Better Walking Performance in Older Children With Cerebral Palsy

Abstract

BackgroundChildren with cerebral palsy (CP) often walk with a slower speed and a higher energy cost. Their walking performance and choice of mobility method may vary in different environments. Independent mobility is important for activity and participation.Questions/purposesWe described walking performance at different distances and environments in relation to gross motor function, CP subtype, and age.Patients and MethodsWe performed a cross-sectional study including all 562 children 3 to 18 years with CP living in southern Sweden during 2008. Data were extracted from a Swedish CP register and healthcare program. The Functional Mobility Scale (FMS) was used for rating mobility at home (5 m), at school (50 m), and in the community (500 m). The FMS scores were analyzed in relation to Gross Motor Function Classification System (GMFCS) level, CP subtype, and age.ResultsIn this population, 57% to 63% walked 5 to 500 m without walking aids and 4% to 8% used walking aids. We found a correlation between FMS and GMFCS. The walking performance varied between the subtypes from 96% to 98% in those with spastic unilateral CP to 16% to 24% in children with dyskinetic CP. An increased proportion of children walked independently on all surfaces in each successive age group.ConclusionsThe overall walking performance increased up to 7 years of age, but the proportion of children walking independently on uneven surfaces was incrementally higher in each age group up to 18 years. The ability to walk on uneven surfaces is important for achieving independent walking in the community.

Ankle-foot orthoses in children with cerebral palsy: a cross sectional population based study of 2200 children

“…As a consequence, children with CP are at increased risk of developing secondary complications such as muscle contractures, skeletal deformities, hip dislocation, and scoliosis [ 3 ]. Two thirds of children with CP walk with or without walking aids [ 4 , 5 ]. However, children with CP usually start to walk later than their peers without CP [ 6 ], walk at a slower speed, and with a higher energy cost [ 7 ].…”

Gait analysis for individually tailored interdisciplinary interventions in children with cerebral palsy: a randomized controlled trial

“…Cerebral palsy (CP) is caused by a non-progressive brain injury in the developing brain, which influences neuromusculoskeletal functions, 1 including gait, 2 walking, and functional mobility; 3 as a consequence it might affect overall health, participation in daily activities, 4 and health-related quality of life. 5 The majority of children with CP walk independently and exhibit altered gait such as stiff knee gait or equinus.…”

Changes in Capacity and Performance in Mobility Across Different Environmental Settings in Children with Cerebral Palsy: An Exploratory Study

“…Factors like lack of time, safety issues, high energy consumption by child, various contextual features like surfaces, distances could contribute to dependent mobility [17].…”