Variability and symmetry of gait in early walkers with and without bilateral cerebral palsy

Prosser, Laura A.; Lauer, Richard T.; VanSant, Ann F.; Barbe, Mary F.; Lee, Samuel C.K.

doi:10.1016/j.gaitpost.2010.03.001

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Volume 31, Issue 4 , Pages 522-526, April 2010

Variability and symmetry of gait in early walkers with and without bilateral cerebral palsy

Laura A. Prosser
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, United States
- Corresponding author at: National Institutes of Health, Building 10-CRC, 1-1469, 10 Center Drive, Bethesda, MD 20892, United States. Tel.: +1 301 451 7534; fax: +1 301 451 7536.
Richard T. Lauer
- Department of Physical Therapy, Temple University, Philadelphia, PA, United States
- Department of Electrical and Computer Engineering, Temple University, Philadelphia, PA, United States
Ann F. VanSant
- Department of Physical Therapy, Temple University, Philadelphia, PA, United States
Mary F. Barbe
- Department of Physical Therapy, Temple University, Philadelphia, PA, United States
- Department of Anatomy and Cell Biology, Temple University, Philadelphia, PA, United States
Samuel C.K. Lee
- Physical Therapy Department, University of Delaware, Newark, DE, United States
- Shriners Hospitals for Children, Philadelphia, PA, United States

Received 11 August 2009; received in revised form 18 February 2010; accepted 1 March 2010. published online 25 March 2010.

Abstract

Purpose

Investigating gait characteristics during the early stages of walking in CP may contribute to the understanding of the development of impaired gait. The objective of this study was to investigate differences in the variability and symmetry of spatiotemporal gait characteristics during the early years of walking in children with bilateral spastic CP compared to children with similar amounts of walking experience and typical development (TD).

Methods

The spatiotemporal gait parameters of 31 children (15 with spastic CP, 16 with TD) who had an average of 28.5 (18.1 SD) months of walking experience were collected using an instrumented walkway.

Results

All primary spatiotemporal parameters were reduced in the CP group, who also demonstrated greater stride-to-stride variability, compared to the TD group. There were no statistically significant differences in side-to-side symmetry between groups.

Implications

Clinical trials investigating gait interventions during the early years of walking in children with CP should be conducted to determine if treatment can reduce the functional limitations that are present during the emergence of walking skills. Further investigation should examine variability and symmetry in the kinematics, kinetics, and muscle activity patterns of early walkers with CP, and the effect of treatment on the variability and symmetry of walking characteristics.

Keywords: Cerebral palsy, Gait, Variability, Symmetry, Early walking