title: A dynamical model of locomotion in spastic hemiplegic cerebral palsy: influence of walking speed.
abstract: OBJECTIVE
  The objective of this study was to assess the capability of an escapement-driven inverted pendulum with springs and damping model to estimate the effects of impairments (e.g. spasticity, muscle weakness) on the dynamics and patterns of locomotion of children with spastic cerebral palsy.
  
  
  METHODS
  Kinematic data of six children with spastic hemiplegic cerebral palsy and six matched, typically developing children were collected at five different self-selected overground walking speeds ('very slow' to 'very fast'). Changes in forcing, stiffness and gravitational potentials were estimated during the stance phase of each leg according to the model's equation of motion.
  
  
  RESULTS
  Significantly greater stiffness and decreased forcing was observed in the more affected limbs of children with spastic hemiplegic cerebral palsy and compared to typically developing peers. The forcing term of the non-affected limb was greater than that of the matched typically developing children.
  
  
  CONCLUSIONS
  Results support the claim that disabled individuals with losses in dynamic resources (stiffness, muscle forcing capability) exploit and develop the remaining resources in their adapted gait patterns. It was suggested that clinical interventions aimed at normalizing a gait pattern may be contraindicated, and that rehabilitation might be more effective if focused at the level of dynamics.
  
  
  CONCLUSIONS
  Pattern formation is seen as an optimal solution based on the individuals' action capabilities and dynamic properties under environmental and task demands. This perspective could lead to the development of interventions that address these dynamic variables with the objective of improving the functional capabilities of children with cerebral palsy.
authors.affiliation: Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Unidade Administrativa II, 3 degrees andar, 270-010, Belo Horizonte, MG, Brazil. sfonseca@metalink.com.br
authors.forename: S T
authors.initials: ST
authors.lastname: Fonseca
authors.forename: K G
authors.initials: KG
authors.lastname: Holt
authors.forename: E
authors.initials: E
authors.lastname: Saltzman
authors.forename: L
authors.initials: L
authors.lastname: Fetters
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D004867:Equipment Design; D005260:Female; D005583:Fourier Analysis; D006429:Hemiplegia / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D008124:Locomotion / Q000502:physiology; D008297:Male; D009128:Muscle Spasticity / Q000503:physiopathology; D016138:Walking / Q000502:physiology*