Kinetic comparison of walking on a treadmill versus over ground in children with cerebral palsy

Krogt, Marjolein van der; Sloot, Lizeth H.; Harlaar, Jaap

doi:10.1016/j.gaitpost.2015.06.155

Cited by 8 publications

(7 citation statements)

References 3 publications

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“…In the present study, the profiles of joint power output during TW showed only minor differences with respect to those recorded in GW of controls. The most relevant finding was a slightly more flexed posture of the hip, knee, and ankle joints and a lower power generated by plantar flexors, again in agreement with the literature ( Tesio and Rota, 2008 ; van der Krogt et al , 2015 ). Given that the plantar flexors are the main providers of ‘external’ power during walking ( Meinders et al , 1998 ; Tesio et al , 2017 ), this is consistent with the shorter step length adopted during TW, allowing a lower power to be exerted against the ground ( Cavagna et al , 1988 ).…”

Section: Discussionsupporting

confidence: 89%

Gait analysis on force treadmill in children: comparison with results from ground-based force platforms

Tesio

Malloggi

Portinaro

et al. 2017

International Journal of Rehabilitation Research

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Gait analysis (GA) typically includes surface electromyographic (sEMG) recording from several lower limb muscles, optoelectronic measurement of joint rotations, and force recordings from ground-based platforms. From the latter two variables, the muscle power acting on the lower limb joints can be estimated. Recently, gait analysis on a split-belt force treadmill (GAFT) was validated for the study of adult walking. It showed high reliability of spatiotemporal, kinematic, dynamic, and sEMG parameters, matching those obtainable with GA on the basis of ground walking. GAFT, however, still needs validation in children. Potential differences with respect to adult GAFT relate to (a) possible high signal-to-noise ratio, given the lower forces applied; (b) higher differences between treadmill and over-ground walking; and (c) limited compliance with the experimental setup. This study aims at investigating whether GAFT provides results comparable with those obtainable from ground walking in children and consistent with results from GAFT in adults. GAFT was applied to three groups of healthy children aged 5–6 years (n=6), 7–8 years (n=6), and 9–13 years (n=8) walking at the same average speed spontaneously adopted overground. The results were compared with those obtained from another study applying GA to an age-matched and speed-matched sample of 47 children, and with those obtained from GAFT in adults. The reliability (as indicated by the SD) of both spatiotemporal and dynamic parameters was higher in GAFT compared with GA. In the 5–6-, 7–8-, and 9–13-year-old groups, at average speeds of 0.83, 1.08, and 1.08 m/s, step length was shorter by 9.19, 3.57, and 2.30% compared with GA in controls at comparable speeds, respectively. For the youngest group, a lower power generation from the plantar flexors (peak power: 1.35±0.32 vs. 2.11±1.02 W/kg) and a slightly more flexed posture of the hip, knee, and ankle joints were observed during GAFT compared with GA in controls. The other gait parameters were very similar between the GAFT and the GA groups. The shortening of step length during GAFT, relative to GA at superimposable speed, was on average of all children 6.8%, in line with the 8% decrease found in adults. The profiles of sEMG and joint rotations, and all of the weight-standardized joint power parameters, matched those recorded in adults. The entire experimental session lasted about 1 h. All children complied with the experimental setting and easily completed the requested tests. In conclusion, GAFT seems to be a promising alternative to conventional GA in children.

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Section: Discussionsupporting

confidence: 89%

Gait analysis on force treadmill in children: comparison with results from ground-based force platforms

Tesio

Malloggi

Portinaro

et al. 2017

International Journal of Rehabilitation Research

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“…The locomotor skills obtained during robotic treadmill training may partially transfer to overground walking in children with CP. While differences in the kinetics between treadmill and overground walking have been observed [ 34 ], the differences in the kinematics [ 35 ] between these two walking conditions are generally small in children with CP. The neural circuits controlling locomotion during treadmill and overground walking may be partially overlapped [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Kinematic and EMG Responses to Pelvis and Leg Assistance Force during Treadmill Walking in Children with Cerebral Palsy

Kim

Arora

et al. 2016

Neural Plasticity

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Treadmill training has been used for improving locomotor function in children with cerebral palsy (CP), but the functional gains are relatively small, suggesting a need to improve current paradigms. The understanding of the kinematic and EMG responses to forces applied to the body of subjects during treadmill walking is crucial for improving current paradigms. The objective of this study was to determine the kinematics and EMG responses to the pelvis and/or leg assistance force. Ten children with spastic CP were recruited to participate in this study. A controlled assistance force was applied to the pelvis and/or legs during stance and swing phase of gait through a custom designed robotic system during walking. Muscle activities and spatial-temporal gait parameters were measured at different loading conditions during walking. In addition, the spatial-temporal gait parameters during overground walking before and after treadmill training were also collected. Applying pelvis assistance improved step height and applying leg assistance improved step length during walking, but applying leg assistance also reduced muscle activation of ankle flexor during the swing phase of gait. In addition, step length and self-selected walking speed significantly improved after one session of treadmill training with combined pelvis and leg assistance.

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“…Recent results demonstrated improvements in gait performance, recovery of trunk movement and muscular reinforcement in amputees [10,25]. The usability of GRAIL and its reliability in evaluating the walking pattern in the pediatric population have been recently proved in both healthy children and Cerebral Palsy subjects [26,27,28]. The use of GRAIL as rehabilitative tool in the pediatric population is promising thanks to the high plasticity of neuronal circuits in children, as shown by preliminary observations [29], but the scientific evidence of its benefits is still lacking.…”

Section: Introductionmentioning

confidence: 99%

An Immersive Virtual Reality Platform to Enhance Walking Ability of Children with Acquired Brain Injuries

et al. 2017

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Kinetic comparison of walking on a treadmill versus over ground in children with cerebral palsy

Cited by 8 publications

References 3 publications

Gait analysis on force treadmill in children: comparison with results from ground-based force platforms

Gait analysis on force treadmill in children: comparison with results from ground-based force platforms

Kinematic and EMG Responses to Pelvis and Leg Assistance Force during Treadmill Walking in Children with Cerebral Palsy

An Immersive Virtual Reality Platform to Enhance Walking Ability of Children with Acquired Brain Injuries

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