Pre-operative walking activity in youth with cerebral palsy.
Kids with CP on surgery lists walk far less than their non-surgical peers—treat their pre-op step count as the true starting line.
01Research in Context
What this study did
Nicholson et al. (2017) clipped small step counters to kids with cerebral palsy who were waiting for leg or foot surgery.
The team wrote down daily steps for several days before the operation.
No extra training or treatment was given; they just watched how much the kids walked at home and school.
What they found
The kids on the surgery list took far fewer steps than other children with CP who were not waiting for surgery.
In short, these youth were already walking much less than their peers before anyone touched a scalpel.
How this fits with other research
Keawutan et al. (2018) show that simply being able to walk, not how many steps you take, links to better quality of life in preschoolers with CP.
Together the papers say: walking status matters for happiness, yet the surgical group is already the lowest movers.
Whitehouse et al. (2014) used the same step-count method in youth with Prader-Willi Syndrome and also found very low activity, hinting that low steps may be common across diagnoses facing surgery.
Hung et al. (2014) add that when kids with unilateral CP carry a small box while walking, their gait worsens; low pre-op steps may partly reflect such daily dual-task hurdles.
Why it matters
Use the child’s own pre-op step count as the baseline goal after surgery instead of textbook norms. If the child averaged 3,000 steps, aim to return to 3,000 first, then push higher. This prevents setting impossible goals for youth who were already low movers.
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Join Free →Check the last week of step-counter data in the chart and write the lowest day’s total as the first post-op target.
02At a glance
03Original abstract
BACKGROUND: No data are available regarding level of walking activity for youth with cerebral palsy (CP) before undergoing orthopeadic surgery. The goals of this study were to quantify pre-operative walking activity, and determine whether pre-operative values are different from previously defined levels of walking activity in youth with CP. PROCEDURES: This study retrospectively evaluated pre-operative walking activity in youth with spastic CP, GMFCS levels I-IV. Walking activity was monitored using the StepWatch™. Outcome variables included mean daily strides, percent of day active, and percent of active time at high activity. Differences between GMFCS levels were examined and comparisons were made to published data. RESULTS: Pre-operative walking activity data from 126 youth with CP were included. All variables demonstrated higher walking activity in youth at GMFCS levels I/II compared to those at GMFCS levels III/IV. When compared to previously defined walking activity levels, pre-operative walking activity was lower. CONCLUSIONS: Walking activity among pre-operative youth with CP is significantly lower than published data for ambulatory youth with CP. Results suggest that youth with CP who are surgical candidates have less walking activity than youth with CP without surgical needs. Therefore this study should encourage the effort to collect and analyze individual pre-operative data for comparison and evaluation of post-operative functional recovery.
Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2016.11.011