During the acquisition of posturokinetic abilities such as walking, postural control of the trunk is of paramount importance. Indeed, its development is strongly linked to the overall motor function of children. In cerebral palsy (CP), a term that refers to a set of motor disorders following a perinatal lesion, deficits in axial control are present from early childhood. These deficits are strongly correlated with the functional deficits observed in this population. In particular, during walking, deviations of the trunk (amplitudes, accelerations) are observed in the three planes of space. While recent literature increasingly questions the impact of trunk control deficit on the walking of children with CP, elements are still missing for a holistic understanding of the interaction between locomotor and postural disorders in children with CP. In particular, no study has focused on the deviations of trunk control and the center of mass (which is a global indicator of balance strategies) during the development and maturation of walking in children with CP. Therefore, the primary objective of this cross-sectional observational study will be to characterize the development of trunk control and center of mass during walking in children with CP.
Children (< 18 years) with cerebral palsy
GMFCS I to III
Independent walking with or without technical walking aids (walker, crutches, etc.)
Able to understand the instructions of various clinical assessments and functional explorations
Neuro-orthopaedic surgery of the lower limbs or trunk within the last 12 months
Botulinum toxin A injections within the last 6 months
Therapeutic intervention targeting trunk control last 6 months
Surgery on lower limbs or trunk last 12 months
Children with cerebral palsy presenting gait pattern disorders receive consultation and/or care (day or full hospitalization) at the Flavigny-sur-Moselle CMPRE.
Case-control
Prospective
Not listed
Trunk and center-of-mass accelerations and acceleration variability
In addition to the zeno walking track, inertial computers will be used to record accelerations of the patient's trunk and center of mass as they walk. One will be attached to the sternum, the other to the lumbosacral hinge, using hypoallergenic double-sided tape. A third will be attached to the patient's shoe to synchronize the data from the treadmill and the inertial units. Acceleration variability is calculated in post-processing.
Gait Variability Index
A composite score of gait variability based on spatio-temporal parameters, giving an index of gait regularity. The mean reference score is 100, and a score above 100 indicates that the patient is at least as stable as a patient from a healthy population.
Trunk Control Measurement Scale score (TCMS)
The TCMS scale assesses trunk control in the seated position in three dimensions. The maximum (and best) score is 58 points, of which 20 correspond to static balance, 28 to selective movement control and 10 to the ability to perform dynamic extension movements.
Early Clinical Assessment of Balance score
The Early Clinical Assessment of Balance is an evaluative measure used by clinicians to assess balance in the cerebral palsy population. Scoring is on a 0-100 scale where higher scores equate to better balance.
Click on the lead sponsor to view all of their trials.
