A descriptive analysis of the upper limb patterns during gait in individuals with cerebral palsy.
CP subtypes have signature arm motions during gait—map them to sharpen your gait reports.
01Research in Context
What this study did
The team watched how arms and shoulders moved while people with cerebral palsy walked.
They filmed hemiplegic and diplegic gait in a motion-capture lab.
No treatment was given; they simply mapped each subtype’s arm motion.
What they found
Diplegic walkers swung the shoulder and elbow through bigger arcs than usual.
Hemiplegic walkers moved the affected arm differently from the sound arm.
These arm patterns are now added to the CP gait picture.
How this fits with other research
Meyns et al. (2011) first showed that hemiplegic kids keep the same small arm swing no matter how fast they walk.
Laugeson et al. (2014) widen the view by showing the whole upper-limb pattern, not just swing size.
Heyrman et al. (2014) found that trunk wobble in diplegia comes from weak core control, not leg problems.
Together the papers say: in CP, arms, trunk, and legs each tell part of the gait story—look at all three.
Why it matters
When you watch a client walk, note arm motion along with leg motion. Bigger shoulder arcs may flag diplegia, while one stiff arm may signal hemiplegia. Share these clues with the physiatrist or orthotist so braces, walkers, or gait drills match the real pattern.
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02At a glance
03Original abstract
Patients with cerebral palsy (CP) are characterized by a large diversity of gait deviations; thus, lower limb movements during gait have been well-analyzed in the literature. However, the question of upper limb movements and, more particularly, arm movements during gait has received less attention for CP patients as a function of the disease type (Hemiplegic, HE or Diplegic, DI). Thus, the aim of this study was to investigate upper limb movements for a large group of CP patients; we used a retrospective search, including upper limb kinematic parameters and 92 CP patients (42 females and 50 males, mean±standard deviation (SD); age: 15.2±6.7 years). The diagnoses consisted of 48 HE and 44 DI. A control group of 15 subjects (7 females and 8 males, age: 18.4±8.4 years) was included in the study to provide normal gait data. For the DI patients and CG, 88 arms and 30 arms were analyzed, respectively. For the HE patients, 48 affected arms and 48 non-affected arms were analyzed. The kinematic parameters selected and analyzed were shoulder elevation angles; elbow flexion angles; thorax tilt and obliquity angles; hand vertical and anterior-posterior movements; and arm angles. Several gait parameters were also analyzed, such as the gait profile score (GPS) and normalized speed. Statistical analyses were performed to compare CG with the affected and non-affected upper limbs of HE patients and with the two upper limbs of DI patients. The results show that HE and DI patients adopt abnormal upper limb movements. However, DI patients have greater shoulder, elbow, thorax and arm angle movements compared with HE patients. However, HE patients adopt different movements between their affected and non-affected arms. Thus, the patients used their upper limbs to optimize their gait more where gait deviations were more important. These observations confirm that the upper limbs must be integrated into rehabilitation programs to improve inter-limb coordination.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.07.013