title: Children with Spastic Cerebral Palsy Experience Difficulties Adjusting Their Gait Pattern to Weight Added to the Waist, While Typically Developing Children Do Not.
abstract: The prevalence of childhood overweight and obesity is increasing in the last decades, also in children with Cerebral Palsy (CP). Even though it has been established that an increase in weight can have important negative effects on gait in healthy adults and children, it has not been investigated what the effect is of an increase in body weight on the characteristics of gait in children with CP. In CP, pre and post three-dimensional gait analyses are performed to assess the effectiveness of an intervention. As a considerable amount of time can elapse between these measurements, and the effect of an alteration in the body weight is not taken into consideration, this effect of increased body weight is of specific importance. Thirty children with the predominantly spastic type of CP and 15 typically developing (TD) children were enrolled (age 3-15 years). All children underwent three-dimensional gait analysis with weight-free (baseline) and weighted (10% of the body weight added around their waist) trials. Numerous gait parameters showed a different response to the added weight for TD and CP children. TD children increased walking velocity, step- and stride length, and decreased double support duration with a slightly earlier timing of foot-off, while the opposite was found in CP. Similarly, increased ranges of motion at the pelvis (coronal plane) and hip (all planes), higher joint angular velocities at the hip and ankle, as well as increased moments and powers at the hip, knee and ankle were observed for TD children, while CP children did not change or even showed decreases in the respective measures in response to walking with added weight. Further, while TD children increased their gastrocnemius EMG amplitude during weighted walking, CP children slightly decreased their gastrocnemius EMG amplitude. As such, an increase in weight has a significant effect on the gait pattern in CP children. Clinical gait analysts should therefore take into account the negative effects of increased weight during pre-post measurements to avoid misinterpretation of treatment results. Overweight and obesity in CP should be counteracted or prevented as the increased weight has detrimental effects on the gait pattern.
authors.affiliation: Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center Amsterdam, Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: Meyns
authors.affiliation: Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences KU Leuven, Leuven, Belgium.
authors.forename: Leen
authors.initials: L
authors.lastname: Van Gestel
authors.affiliation: Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation SciencesKU Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospital LeuvenLeuven, Belgium.
authors.forename: Lynn
authors.initials: L
authors.lastname: Bar-On
authors.affiliation: Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation SciencesKU Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospital LeuvenLeuven, Belgium.
authors.forename: Marije
authors.initials: M
authors.lastname: Goudriaan
authors.affiliation: Division of Production Engineering, Machine Design and Automation, Faculty of Engineering, Department of Mechanical Engineering, KU Leuven Leuven, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Wambacq
authors.affiliation: Division of Production Engineering, Machine Design and Automation, Faculty of Engineering, Department of Mechanical Engineering, KU Leuven Leuven, Belgium.
authors.forename: Erwin
authors.initials: E
authors.lastname: Aertbeliën
authors.affiliation: Division of Production Engineering, Machine Design and Automation, Faculty of Engineering, Department of Mechanical Engineering, KU Leuven Leuven, Belgium.
authors.forename: Herman
authors.initials: H
authors.lastname: Bruyninckx
authors.affiliation: Clinical Motion Analysis Laboratory, University Hospital LeuvenLeuven, Belgium; Department of Pediatric Orthopaedics, University Hospital LeuvenLeuven, Belgium; Faculty of Medicine, Department of Musculoskeletal SciencesKU Leuven, Leuven, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: Molenaers
authors.affiliation: Centre for Developmental Disabilities, University Hospital Leuven Leuven, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: De Cock
authors.affiliation: Centre for Developmental Disabilities, University Hospital Leuven Leuven, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Ortibus
authors.affiliation: Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation SciencesKU Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospital LeuvenLeuven, Belgium.
authors.forename: Kaat
authors.initials: K
authors.lastname: Desloovere
keywords: Cerebral Palsy; EMG; body mass; gait; muscle weakness; weight