Is interlimb coordination during walking preserved in children with cerebral palsy?
Faster walking can partly fix arm-leg timing in diplegic CP but not in hemiplegic CP.
01Research in Context
What this study did
Meyns et al. (2012) filmed kids with cerebral palsy while they walked. They used 3-D cameras to watch how the arms and legs moved together. The team compared kids with diplegia and hemiplegia to typically-developing peers. They also asked the CP kids to walk faster and slower to see if speed helped.
What they found
Both CP groups showed messy arm-leg timing that the controls did not. The diplegic group could clean up the pattern a little when they walked faster. The hemiplegic group still looked uneven even when they sped up.
How this fits with other research
Iosa et al. (2012) saw the same trouble using small trunk sensors instead of cameras. Their preschool hemiplegic kids wobbled more and walked slower, backing up Pieter’s camera data.
Tomita et al. (2016) went further and tied the mess to GMFCS level. Kids rated level III had the weakest forward-posture muscles, showing the deficit grows with severity.
Hattier et al. (2011) looked at quiet standing, not walking, and found CP kids could follow a moving screen but failed to tune the signal down. That earlier study hints the walking-timing problem starts with poor weighting of sensory cues.
Why it matters
You now have a quick rule: if a CP child shows shaky trunk readings or uneven arm swing, check walking speed first. A small pace boost may help diplegic clients tidy their pattern enough to cut falls and fatigue. For hemiplegic clients, speed alone is not enough—add separate arm swing or trunk drills.
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02At a glance
03Original abstract
Arm movements during gait in children with cerebral palsy (CP) are altered compared to typically developing children (TD). We investigated whether these changes in arm movements alter interlimb coordination in CP gait. 3D gait analysis was performed in CP (diplegia [DI]: N = 15 and hemiplegia [HE]: N = 11) and TD (N = 24) children at preferred and fast walking speeds. Mean Relative Phase (MRP, i.e. mean over the gait cycle of the Continuous Relative Phase or CRP) was calculated as a measure of coordination, standard deviation of CRP was used as a measure of coordinative stability, and the sign of MRP indicated which limb was leading (for all pair combinations of the four limbs). In HE, coordination was significantly altered, less stable and a different leading limb was found compared to TD whenever the most affected arm was included in the studied limb pair. In DI, coordination deteriorated significantly when any of the two legs was included in the studied limb pair, and coordinative stability was significantly affected when any of the two arms was included. In almost all limb pair combinations, a different limb was leading in DI compared to TD. Increasing walking speed significantly improved coordination and coordinative stability of several limb pairs in DI. Coordination and limb-leading deficits were mostly linked to the affected limb. The compensating (non-affected) arm primarily affected coordinative stability, which underlines the importance of active arm movements in HE. Increasing walking speed may be used to improve interlimb coordination in DI.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2012.03.020