Szopa A1,2, Domagalska-Szopa M3, Czamara A4, Hagner-Derengowska M5, Królikowska A4
1Medical University of Silesia in Katowice, Department of Physiotherapy, School of Health Sciences in Katowice, Katowice, Poland, 2Medical Rehabilitation Center Neuromed sc, Katowice, Poland, 3Medical University of Silesia in Katowice, Department of Medical Rehabilitation, School of Health Sciences in Katowice, Katowice, Poland, 4College of Physiotherapy in Wrocław, Department of Physiotherapy, Wrocław, Poland, 5University of Nicolaus Copernicus, Department of Neuropsychology, Faculty of Health Science, Collegium Medicum Bydgoszcz, Toruń, Poland
Background: Children with cerebral palsy present atypical body posture patterns and abnormal gait patterns resulting from functional strategies to compensate process for primary anomalies, that are directly attributable to damage to the central nervous system. Although our previous studies provided evidence for a strong correlation between postural and gait patterns in children with unilateral cerebral palsy little is known about these dependences in children with bilateral cerebral palsy.
Purpose: The aim of this study was to investigate the association between postural stability and gait in children with bilateral cerebral palsy. We searched for the correlation between the posturographic weight-bearing distribution and center of pressure sway during quiet standing with Gillette Gait Index (GGI) and the 16 distinct gait parameters that composed GGI.
Methods: There were 80 children with bilateral cerebral palsy from 7-12 years of age (30 females and 50 males) aged from 7 to 13 years (mean age = 11.4y (SD 3y) included to this study. Present study obtained two inter-related parts: 1) paedobarographic measurements of the distribution of body mass and posturographic tests during 1) quiet stance, 2) sitting, and 3) kneeling with the eyes open; and 2) three-dimensional instrumented gait analysis. The paedobarographic measuremets was recorded three times (3 trials, each lasting for 30 s, with a 30 s pause between trials), using a force platform (PDM, Zebris, Germany). The mean values from three trials were used to statistical analysis. Three-dimensional kinematic data were collected using the Measuring System for 3D Motion Analysis (Zebris Medizintechnik GmbH, Germany). The gait data was recorded as the participants walked barefoot on a treadmill (Alfa XL, Kettler, Germany). The procedure of trials included three trials with comfortable walking speed were averaged and then analysed. To characterize the gait pattern, the GGI as well as the 16 distinct gait parameters that composed the GGI was used. The canonical correlation analysis was used to investigate the association between postural stability and gait. Two canonical correlation matraces used in this study were matrix for postural control (posturographic weight-bearing and center of pressure sway during quiet standing) and matrix for gait (GGI and the 16 distinct gait parameters that composed the GGI).
Results: In this study, applying of the canonical correlation analisis leads to identification two of postural control variables, such as: area of the centres of pressure and sway path length of the CoP in stance and four gait variables: GGI, mean pelvic rotation, knee flexion at initial contact, and peak dorsiflexion in stance, as as important factors. The largest absolute canonical weighs values obtain: area of the centres of pressure in stance variables and GGI. It can be assumed that correlation between these two variables influenced the canonical correlation between two matrix that were used in study.
Conclusion(s): Present study provides evidence for a strong correlation between postural control and gait in children with bilateral cerebral palsy.
Implications: For early therapy programing it is important to investigate the effects of body posture impairment on postural stability control among children with bilateral Cerebral Palsy.
Keywords: Gillette Gait Index, Canonical Corelation Analysis, Bilateral cerebral palsy
Funding acknowledgements: The authors declare that the research was conducted in the absence of any commercial or financial relationships
Purpose: The aim of this study was to investigate the association between postural stability and gait in children with bilateral cerebral palsy. We searched for the correlation between the posturographic weight-bearing distribution and center of pressure sway during quiet standing with Gillette Gait Index (GGI) and the 16 distinct gait parameters that composed GGI.
Methods: There were 80 children with bilateral cerebral palsy from 7-12 years of age (30 females and 50 males) aged from 7 to 13 years (mean age = 11.4y (SD 3y) included to this study. Present study obtained two inter-related parts: 1) paedobarographic measurements of the distribution of body mass and posturographic tests during 1) quiet stance, 2) sitting, and 3) kneeling with the eyes open; and 2) three-dimensional instrumented gait analysis. The paedobarographic measuremets was recorded three times (3 trials, each lasting for 30 s, with a 30 s pause between trials), using a force platform (PDM, Zebris, Germany). The mean values from three trials were used to statistical analysis. Three-dimensional kinematic data were collected using the Measuring System for 3D Motion Analysis (Zebris Medizintechnik GmbH, Germany). The gait data was recorded as the participants walked barefoot on a treadmill (Alfa XL, Kettler, Germany). The procedure of trials included three trials with comfortable walking speed were averaged and then analysed. To characterize the gait pattern, the GGI as well as the 16 distinct gait parameters that composed the GGI was used. The canonical correlation analysis was used to investigate the association between postural stability and gait. Two canonical correlation matraces used in this study were matrix for postural control (posturographic weight-bearing and center of pressure sway during quiet standing) and matrix for gait (GGI and the 16 distinct gait parameters that composed the GGI).
Results: In this study, applying of the canonical correlation analisis leads to identification two of postural control variables, such as: area of the centres of pressure and sway path length of the CoP in stance and four gait variables: GGI, mean pelvic rotation, knee flexion at initial contact, and peak dorsiflexion in stance, as as important factors. The largest absolute canonical weighs values obtain: area of the centres of pressure in stance variables and GGI. It can be assumed that correlation between these two variables influenced the canonical correlation between two matrix that were used in study.
Conclusion(s): Present study provides evidence for a strong correlation between postural control and gait in children with bilateral cerebral palsy.
Implications: For early therapy programing it is important to investigate the effects of body posture impairment on postural stability control among children with bilateral Cerebral Palsy.
Keywords: Gillette Gait Index, Canonical Corelation Analysis, Bilateral cerebral palsy
Funding acknowledgements: The authors declare that the research was conducted in the absence of any commercial or financial relationships
Topic: Paediatrics: cerebral palsy; Paediatrics
Ethics approval required: Yes
Institution: Medical University of Silesia, Poland
Ethics committee: Bioethics Committee of the Medical University of Silesia
Ethics number: NN-013-350/I/03/09
All authors, affiliations and abstracts have been published as submitted.
