Background

While gait termination is challenging for children with spastic cerebral palsy (CCP), few studies have quantitatively assessed this issue.

Research question

What are the characteristics of center of mass (COM) and center of pressure (COP) displacement during gait termination in CCP, and how do they compare with those in children with typical development (CTD)?

Methods

This cross-sectional study included 13 adults with typical development (19.85 ± 0.52 years), 12 CTD (10.41 ± 2.98 years), and 16 CCP (11.15 ± 2.71 years). Participants were instructed to immediately stop walking when a stop sign appeared on a screen, which was placed at the end of an 8-m walkway. COM and COP were determined via 3-dimensional motion analysis and force plate data. Differences between the groups were assessed using the two sample t-test or Wilcoxon rank sum test. The level of statistical significance was set at P < 0.05.

Results

The normalized time for stopping in CCP (4.556 ± 0.602) was higher than that in CTD (3.617 ± 0.545, P < 0.001). The normalized COP displacement (P < 0.001) and divergence between COM and COP (P < 0.001) in the mediolateral (ML) direction were significantly higher in CCP than CTD. However, the normalized divergence between COM and COP in the anteroposterior (AP) direction in CCP was lower than that in CTD (P = 0.034).

Significance

The more minor divergence between COM and COP in the AP direction and the more significant COP displacement in the ML direction cause difficulty to exert braking force during gait termination. Thus, CCP require a longer time for gait termination. This finding may facilitate the development of interventions for improving gait in CCP.

中文翻译：

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脑瘫患儿步态终止时横断面质心和压力中心位移分析

背景

虽然步态终止对痉挛性脑瘫 (CCP) 儿童具有挑战性，但很少有研究对这个问题进行定量评估。

研究问题

CCP步态终止时的质心（COM）和压力中心（COP）位移有何特点，与典型发育（CTD）儿童相比如何？

方法

该横断面研究包括 13 名典型发育成人（19.85 ± 0.52 岁）、12 名 CTD（10.41 ± 2.98 岁）和 16 名 CCP（11.15 ± 2.71 岁）。当屏幕上出现停车标志时，参与者被指示立即停止行走，屏幕放置在 8 米长的走道尽头。COM 和 COP 是通过 3 维运动分析和测力板数据确定的。使用两个样本t检验或 Wilcoxon 秩和检验评估组之间的差异。统计显着性水平设为P < 0.05。

结果

CCP 中停止的归一化时间（4.556±0.602）高于 CTD（3.617±0.545，P < 0.001）。CCP 中的归一化 COP 位移 ( P < 0.001) 和 COM 和 COP 之间的偏差 ( P < 0.001) 在中外侧 (ML) 方向上显着高于 CTD。然而，CCP在前后（AP）方向上COM和COP之间的归一化差异低于CTD（P = 0.034）。

意义

在 AP 方向上 COM 和 COP 之间的差异越小，而在 ML 方向上的 COP 位移越显着，导致在步态终止期间难以施加制动力。因此，CCP 需要更长的时间来终止步态。这一发现可能有助于开发改善 CCP 步态的干预措施。