School of Kinesiology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
CHU Sainte-Justine Research Center, Montréal, Québec, Canada.
Disabil Rehabil. 2019 Dec;41(26):3210-3215. doi: 10.1080/09638288.2018.1493158. Epub 2018 Sep 28.
The strategies for walking fast have never been reported in children with cerebral palsy who walk in crouch gait. This study aimed to assess to what extent children who walk in crouch gait are able to increase their gait speed and to report the corresponding three-dimensional kinematic adaptations. Eleven children and adolescents (aged between 7 and 17years) with bilateral cerebral palsy, who walk in crouch gait, were asked to walk at their self-selected comfortable speed and then as fast as possible without running. The spatio-temporal and kinematic parameters, as well as the center of mass displacements were compared between walking conditions. Children were able to walk 30% faster than their comfortable speed (+0.30m/s, =0.000) by increasing both cadence (+21 step/min, =0.000) and step length (+0.05m, =0.001). During the stance phase, pelvis anteversion (+3 Deg, =0.010), hip flexion-extension range of motion (+4 Deg, =0.002), and knee extension (+5 Deg, =0.000) were increased in fast walking. During fast walking, the center of mass showed larger range of vertical displacements ( < 0.05). Children with cerebral palsy who walk in crouch gait increased their walking speed by adopting a less crouched posture. Compared to comfortable walking speed condition, fast walking could be beneficial in rehabilitation to solicit higher lower limbs range of motion.Implications for rehabilitation:Children who walk in crouch gait can walk 30% fasterFast walking required higher hip and knee extensions during stance phaseFast walking could be an interesting training modality to improve the lower limb range of motion of children who walk in crouch gait.
在患有 crouch 步态脑瘫的儿童中,尚未有关于快走策略的报道。本研究旨在评估 crouch 步态患儿在多大程度上能够提高其步行速度,并报告相应的三维运动学适应性。11 名年龄在 7 至 17 岁之间的双侧脑瘫患儿,以 crouch 步态行走,要求他们以自我选择的舒适速度行走,然后尽可能快地行走但不跑步。比较了行走条件下的时空和运动学参数以及质心位移。儿童通过增加步频(+21 步/分钟,=0.000)和步长(+0.05 米,=0.001),能够以比舒适速度快 30%(+0.30 米/秒,=0.000)的速度行走。在站立阶段,骨盆前倾角(+3°,=0.010)、髋关节屈伸运动范围(+4°,=0.002)和膝关节伸展(+5°,=0.000)增加。在快速行走时,质心的垂直位移范围更大(<0.05)。以 crouch 步态行走的脑瘫患儿通过采用更不 crouch 的姿势来提高步行速度。与舒适步行速度相比,快速行走在康复中可能更有益,可以募集更高的下肢运动范围。康复意义:以 crouch 步态行走的儿童可以快 30%快速行走需要在站立阶段进行更高的髋关节和膝关节伸展快速行走可能是一种有趣的训练方式,可以改善以 crouch 步态行走的儿童的下肢运动范围。