gms | German Medical Science

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation, Annual Assembly of the German and the Austrian Society of Physical Medicine and Rehabilitation

Austrian Society of Physical Medicine and Rehabilitation

26.-29.10.2011, Salzburg, Österreich

Lower limb kinematic differences in children with and without Cerebral Palsy concerning gait and obstacle avoidance

Meeting Abstract

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation. Salzburg, 26.-29.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11esm063

DOI: 10.3205/11esm063, URN: urn:nbn:de:0183-11esm0635

Veröffentlicht: 24. Oktober 2011

© 2011 Manavis et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: The purpose of the present study was to examine the neuromuscular, dynamic and kinematic differences of the lower limb between children with and without Cerebral Palsy concerning horizontal obstacle avoidance (HOA).

Material/Methods: 16 children without (CG; boys: n=8, girls: n=8, aged 9.5±2 years) and 12 children with cerebral palsy (CPG; boys: n=6, girls: n=6, aged 8.8±2 years) were examined. Subjects walked through an 8-meter corridor, in the middle of which a 1.5 m x 0.02 cylinder was placed on the ground perpendicular to the walking direction and served as an obstacle. Data were recorded using a six-camera 3D motion analysis system (VICON 612, Oxford Metrics Ltd, Oxford, Oxfordshire, UK), an EMG device (BTS Telemg, Milano, Italy) and a ground mounted 40x60 cm force plate (Bertec Type 4060, Bertec Corporation, Columbus, OH, USA). All devices were triggered by the motion analysis system, with the sampling frequency set at 100 Hz and 1 kHz, respectively. The parameters evaluated were: contact time (Tc) of the support before the obstacle, step length (SL), vertical ground reaction force (vGRF), agonist activity of plantar flexors (PF), antagonist activity of dorsal flexors (DF), swing leg’s lateral malleolus vertical distance from the obstacle (H), ankle joint flexion (Aang) and knee joint flexion (Kang). Subjects performed eight trials, but five successful trials were selected. The selected trials were averaged for further analysis. Differences between CPG and CG were investigated utilizing independent samples T-test using SPSS 10.1 software (SPSS, Chicago, Illinois, USA). The level of statistical significance was set at p=.05.

Results: CPG performed the HOA with significantly (p<.01) longer Tc (1.4±0.6 sec vs 0.6±0.1 sec), shorter SL (0.85±0.4 m vs 1.48±0.2 m) and lower H (0.14±0.05 m vs 0.09±0.03 m). Non-significant (p>.05) differences between groups were observed concerning vGRF (lower in CPG), PF (higher in CG) and DF (lower in CG). Swing leg’s Kang was more flexed in CG, while support leg’s Aang was more flexed in CPG (p<0.01).

Conclusion: CPG and CG followed different motor patterns in HOA. Results indicated that CPG did not prepare effectively their neuromuscular system during the supporting phase, since a lower activation of their agonist muscles and higher activation of their antagonist lower limb muscles was observed. CPG seemed to follow an insecure walking pattern, with signs of some adaptations concerning their motor program referred to walking [1], [2]. In general, the deficit which was observed in CPG during the landing phase could also be attributed to their inability to optimally organize complex movements .


References

1.
Chou LS, Draganich LF. Placing the trailing foot closer to an obstacle reduces flexion of the hip, knee, and ankle to increase the risk oft ripping. J Biomech. 1998;31:685–91.
2.
Law LSH, Webb CY. Gait adaptation of children with cerebral palsy compared with control children when stepping over an obstacle. Dev Med Child Neurol. 2005;47:321–8.