Gait and Mobility in CP

• Conditions: G80.0; G80.1; G80.2; Spastic quadriplegic cerebral palsy; Spastic diplegic cerebral palsy; Spastic hemiplegic cerebral palsy

• Registration Number: DRKS00029546
• Lead Sponsor: Schön Klinik Vogtareuth

Brief Summary

Background 3D gait analysis (3DGA) is a common assessment in Cerebral Palsy (CP) to quantify the extent of movement abnormalities. Yet, 3DGA is performed in laboratories and may thus be of debatable significance to everyday life. Aim The aim was to assess the relationship between kinematic gait abnormality and everyday mobility in ambulatory children and youth with spastic CP. Methods 73 paediatric and juvenile patients with uni- or bilateral spastic CP (N = 21 USCP, N = 52, BSCP, age: 4–20 y, GMFCS I-III) underwent a 3DGA, while the MobQues47 Questionnaire quantified caregiver-reported mobility. We calculated the Gait Profile Score (GPS), a metric that summarizes how far the lower limb joint angles during walking deviate from those of matched controls. Results The GPS correlated well with indoor and outdoor mobility (rho = -0.69 and -0.70, both p < 0.001) and the relationships were not significantly different for USCP and BSCP. Still, mobility was lower in BSCP (p < 0.001) and more compromised outdoors (p = 0.002). Indoor mobility could be predicted by walking speed, GPS and age (adj. R2 = 0.62). Outdoor mobility was best predicted by walking speed and GPS (adj. R2 = 0.60). The additive explained variance by the GPS was even higher outdoors than indoors (17.1% vs. 11.4%). Conclusions Measuring movement deviations with 3DGA seems equally meaningful in uni- and bilaterally affected children and has considerable relevance for real-life ambulation, particurlarly outdoors, where children with spastic CP typically face greater difficulties. Therapeutic strategies that achieve faster walking and reduction of kinematic deviations may increase outdoor mobility.

Detailed Description

Not available

Study Timeline

• Study Completion: 2021-11-30
• Study Start: 2022-08-09
• Results First Posted: 2022-12-05
• Last Update Posted: 19 August 2024

Recruitment & Eligibility

• Status: Complete
• Sex: All
• Target Recruitment: 73

Inclusion Criteria

Retrospective: All patients must have both a mobility documentation and 3D gait analysis.
They also demonstrate spasticity of the lower extremity.

Exclusion Criteria

purely ataxic or dyskinetic forms of CP, acquired damage to the brain
(traumatic brain injury, tumors), severe cognitive or orthoptic dysfunction

Study & Design

• Study Type: observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
3DGA: A) Gait Profile score [GPS] (the root mean square deviation of the curve with respect to a reference collective) and its 9 GVS scores.<br>B) Symmetry Index [CGA].<br><br>Everyday mobility: Score for indoor and outdoor mobility, Mobques47.

Secondary Outcome Measures

Name	Time	Method
3DGA: gait speed, step length, cadence<br>General: topography of involvement (uni- vs. bilateral), age, gender, GMFCS level, Functional Mobility Scale.