Integral method (IM) as a quantitative and objective method to supplement the GMFCS classification of gait in children with cerebral palsy (CP)

• Autorzy: Dziuba A. , Bober T. , Kobel-Buys K. , Stempień M.
• Języki publikacji: EN

Abstrakty

EN

Gait analysis is an objective tool for the clinical assessment of locomotor activity in children with cerebral palsy (CP). Correct diagnosis and properly planned rehabilitation are necessary for enhanced motor functions in persons suffering from cerebral palsy. Orthoses, orthopedic operations, medications and physiotherapy are the most common treatments. However, there is still a lack of objective methods for assessing motor behavior and monitoring the progress of recovery. The aim of the study was to use the ground reaction force patterns generated during walking to create the Integral Method (IM), which could become an objective tool that could supplement the functional classification of CP children based on the Gross Motor Function Classification System (GMFCS). A total of 15 healthy children and 34 children with CP who walk independently participated in the study. A Kistler force plate and GRFintegral software were used. Of the 34 measurements based on the IM for CP children, 17 matched the level assigned by the GMFCS, 2 children were assigned a higher level, and 15 were assigned a lower level. Pearson’s correlation coefficient between the IM and the GMFCS was moderate (r = 0.61, p ≤ 0.01). Asymmetry was found in 11 cases. The IM supplements the GMFCS and is an objective and quantitative assessment of motor abilities. The method allows for the detection of asymmetry, diagnosis of the improvement of gait pattern and assessment of foot support technique. With the appropriate software, the IM provides pediatricians, neurologists, orthopedists, surgeons and physiotherapists with a simple and fast way to assess gait.

Słowa kluczowe

EN

children walking; cerebral palsy; ground reaction forces

PL

chód dziecka; porażenie mózgowe; reakcja podłoża

• Wydawca: Oficyna Wydawnicza Politechniki Wrocławskiej
• Czasopismo: Acta of Bioengineering and Biomechanics
• Rocznik: 2013
• Tom: Vol. 15, no. 2
• Strony: 105--111
• Opis fizyczny: Bibliogr. 25 poz., tab., wykr.

Twórcy

autor

Dziuba A.

• University School of Physical Education, Institute of Biomechanics, Wrocław, Poland

autor

Bober T.

• University School of Physical Education, Institute of Biomechanics, Wrocław, Poland

autor

Kobel-Buys K.

• Rehabilitation and Neuropsychiatry Center, Mikoszów, Poland

autor

Stempień M.

• University School of Physical Education, Institute of Biomechanics, Wrocław, Poland

Bibliografia

• [1] STANISZEWSKI M., MASTALERZ A., URBANIK C., Effects of training on inclined plane device on muscle torques, Physical Education and Sport, 2007, Vol. 51, 15–19.
• [2] BECK R.J., ANDRIACCHI T.P., KUO K.N., FERMIER R.W., GALANTE J.O., Changes in the gait patterns of growing children, Journal of Bone and Joint Surgey, 1981, Vol. 63, 1452–1457.
• [3] BOBER T., DZIUBA A., KOBEL-BUYS K., KULIG K., Gait characteristics following Achilles tendon elongation: the foot rocker perspective, Acta of Bioengineering and Biomechanics, 2008, Vol. 10, 37–42.
• [4] DIOP M., RAHMANI A., BELLI A., GAUTHERON V., GEYSSANT A., COTTALORDA J., Influence of Speed Variation and age on ground reaction forces and stride parameters of children’s normal gait, International Journal of Sports Medicine, 2005, Vol. 26, 682– 687.
• [5] DZIUBA A., The mimic of horse’s back movement by mechanical saddle for hippotherapy, Acta of Bioengineering and Biomechanics, 2000, Vol. 2, 159–161.
• [6] DZIUBA A., SZPALA A., Foot kinematics in gait of children,with cerebral palsy (CP), Acta of Bioengineering and Biomechanics, 2008, Vol. 10, 3–6.
• [7] GAGE J.R., The Treatment of Gait Problems in Cerebral Palsy, Mac Keith Press, Cambridge, 2004.
• [8] HERZOG W., NIGG B.M., READ L.J., OLSSON E., Asymmetries in ground reaction force patterns in normal human gait, Medicine and Science in Sport and Exercise, 1989, Vol. 21, 110–114.
• [9] MANN A.M., LOUDEN I.R., LAWSON A.M., ROBB J.E., MEADOWS C.B., Prospective study of gait maturation in normal children, Gait & Posture, 1995, Vol. 3, 271–272.
• [10] ODDING E., ROEBROECK M.E., STAM H.J., The epidemiology of cerebral palsy: Incidence, impairments and risk factors, Disability and Rehabilitation, 2006, Vol. 28, 183 – 191.
• [11] PALISANO R., ROSENBAUM P.L., Development and reliability of a system, to classify gross motor function in children with cerebral palsy, Developmental Medicine and Child Neurology, 1997, Vol. 39, 214–223.
• [12] PERRY J., Normal and pathological gait, [in:] W.H. Bunch (ed.) Atlas of Orthotics, 2nd ed., CV Mosby, St. Louis, 1985, 76–111.
• [13] RICKEN A.X.C., SAVELSBERGH G.J.P., BENNETT S.J., External timing constraints facilitate performance of everyday interceptive actions in children with Spastic Hemiparetic Cerebral Palsy, Neuroscience Letters, 2006, Vol. 410, 187–192.
• [14] ROGOZINSKI B.M., DAVIDS J.R., DAVIDS R.B., JAMESON G.G., BLACKHURST D.W., The efficacy of the floor-reaction anklefoot orthosis in children with cerebral palsy, The Journal of Bone and Joint Surgey, 2009, Vol. 91, 2440–2447.
• [15] SCHWARZ M.H., ROZUMALSKI A., TROST J.P., The effect of walking speed on the gait of typically developing children, Journal of Biomechanics, 2008, Vol. 41, 1639–1650.
• [16] SEEGER B.P., CONDREY D.J., Biofeedback therapy to Achieve Symmetrical gait in Children with Hemiplegic Cerebral Palsy: Long term efficacy. Archives of Physical Medicine and Rehabilitation, 1983, Vol. 64, 160–162.
• [17] STANSFIELD B.W., HILLMAN S.J., HAZLEWOOD M.E., LAWSON A.A., MANN A.M., LOUDON I.R., ROBB J.E., Normalized Speed, Not Age, Characterizes Ground Reaction Force Patterns in 5- to 12-Year-Old Children Walking At Self-Selected Speeds, Journal of Pediatric Orthopaedics, 2001, Vol. 21, 395–402.
• [18] STANSFIELD B.W., HILLMAN S.J., HAZLEWOOD M.E., LAWSON A.M., MANN A.M., LOUDON I.R., ROBB J.E., Normalization of gait data in children, Gait & Posture, 2003, Vol. 17, 81–87.
• [19] SUTHERLAND D.H., OLSHEN R.A., BIDEN E.N., WYATT M.P., The development of Mature Walking, Mac Keith Press, London, 1988.
• [20] SYCZEWSKA M., KALINOWSKA M., Reference data of ground reaction forces for healthy children of 6–18 year of age, Procedings of the third Annual Conference of the European Society of Movement Analysis in Children, Enschede, The Netherlands, Gait & Posture, 1995, 3, 272.
• [21] VAUGHAN C.L., Theories of bipedal walking: An odyssey, Journal of Biomechanics, 2003, Vol. 36, 513–523.
• [22] WHITE R., AGOURIS I., FLETCHER E., Harmonic analysis of force platform data in normal and cerebral palsy gait, Clinical Biomechanics, 2005, Vol. 20, 508–516.
• [23] WHITE R., AGOURIS I., SELBIE R.D., KIRKPATRIK M., The variability of force platform data in normal and cerebral palsy gait, Clinical Biomechanics, 1999, Vol. 14, 185–192.
• [24] WINIARSKI S., RUTKOWSKA-KUCHARSKA A., Estimated ground reaction force in normal and pathological gait, Acta of Bioengineering and Biomechanics, 2009, Vol. 11, 53–60.
• [25] WIT A., CZAPLICKI A., Inverse dynamics and artificial neural network applications in gait analysis of the disabled subjects, Human Movement, 2008, Vol. 9, 93–102.