title: Gait characteristics, balance performance and falls in ambulant adults with cerebral palsy: An observational study.
abstract: The relationship between spatiotemporal gait parameters, balance performance and falls history was investigated in ambulant adults with cerebral palsy (CP). Participants completed a single assessment of gait using an instrumented walkway at preferred and fast speeds, balance testing (Balance Evaluation Systems Test; BESTest), and reported falls history. Seventeen ambulatory adults with CP, mean age 37 years, participated. Gait speed was typically slow at both preferred and fast speeds (mean 0.97 and 1.21m/s, respectively), with short stride length and high cadence relative to speed. There was a significant, large positive relationship between preferred gait speed and BESTest total score (ρ=0.573; p<0.05) and fast gait speed and BESTest total score (ρ=0.647, p<0.01). The stride lengths of fallers at both preferred and fast speeds differed significantly from non-fallers (p=0.032 and p=0.025, respectively), with those with a prior history of falls taking shorter strides. Faster gait speed was associated with better performance on tests of anticipatory and postural response components of the BESTest, suggesting potential therapeutic training targets to address either gait speed or balance performance. Future exploration of the implications of slow walking speed and reduced stride length on falls and community engagement, and the potential prognostic value of stride length on identifying falls risk is recommended.
authors.affiliation: Department of Physiotherapy, Monash University, Australia. Electronic address: prue.morgan@monash.edu.
authors.forename: P
authors.initials: P
authors.lastname: Morgan
authors.affiliation: Clinical Research Centre for Movement Disorders & Gait, Monash Health, Australia. Electronic address: annat.murphy@monashhealth.org.
authors.forename: A
authors.initials: A
authors.lastname: Murphy
authors.affiliation: Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway,; University of Gothenburg, Institution of Neuroscience and Physiology, Rehabilitation Medicine, Gothenburg, Sweden. Electronic address: arve.opheim@sunnaas.no.
authors.forename: A
authors.initials: A
authors.lastname: Opheim
authors.affiliation: Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Australia. Electronic address: mcginley@unimelb.edu.au.
authors.forename: J
authors.initials: J
authors.lastname: McGinley
mesh_terms: D000058:Accidental Falls; D000328:Adult; D002547:Cerebral Palsy / Q000503:physiopathology*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D000072797:Walking Speed; D055815:Young Adult
keywords: Balance; Cerebral palsy; Falls; Gait; Gait analysis