Gait characteristics in children and adolescents with cerebral palsy assessed with a trunk-worn accelerometer.
A cheap trunk sensor shows kids with CP have big balance gaps that grow with speed.
01Research in Context
What this study did
Researchers strapped a small accelerometer to the lower back of the kids.
Half had cerebral palsy. Half were typical peers.
Everyone walked at slow, normal, and fast speeds while the device tracked trunk wobble.
What they found
Kids with CP swayed and jerked their trunks far more than peers.
The faster they walked, the worse the sway became.
Balance trouble, not leg speed, was the real problem.
How this fits with other research
van Drongelen et al. (2013) used fancy 3-D cameras and also saw shaky balance in CP.
Both studies show balance is the weak link, even if tools differ.
Bleyenheuft et al. (2013) found grip control issues in hemiplegic CP.
Together, these papers say CP motor problems show up in both hands and feet.
Danitz et al. (2014) reviewed games for rehab but lacked clear measures.
Saether et al. (2014) now gives a simple, cheap yardstick: trunk sway.
Why it matters
You can tape a $50 accelerometer to a kid’s back and get clear balance data in five minutes.
Use the sway score to set safer gait-speed targets and to show parents real numbers after balance drills.
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02At a glance
03Original abstract
This study aimed to investigate gait characteristics reflecting balance and progression in children and adolescents with cerebral palsy (CP) compared with typically developing (TD) children. Gait characteristics variables representing aspects of balance were trunk acceleration, interstride regularity and asymmetry of accelerations while gait characteristics representing progression were gait speed, cadence, step time and step length. Children in the age range 5-18 years (mean age 11.1 years) with spastic CP (n=41) and a gross motor function corresponding to GMFCS I-III and children with TD (n=29) were included. The children walked back and forth along a 5m pathway with a tri-axial accelerometer worn on the lower back to allow assessment of their gait characteristics. Data were recorded along the anterioposterior (AP), mediolateral (ML), and vertical (V) axes. To assess the magnitude of potential differences in gait characteristics, standard deviation scores were calculated, using TD children as reference. Gait parameters related to balance, such as AP, ML, and V accelerations, were higher in the children with CP (z-scores between 0.4 and 0.7) and increased with increasing GMFCS levels. The differences in accelerations in the AP and V directions increased between children with CP and TD children with increasing speed. Also asymmetry in trunk accelerations differed significantly between the two groups in all three directions (z-scores between 0.8 and 1.8 higher in the CP group), while interstride regularity differed only slightly between children with CP and TD children, and only in the AP direction. Gait characteristics also differed between children with the spastic subtypes unilateral and bilateral CP, for accelerations and asymmetry in the AP and ML directions. Our results showed significant differences in gait characteristics between children with CP and TD children. The differences may be more related to balance than progression, and these problems seem to rise with increasing gross motor impairment and speed.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.02.011