title: Gait characteristics in children and adolescents with cerebral palsy assessed with a trunk-worn accelerometer.
abstract: This study aimed to investigate gait characteristics reflecting balance and progression in children and adolescents with cerebral palsy (CP) compared with typically developing (TD) children. Gait characteristics variables representing aspects of balance were trunk acceleration, interstride regularity and asymmetry of accelerations while gait characteristics representing progression were gait speed, cadence, step time and step length. Children in the age range 5-18 years (mean age 11.1 years) with spastic CP (n=41) and a gross motor function corresponding to GMFCS I-III and children with TD (n=29) were included. The children walked back and forth along a 5m pathway with a tri-axial accelerometer worn on the lower back to allow assessment of their gait characteristics. Data were recorded along the anterioposterior (AP), mediolateral (ML), and vertical (V) axes. To assess the magnitude of potential differences in gait characteristics, standard deviation scores were calculated, using TD children as reference. Gait parameters related to balance, such as AP, ML, and V accelerations, were higher in the children with CP (z-scores between 0.4 and 0.7) and increased with increasing GMFCS levels. The differences in accelerations in the AP and V directions increased between children with CP and TD children with increasing speed. Also asymmetry in trunk accelerations differed significantly between the two groups in all three directions (z-scores between 0.8 and 1.8 higher in the CP group), while interstride regularity differed only slightly between children with CP and TD children, and only in the AP direction. Gait characteristics also differed between children with the spastic subtypes unilateral and bilateral CP, for accelerations and asymmetry in the AP and ML directions. Our results showed significant differences in gait characteristics between children with CP and TD children. The differences may be more related to balance than progression, and these problems seem to rise with increasing gross motor impairment and speed.
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Trondheim, Norway. Electronic address: rannei.sather@ntnu.no.
authors.forename: Rannei
authors.initials: R
authors.lastname: Saether
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; Clinic for Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Electronic address: jorunn.helbostad@ntnu.no.
authors.forename: Jorunn L
authors.initials: JL
authors.lastname: Helbostad
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Clinic for Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. Electronic address: lars.adde@ntnu.no.
authors.forename: Lars
authors.initials: L
authors.lastname: Adde
authors.affiliation: Clinic for Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Human Movement Science Programme, Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: siri.merete.brandvik@svt.ntnu.no.
authors.forename: Siri
authors.initials: S
authors.lastname: Brændvik
authors.affiliation: Department of Pediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Trondheim, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: stian.lydersen@ntnu.no.
authors.forename: Stian
authors.initials: S
authors.lastname: Lydersen
authors.affiliation: Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Trondheim, Norway. Electronic address: torstein.vik@ntnu.no.
authors.forename: Torstein
authors.initials: T
authors.lastname: Vik
mesh_terms: D061725:Accelerometry / Q000295:instrumentation*; D000293:Adolescent; D002547:Cerebral Palsy / Q000175:diagnosis*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008432:Mathematical Computing; D009043:Motor Activity; D009664:Norway; D004856:Postural Balance; D012984:Software
keywords: Balance control; Cerebral palsy; Children/adolescents; Gait