Predictors of Walking Efficiency in Children With Cerebral Palsy: Lower-Body Joint Angles, Moments, and Power.
Journal
Physical therapy
ISSN: 1538-6724
Titre abrégé: Phys Ther
Pays: United States
ID NLM: 0022623
Informations de publication
Date de publication:
01 06 2019
01 06 2019
Historique:
accepted:
01
03
2019
received:
18
05
2018
entrez:
4
6
2019
pubmed:
4
6
2019
medline:
4
12
2019
Statut:
ppublish
Résumé
People with cerebral palsy (CP) experience increased muscle stiffness, muscle weakness, and reduced joint range of motion. This can lead to an abnormal pattern of gait, which can increase the energy cost of walking and contribute to reduced participation in physical activity. The aim of the study was to examine associations between lower-body joint angles, moments, power, and walking efficiency in adolescents with CP. This was a cross-sectional study. Sixty-four adolescents aged 10 to 19 years with CP were recruited. Walking efficiency was measured as the net nondimensional oxygen cost (NNcost) during 6 minutes of overground walking at self-selected speed. Lower-body kinematics and kinetics during walking were collected with 3-dimensional motion analysis, synchronized with a treadmill with integrated force plates. The associations between the kinematics, kinetics, and NNcost were examined with multivariable linear regression. After adjusting for age, sex, and Gross Motor Function Classification System level, maximum knee extension angle (β = -0.006), hip angle at midstance (β = -0.007), and maximum hip extension (β = -0.008) were associated with NNcost. Age was a significant modifier of the association between the NNcost and a number of kinematic variables. This study examined kinetic and kinematic variables in the sagittal plane only. A high interindividual variation in gait pattern could have influenced the results. Reduced knee and hip joint extension are associated with gait inefficiency in adolescents with CP. Age is a significant factor influencing associations between ankle, knee, and hip joint kinematics and gait efficiency. Therapeutic interventions should investigate ways to increase knee and hip joint extension in adolescents with CP.
Sections du résumé
BACKGROUND
People with cerebral palsy (CP) experience increased muscle stiffness, muscle weakness, and reduced joint range of motion. This can lead to an abnormal pattern of gait, which can increase the energy cost of walking and contribute to reduced participation in physical activity.
OBJECTIVE
The aim of the study was to examine associations between lower-body joint angles, moments, power, and walking efficiency in adolescents with CP.
DESIGN
This was a cross-sectional study.
METHODS
Sixty-four adolescents aged 10 to 19 years with CP were recruited. Walking efficiency was measured as the net nondimensional oxygen cost (NNcost) during 6 minutes of overground walking at self-selected speed. Lower-body kinematics and kinetics during walking were collected with 3-dimensional motion analysis, synchronized with a treadmill with integrated force plates. The associations between the kinematics, kinetics, and NNcost were examined with multivariable linear regression.
RESULTS
After adjusting for age, sex, and Gross Motor Function Classification System level, maximum knee extension angle (β = -0.006), hip angle at midstance (β = -0.007), and maximum hip extension (β = -0.008) were associated with NNcost. Age was a significant modifier of the association between the NNcost and a number of kinematic variables.
LIMITATIONS
This study examined kinetic and kinematic variables in the sagittal plane only. A high interindividual variation in gait pattern could have influenced the results.
CONCLUSIONS
Reduced knee and hip joint extension are associated with gait inefficiency in adolescents with CP. Age is a significant factor influencing associations between ankle, knee, and hip joint kinematics and gait efficiency. Therapeutic interventions should investigate ways to increase knee and hip joint extension in adolescents with CP.
Identifiants
pubmed: 31155663
pii: 5505346
doi: 10.1093/ptj/pzz041
pmc: PMC10468027
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
711-720Informations de copyright
© 2019 American Physical Therapy Association.
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