Πέμπτη 15 Νοεμβρίου 2018

Influence of accuracy constraints on bimanual coordination and gait performance in children with unilateral spastic cerebral palsy

Publication date: Available online 14 November 2018

Source: Gait & Posture

Author(s): Hung Ya-Ching

Abstract
Background

Children with unilateral spastic cerebral palsy (USCP) have both upper and lower extremities movement impairments of their more affected side. Many daily activities require whole body movement control. However, most studies for children with USCP only evaluated either upper or lower extremity impairments.

Research Question

The present study aimed to assess the effects of accuracy constraints on walking and bimanual coordination for children with USCP during a whole body task.

Methods

Ten children with USCP (age: 7-12 years; GMFCS levels: I - II) and ten age-matched typically-developed children (TDC) participated in the study. They were asked to walk and carry a water bottle with and without a cap using a tray at a preferred speed while 3-D kinematic analyses were performed. The two tasks of carrying a water bottle with and without a cap were each performed 5 trials with randomized order between participants.

Results

TDC significantly decreased their walking speed, stride length, height differences between the two hands (symmetric bimanual coordination), vertical hand movement, and elbow joint excursion under higher accuracy constraints with no water bottle cap. Children with USCP showed significantly decreased walking speed, vertical hand movement, and elbow joint excursion under higher accuracy constraints. Children with USCP also significantly decreased walking deviation of line of progression.

Significance

It is exciting to see that children with USCP GMFCS levels I and II were able to maintain their bimanual coordination and modify their gait performance under higher accuracy constraints. Therefore, future treatments or assessments could consider manipulating accuracy constraints even during complex whole body tasks for children with USCP.



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