Goal-oriented locomotion in children with spastic diplegia: Anticipatory orienting strategies and trajectory formation

ABSTRACT

Goal-oriented locomotion (GOL) is a complex task integrating navigation and gait control. To our knowledge, this is the first study of GOL in subjects with Cerebral Palsy (CP). Thirteen subjects with spastic diplegia and 26 with typical development were enrolled in the study. Subjects performed a GOL task to reach luminous targets. Within-subject trajectory variability, maximal head deviation from trajectory and mean head anticipation over trajectory were analyzed. While all subjects showed gait impairment, only 8 of 13 subjects also showed navigation abnormalities as revealed by either: a) abnormal head orientation and trajectory formation, or b) abnormal head orientation with normal trajectory formation. Abnormal gait patterns do not account for and can be distinguished from navigation disorders in spastic diplegic CP. This distinction has important implications for novel rehabilitation methods that should specifically address navigation, not only gait.

KEYWORDS:

• Navigation
• cerebral palsy
• development
• motor control
• head anticipation
• rehabilitation

Acknowledgments

Alexander Castilla was supported by Institut de Médecine Environnementale (IME), Paris, and we thank its Director Jacques Fradin for continuous and generous support.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was partially supported by Current Research funds by the Italian Ministry of Health and by 5 for 1000 Funds to IRCCS Fondazione Stella Maris.