title: Gait cycle and plantar pressure distribution in children with cerebral palsy: clinically useful outcome measures for a management and rehabilitation.
abstract: BACKGROUND
  Information on altered foot pressures during ambulation would clarify how far limb deformities modify walking patterns in cerebral palsy (CP), and whether such data can inform prognosis and guide rehabilitation.
  
  
  OBJECTIVE
  To compare patterns of plantar pressures during walking between children with CP and their able-bodied (AB) peers.
  
  
  METHODS
  Twenty-five children/adolescents (10 with hemiplegia, 5 with diplegia, and 10 AB, respective ages 13.0 ± 1.9, 13.0 ± 0.6 and 14.0 ± 0.7 years) walked a 12 m line at a self-selected speed. Spatio-temporal parameters and peak in-shoe plantar pressures were recorded for both feet, using the Parotec analysis system.
  
  
  RESULTS
  Walking speeds (m·-1) differed significantly between groups (0.65 ± 0.13, hemiplegia, 0.93 ± 0.22 diplegia and 1.26 ± 0.05 AB), with shorter stride lengths in CP. Contact time, double support time and step duration were also shorter in hemiplegia. Plantar pressures differed substantially and consistently between AB and CP, with increased medial heel pressures in hemiplegia, and reduced hallux and lateral heel pressures but increased lateral, medial mid-foot and first metatarsal pressures in diplegia.
  
  
  CONCLUSIONS
  Substantial alterations in spatio-temporal parameters (greater in hemiplegia than in diplegia) and plantar pressure distribution reflect attempts to compensate for poor stability of posture in CP. Further study of these adaptive changes holds clinical promise in providing data relevant to the design of orthotics, determinations of prognosis and the planning of neurorehabilitation.
authors.affiliation: Laboratoire de Recherche EA: 3300 "Adaptations Physiologiques á l'Exercice et Réadaptation á l'Effort", Faculté des Sciences du Sport, Université de Picardie Jules Verne, Amiens, France.
authors.forename: Angeline
authors.initials: A
authors.lastname: Nsenga Leunkeu
authors.affiliation: Laboratoire de Recherche EA: 3300 "Adaptations Physiologiques á l'Exercice et Réadaptation á l'Effort", Faculté des Sciences du Sport, Université de Picardie Jules Verne, Amiens, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Lelard
authors.affiliation: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada.
authors.forename: Roy J
authors.initials: RJ
authors.lastname: Shephard
authors.affiliation: Service d'Explorations Fonctionnelles de l'appareil locomoteur, Centre Hospitalier Universitaire (CHU), Nord, France.
authors.forename: Pierre-Louis
authors.initials: PL
authors.lastname: Doutrellot
authors.affiliation: Laboratoire de Recherche EA: 3300 "Adaptations Physiologiques á l'Exercice et Réadaptation á l'Effort", Faculté des Sciences du Sport, Université de Picardie Jules Verne, Amiens, France.
authors.forename: Said
authors.initials: S
authors.lastname: Ahmaidi
mesh_terms: D000293:Adolescent; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000534:rehabilitation*; D002648:Child; D005528:Foot / Q000503:physiopathology*; D005684:Gait; D006365:Heel; D006429:Hemiplegia / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D010243:Paralysis / Q000503:physiopathology / Q000534:rehabilitation; D010347:Patient Care Planning; D011312:Pressure; D016896:Treatment Outcome; D016138:Walking
keywords: Children; cerebral palsy; gait cycle; plantar pressures; rehabilitation