Gait characteristics of children with spastic cerebral palsy assessed by dynamic plantar pressure measurement

Hai LI; Anyan ZHOU; Dongfeng HUANG; Jianxin DING; Qin JIANG

ABSTRACT

BACKGROUND:

Pressure sensitive instrumented shoes are fast and easily used tools to measure ground reaction forces. Currently researches about the utilities of these systems in assessment of gait in children with neurological diseases have been started to run.

OBJECTIVE:

To find the gait characteristics of dynamic plantar pressure in children with spastic cerebral palsy.

DESIGN:

A cross-sectional study.SETTINGS Department of Rehabilitation, Songgang People's Hospital; Department of Rehabilitation, Shenzhen Children's Hospital; Department of Rehabilitation Medicine, the First Affiliated Hospital of Sun Yat-sen University.

PARTICIPANTS:

① Patient group Twenty children with spastic cerebral palsy were selected from Shenzhen Children's Hospital from May 2004 to April 2005, including 9 boys and 11 girls, aged 26-66 months old, and they all could walk for more than 10 m independently. ② Normal control group 52 healthy children with normal walking ability were enrolled, including 28 boys.and 24 girls, aged 35-76 months old.

METHODS:

Ultraflex gait analysis system was used to perform continuous plantar pressure tests of both groups of children. Diagram and data of dynamic plantar pressures in gait were recorded and analyzed with a computer. MAIN OUTCOME

MEASURES:

① 10 sequential gait cycles were chosen from the continuous stable steps to calculate the average data with the software; ② Differences of the characteristic parameters of plantar pressure curve between the two groups.

RESULTS:

① The curves of plantar pressure to time of testees in the normal control group were of the wave shapes with two peaks and one valley. Half of the CP children could not perform the two-peak shape pressure curve in the gait analysis. One kind of abnormal plantar pressure curve style was a wave shape with only one peak. Another kind of abnormal plantar pressure curve style was a shape showing asymmetry between sides and variation in different steps even in the same side. Two-peak shapes of dynamic plantar pressure were recorded in 10 CP children. ② Characteristic parameters picked up from the curves of plantar pressure had been compared between the two groups. Significant difference have been found in ts of both sides and tz1,tz2,tz3 on the right side between the two groups. It was shown that the single-limb support time of both sides in the CP children was longer than that in healthy children [left (0.879± 0.658), (0.472±0.051) s; right (0.818±0.682), (0.478±0.050) s; P ＜ 0.01]. The tz1 and tz3 on the right side in the CP children were longer and while the tz2 was shorter than those in the healthy children.

CONCLUSION:

① Using dynamic plantar pressure gait analysis system, plantar pressure curves can be observed directly, and information about kinetic characters can be drawn straightly. ② Part of patients with spastic CP could not perform the two-peak shape pressure curves in gait analysis. In patient can be recorded of two-peak shape dynamic plantar pressure curves, ts of both sides are shorter than those in healthy children, tz1 and tz3 on the right side is longer and tz2 is shorter than those in healthy children.