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Meyns P, Van Gestel L, Bar-On L, et al. Children with Spastic Cerebral Palsy Experience Difficulties Adjusting Their Gait Pattern to Weight Added to the Waist, While Typically Developing Children Do Not. Front Hum Neurosci. 2016;10:657doi: 10.3389/fnhum.2016.00657.
Meyns, P., Van Gestel, L., Bar-On, L., Goudriaan, M., Wambacq, H., Aertbeliën, E., Bruyninckx, H., Molenaers, G., De Cock, P., Ortibus, E., & Desloovere, K. (2016). Children with Spastic Cerebral Palsy Experience Difficulties Adjusting Their Gait Pattern to Weight Added to the Waist, While Typically Developing Children Do Not. Frontiers in human neuroscience, 10657. https://doi.org/10.3389/fnhum.2016.00657
Meyns, Pieter, et al. "Children with Spastic Cerebral Palsy Experience Difficulties Adjusting Their Gait Pattern to Weight Added to the Waist, While Typically Developing Children Do Not." Frontiers in human neuroscience vol. 10 (2016): 657. doi: https://doi.org/10.3389/fnhum.2016.00657
Meyns P, Van Gestel L, Bar-On L, Goudriaan M, Wambacq H, Aertbeliën E, Bruyninckx H, Molenaers G, De Cock P, Ortibus E, Desloovere K. Children with Spastic Cerebral Palsy Experience Difficulties Adjusting Their Gait Pattern to Weight Added to the Waist, While Typically Developing Children Do Not. Front Hum Neurosci. 2016 Dec 23;10:657. doi: 10.3389/fnhum.2016.00657. eCollection 2016. PMID: 28123360; PMCID: PMC5226450.
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Front Hum Neurosci. 2016 Dec 23;10:657. doi: 10.3389/fnhum.2016.00657. eCollection 2016.

Children with Spastic Cerebral Palsy Experience Difficulties Adjusting Their Gait Pattern to Weight Added to the Waist, While Typically Developing Children Do Not.

Frontiers in human neuroscience

Pieter Meyns, Leen Van Gestel, Lynn Bar-On, Marije Goudriaan, Hans Wambacq, Erwin Aertbeliën, Herman Bruyninckx, Guy Molenaers, Paul De Cock, Els Ortibus, Kaat Desloovere

Affiliations

  1. Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center Amsterdam, Netherlands.
  2. Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences KU Leuven, Leuven, Belgium.
  3. Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation SciencesKU Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospital LeuvenLeuven, Belgium.
  4. Division of Production Engineering, Machine Design and Automation, Faculty of Engineering, Department of Mechanical Engineering, KU Leuven Leuven, Belgium.
  5. Clinical Motion Analysis Laboratory, University Hospital LeuvenLeuven, Belgium; Department of Pediatric Orthopaedics, University Hospital LeuvenLeuven, Belgium; Faculty of Medicine, Department of Musculoskeletal SciencesKU Leuven, Leuven, Belgium.
  6. Centre for Developmental Disabilities, University Hospital Leuven Leuven, Belgium.

PMID: 28123360 PMCID: PMC5226450 DOI: 10.3389/fnhum.2016.00657

Abstract

The prevalence of childhood overweight and obesity is increasing in the last decades, also in children with Cerebral Palsy (CP). Even though it has been established that an increase in weight can have important negative effects on gait in healthy adults and children, it has not been investigated what the effect is of an increase in body weight on the characteristics of gait in children with CP. In CP, pre and post three-dimensional gait analyses are performed to assess the effectiveness of an intervention. As a considerable amount of time can elapse between these measurements, and the effect of an alteration in the body weight is not taken into consideration, this effect of increased body weight is of specific importance. Thirty children with the predominantly spastic type of CP and 15 typically developing (TD) children were enrolled (age 3-15 years). All children underwent three-dimensional gait analysis with weight-free (baseline) and weighted (10% of the body weight added around their waist) trials. Numerous gait parameters showed a different response to the added weight for TD and CP children. TD children increased walking velocity, step- and stride length, and decreased double support duration with a slightly earlier timing of foot-off, while the opposite was found in CP. Similarly, increased ranges of motion at the pelvis (coronal plane) and hip (all planes), higher joint angular velocities at the hip and ankle, as well as increased moments and powers at the hip, knee and ankle were observed for TD children, while CP children did not change or even showed decreases in the respective measures in response to walking with added weight. Further, while TD children increased their gastrocnemius EMG amplitude during weighted walking, CP children slightly decreased their gastrocnemius EMG amplitude. As such, an increase in weight has a significant effect on the gait pattern in CP children. Clinical gait analysts should therefore take into account the negative effects of increased weight during pre-post measurements to avoid misinterpretation of treatment results. Overweight and obesity in CP should be counteracted or prevented as the increased weight has detrimental effects on the gait pattern.

Keywords: Cerebral Palsy; EMG; body mass; gait; muscle weakness; weight

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