Relationship Between Kinematic Gait Quality and Caregiver-Reported Everyday Mobility in Children and Youth with Spastic Cerebral Palsy.
EUROPEAN JOURNAL OF PAEDIATRIC NEUROLOGY(2023)
摘要
Background: 3D gait analysis (3DGA) is a common assessment in Cerebral Palsy (CP) to quantify the extent of movement abnormalities. Yet, 3DGA is performed in laboratories and may thus be of debatable significance to everyday life.Aim: The aim was to assess the relationship between kinematic gait abnormality and everyday mobility in ambulatory children and youth with spastic CP.Methods: 73 paediatric and juvenile patients with uni-or bilateral spastic CP (N = 21 USCP, N = 52, BSCP, age: 4-20 y, GMFCS I-III) underwent a 3DGA, while the MobQues47 Questionnaire quantified caregiver-reported mobility. We calculated the Gait Profile Score (GPS), a metric that summarizes how far the lower limb joint angles during walking deviate from those of matched controls.Results: The GPS correlated well with indoor and outdoor mobility (rho =-0.69 and-0.70, both p < 0.001) and the relationships were not significantly different for USCP and BSCP. Still, mobility was lower in BSCP (p < 0.001) and more compromised outdoors (p = 0.002). Indoor mobility could be predicted by walking speed, GPS and age (adj. R2 = 0.62). Outdoor mobility was best predicted by walking speed and GPS (adj. R2 = 0.60). The additive explained variance by the GPS was even higher outdoors than indoors (17.1% vs. 11.4%).Conclusions: Measuring movement deviations with 3DGA seems equally meaningful in uni-and bilaterally affected children and has considerable relevance for real-life ambulation, particurlarly outdoors, where children with spastic CP typically face greater difficulties. Therapeutic strategies that achieve faster walking and reduc-tion of kinematic deviations may increase outdoor mobility.
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关键词
Cerebral palsy,Mobility,Gait analysis,Gait profile score
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