Lower limb extension is improved in fast walking condition in children who walk in crouch gait

Abstract

Background and purpose: The strategies for walking fast have never been reported in children with cerebral palsy who walk in crouch gait. This study aimed to assess to what extent children who walk in crouch gait are able to increase their gait speed and to report the corresponding three-dimensional kinematic adaptations.

Methods: Eleven children and adolescents (aged between 7 and 17 years) with bilateral cerebral palsy, who walk in crouch gait, were asked to walk at their self-selected comfortable speed and then as fast as possible without running. The spatio-temporal and kinematic parameters, as well as the center of mass displacements were compared between walking conditions.

Results: Children were able to walk 30% faster than their comfortable speed (+0.30 m/s, p = 0.000) by increasing both cadence (+21 step/min, p = 0.000) and step length (+0.05 m, p = 0.001). During the stance phase, pelvis anteversion (+3 Deg, p = 0.010), hip flexion-extension range of motion (+4 Deg, p = 0.002), and knee extension (+5 Deg, p = 0.000) were increased in fast walking. During fast walking, the center of mass showed larger range of vertical displacements (p < 0.05).

Conclusions: Children with cerebral palsy who walk in crouch gait increased their walking speed by adopting a less crouched posture. Compared to comfortable walking speed condition, fast walking could be beneficial in rehabilitation to solicit higher lower limbs range of motion.

Implications for rehabilitation:

• Children who walk in crouch gait can walk 30% faster

• Fast walking required higher hip and knee extensions during stance phase

• Fast walking could be an interesting training modality to improve the lower limb range of motion of children who walk in crouch gait

Keywords:

• Crouch gait
• kinematics
• cerebral palsy
• walking speed
• fast walking

Acknowledgements

The authors would like to thank the research assistants of the LAM-CRME, the medical and administrative staff of CHU Sainte Justine (CRME) as well as all children and parents who participated in this study. The first author is scholar of CHU Sainte Justine foundation.

Disclosure statement

The authors state that there is no conflict of interest.