Mechanical work performed by the legs of children with spastic diplegic cerebral palsy

Abstract 

The purpose of this investigation was to evaluate the work performed on the center of mass by the legs of children with cerebral palsy. 10 children that were diagnosed as having cerebral palsy with spastic diplegia (Age=9.1±2 years), and 10 healthy children with no walking disabilities participated (Age=9.4±2 years). We collected individual leg ground reaction forces from four force platforms, and calculated the mechanical work performed on the center of mass by the lead and trail legs. The normalized walking speeds were not significantly (p=0.33) different between the children with cerebral palsy (0.26±0.07) and the controls (0.28±0.06). The children with cerebral palsy performed significantly more negative work by the lead leg during double support (p=0.0004), and significantly less positive work by the trail leg (p<0.00001). During single support, the children with cerebral palsy performed significantly more positive work on the center of mass (p<0.00001). No significant differences were found for the amount of negative work performed by the leg in single support (p=0.84). Children with spastic diplegic cerebral palsy show a diminished ability to appropriately perform mechanical work by the legs to lift and redirect the center of mass. The altered mechanical work performed by the legs on the center of mass may play a role in the higher metabolic cost for walking noted in children with cerebral palsy.

Keywords: Gait, Walking, Work, Locomotion, Biomechanics