Acute responses to locomotor tasks differ according to gait-asymmetry patterns in children with hemiplegic cerebral palsy: An exploratory analysis |
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| Institution: | 1. Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia;2. Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt;1. School of Biological and Health Systems Engineering, Arizona State University, United States of America;2. Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, and Department of Neurology, Keck School of Medicine, University of Southern California, United States of America;1. Sport Sciences – Performance and Technology, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 12, 9220 Aalborg East, Denmark;2. Federal University of ABC, Biomedical Engineering, São Bernardo do Campo, São Paulo, Brazil;1. Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA;2. US Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis McChord, WA, USA;3. School of Kinesiology and Center for Neuroscience, Auburn University, Auburn, AL, USA;4. Program in Physical Therapy, Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA;1. Department of Physical Performance, Norwegian School of Sport Sciences, Sognsveien 220, 0806 Oslo, Norway;2. Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, 6160 University Drive, Omaha, NE 68182-0860, USA;3. Department of Physical Therapy, University of Nevada Las Vegas, 4505 S Maryland Pkwy, Las Vegas, NV 89154, USA;4. College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4355, USA |
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| Abstract: | This study aimed at determining if differential responses to locomotor tasks in children with spastic hemiplegia occur on account of step-length asymmetry patterns symmetrical step-length (S-SL); affected side short (AFFshort), and non-affected short (Non-AFFshort)] observed during on-ground walking. Thirty-two children (5–8 years) were assessed for spatial/temporal measures of gait while walking on the ground with self-selected speed. Data from on-ground walking were compared against three locomotor tasks that were examined on a treadmill: self-imposed walking velocity with bodyweight support of 0% (BWS-0%), self-imposed walking velocity with a BWS of 20% (BWS-20%), and fastest walking velocity with a BWS of 20% and a manually-guided response of the non-affected leg (MGRnon-affected). The primary outcome measures were the spatial (step length) and temporal (single-limb support time) symmetry indices. The step-length asymmetry subgroups responded differently to the locomotor tasks. The MGRnon-affected produced spatial symmetry in the S-SL and Non-AFFshort groups and temporal symmetry in the AFFshort group. The BWS-0% and BWS-20% treadmill walking conditions were insufficient to remediate either spatial or temporal walking asymmetry. In conclusion, acute responses to locomotor tasks are not consistent among asymmetry subgroups, suggesting that they might need individual treatment plans. In spite of the differences in walking characteristics between asymmetry subgroups, the improvement in gait-symmetry arose out of changes in affected and non-affected sides together. |
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