Influence of dual task constraints on gait performance and bimanual coordination during walking in children with unilateral cerebral palsy.
A simple box-carry while walking cuts gait quality and arm swing in half for kids with unilateral CP.
01Research in Context
What this study did
The team watched the kids walk across a 10-meter mat. Half had unilateral cerebral palsy. Half were typically developing.
Each child walked three ways: normal, while counting aloud, and while carrying a small box. Cameras tracked steps and arm swing.
What they found
When the CP kids added the box, their steps got shorter and slower. Their weak arm also swung less.
Typical kids barely changed. The gap between groups doubled under dual-task.
How this fits with other research
Sasson et al. (2022) saw the same pattern in autistic teens who ran. More task = more messy moves.
Spruijt et al. (2013) showed CP kids can picture walking fine. Ya-Ching shows they stumble once an extra job is added.
Lennon et al. (2015) warn the 6-minute walk test misses max effort in adults. Our lab note: even a light box can mask true gait limits in kids.
Why it matters
If you test gait for surgery choices or equipment, drop the dual-task first. One added job hides how far or fast a CP child can really go. Score walking clean, then add real-life loads in training, not during the baseline measure.
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02At a glance
03Original abstract
The purpose of the current study was to evaluate the effects of dual task constraints on walking and bimanual coordination for children with and without unilateral Cerebral Palsy (CP). Ten children with unilateral CP (age 7-11 years; MACS levels I-II) and ten age-matched typically developed children were asked to first stand still while holding a box level (standing condition), second, to walk along a path (baseline condition), and third to walk again while carrying a box steady and level (dual task condition) at a preferred speed. The results showed that children with unilateral CP decreased their walking speed, stride length, step width, and toe clearance from the floor under dual task constraints when compared to the baseline condition (all p's<0.05), however, typically developing children did not change. Children with unilateral CP also had less level box carrying, larger vertical box movement, and larger elbow movements when compared to typically developing children under dual task condition (all p's<0.05). Dual task constraints with a secondary motor task like the current walking with a box task seemed challenging for children with unilateral CP. Therefore, future treatments or assessments should consider using dual task constraints to manipulate the difficulty of tasks.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.01.024