Objective. To investigate gait characteristics in children with spastic cerebral palsy during inclined treadmill walking under a virtual reality environment. Methods. Ten spastic cerebral palsy (CP) children and ten typically developing (TD) children were asked to walk at their comfortable speed on a treadmill at a ground level and 10° inclined. Three-dimensional kinematic data and ground reaction force data were captured in a computer-assisted rehabilitation environment system. Kinetic parameters and dynamic balance parameters were calculated using a standard biomechanical approach. Results. During uphill walking, both groups decreased walking speed and stride length and increased peak pelvis tilt, ankle dorsiflexion, and hip flexion. Compared with TD children, CP children had decreased walking speed and stride length, decreased peak hip abduction moment, increased stance phase percentage, increased peak ankle dorsiflexion and knee flexion, and increased peak hip extension moment. The peak trunk rotation angle, ankle angle at initial contact, and stride length showed a significant interaction effect. Conclusions. CP children showed similar adjustments for most gait parameters during uphill walking as TD children. With a lower walking speed, CP children could maintain similar dynamic balance as TD children. Uphill walking magnifies the existing abnormal gait patterns of the cerebral palsy children. We suggest that during a treadmill training with an inclination, the walking speed should be carefully controlled in the case of improving peak joint loading too much.

中文翻译：

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虚拟现实环境下痉挛性脑瘫儿童倾斜跑步机行走的步态特征。


客观的。探讨虚拟现实环境下痉挛性脑瘫患儿倾斜跑步机行走的步态特征。方法。十名痉挛性脑瘫(CP) 儿童和十名正常发育(TD) 儿童被要求在地面水平且倾斜 10° 的跑步机上以他们舒适的速度行走。在计算机辅助康复环境系统中捕获三维运动学数据和地面反作用力数据。使用标准生物力学方法计算动力学参数和动态平衡参数。结果。在上坡行走过程中，两组人的行走速度和步幅均降低，骨盆倾斜峰值、踝背屈和髋屈增加。与TD儿童相比，CP儿童步行速度和步幅降低，髋部外展峰值力矩降低，站立相百分比增加，踝背屈和膝关节峰值增加，髋部伸展峰值力矩增加。躯干峰值旋转角度、初始接触时的踝关节角度和步幅显示出显着的交互作用。结论。 CP 儿童在上坡行走时对大多数步态参数的调整与 TD 儿童相似。由于步行速度较低，CP 儿童可以保持与 TD 儿童相似的动态平衡。上坡行走放大了脑瘫儿童现有的异常步态模式。我们建议在有倾斜度的跑步机训练中，应谨慎控制行走速度，以免关节峰值负荷提高过多。