy the diparetic type have difficulties on walking ability and ramps are enviromental modifications used to help special needs.
Purpose: The present study investigated the influence of an inclined surface (uphill and downhill) on the kinematic characteristics during gait of the sapastic diparetic (SD) when compared to typically developing (TD) children.
Methods: Twenty children took part in this trial (10 SD and 10 TD), who were assessed in 3 experimental conditions of surface/plane (horizontal plane, uphill and downhill) by means of an optoelectric system of images which allowed a tridimensional reconstruction of movement. Tendinous muscle shortening tests (modified Thomas test, straight leg raising test and Duncan-Ely test) were employed to characterize the participants´ muscle shortening status.
Results: Among the linear kinematic variables, only the stride width was different between groups, however not influenced by the plane. The foot height differed between groups only in the downhill, where SD had more difficulty in raising their foot. Angular kinematic variables allowed for the identification of differences between groups, which revealed the influence of plane inclination. The SD flexor pattern (of hip and knee), made evident by the tendinous muscle shortening tests and confirmed by kinematic analysis for the flexion and extension movement of the hip in the three planes. The influence of the horizontal plane, uphill and downhill, occurred for both groups, however SD presented a significant maximum hip flexion when uphill and lesser extension when downhill. As to uphill knee flexion and extension, it was observed that children with SD had greater difficulty in extending this joint when compared to the TD.
Conclusion(s): Although a hip and knee flexion pattern is evident in SD on inclinations of 7º, the functional activity of independent gait can be maintained, that is, despite the limitations children are capable of adopting strategies and undertaking gait function in a condition which can be regarded as accessible.
Implications: this study clarify kinematics strategies adopted by diparetic children walking on inclined surface and reinforce the need of accessibility.
Funding acknowledgements: The authors thank the Support Program for the Restructuring and Expansion of Federal Universities (Reuni).
Topic: Human movement analysis
Ethics approval: This project was approved by the Research Ethics Committee of the Health Sciences Sector/UFPR, registration CEP/SD: 936.061.10.06, CAAE: 0037.0.091.000-10.
All authors, affiliations and abstracts have been published as submitted.
