Coordination between pelvis and shoulder girdle during walking in bilateral cerebral palsy. (February 2016) - Tavernese, Emanuela
Abstract: Background: Studies revealed that pelvis and shoulder girdle kinematics is impaired in children with the diplegic form of bilateral cerebral palsy while walking. The features of 3D coordination between these segments, however, have never been evaluated. Methods: The gait analyses of 27 children with bilateral cerebral palsy (18 males; mean age 124 months) have been retrospectively reviewed from the database of a Movement Analysis Laboratory. The spatial–temporal parameters and the range-of-motions of the pelvis and of the shoulder girdle on the three planes of motion have been calculated. Continuous relative phase has been calculated for the 3D pelvis–shoulder girdle couplings on the transverse, sagittal and frontal planes of motion to determine coordination between these segments. Data from 10 typically developed children have been used for comparison. Findings: Children with bilateral cerebral palsy walk with lower velocity ( P = 0.01), shorter steps ( P < 0.0001), larger base of support ( P < 0.01) and increased duration of the double support phase ( P = 0.005) when compared to typically developed children. The mean continuous relative phase on the transverse plane has been found lower in the cerebral palsy group throughout the gait cycle ( P = 0.003), as well as in terminal stance, pre-swing and mid-swing. The age, gait speed and pelvis range-of-motions on the transverse plane have been found correlated to continuous relative phase on the transverse plane. Interpretation: Compared with typically developed children, children with bilateral cerebral palsy show a more in-phase coordination between the pelvis and the shoulder girdle on the transverse plane while walking. Highlights: Pelvis and shoulder girdle show an in-phase coordination in diplegic cerebral palsy. The reduced walking velocity is correlated with the in-phase coordination pattern. This coordination pattern is observed in the transverse plane only. The frontal and the sagittal planes of motion do not show altered coordination pattern. Therapies that correct rotational abnormalities might restore coordination pattern.