The gait is less stable in children with cerebral palsy in normal and dual-task gait compared to typically developed peers

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Piitulainen, H, Kulmala, J-P, Mäenpää, H & Rantalainen, T 2021, ' The gait is less stable in children with cerebral palsy in normal and dual-task gait compared to typically developed peers ', Journal of Biomechanics, vol. 117, 110244 . https://doi.org/10.1016/j.jbiomech.2021.110244

Title: The gait is less stable in children with cerebral palsy in normal and dual-task gait compared to typically developed peers
Author: Piitulainen, Harri; Kulmala, Juha-Pekka; Mäenpää, Helena; Rantalainen, Timo
Contributor organization: HUS Children and Adolescents
Children's Hospital
Lastenneurologian yksikkö
Helsinki University Hospital Area
University of Helsinki
Date: 2021-03-05
Language: eng
Number of pages: 7
Belongs to series: Journal of Biomechanics
ISSN: 0021-9290
DOI: https://doi.org/10.1016/j.jbiomech.2021.110244
URI: http://hdl.handle.net/10138/330707
Abstract: There is limited evidence about gait stability and its alteration by concurrent motor and cognitive tasks in children with cerebral palsy (CP). We examined gait stability and how it is altered by constrained cognitive or motor task in CP and their typically developed (TD) controls. Gait kinematics were recorded using inertial-measurement units (IMU) from 18 patients with hemiplegia (13.5 +/- 2.4 years), 12 with diplegia (13.0 +/- 2.1 years), and 31 TD controls (13.5 +/- 2.2 years) during unconstrained gait, and motor (carrying a tray) and cognitive (word naming) task constrained gait at preferred speed (similar to 400 steps/task). Step duration, its standard deviation and refined-compound-multiscale entropy (RCME) were computed independently for vertical and resultant horizontal accelerations. Gait complexity was higher for patients with CP than TD in all tasks and directions (p <0.001-0.01), being pronounced in vertical direction, cognitive task and for diplegic patients (p <0.05-0.001). The gait complexity increased more (i.e. higher dual-task cost) from the unconstrained to the constrained gait in CP compared to TD (p <0.05). Step duration was similar in all groups (p > 0.586), but its variation was higher in CP than TD (p <0.001-0.05), and during the constrained than unconstrained gait in all groups (p <0.01-0.001). The gait in children with CP was more complex and the dual-task cost was higher primarily for children with diplegic CP than TD during cognitive task, indicating that attentional load hinders their gait more. This raises the hypothesis that more attention and cortical resources are needed to compensate for the impaired gait in children with CP. (c) 2021 The Author(s). Published by Elsevier Ltd.
Subject: Gait variability
Inertial measurement unit
Kinematics
Stability
Walking
Attention
3123 Gynaecology and paediatrics
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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