Power generation in children with spastic hemiplegic cerebral palsy

Abstract Background Spastic hemiplegic cerebral palsy is a challenging disorder often affecting children with high functional and cognitive level, who are good candidates for physiotherapy treatment, including co-ordination and muscle strengthening exercises. The goal of this study was to investigat...

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Bibliographic Details
Published in:Gait & posture 2008-05, Vol.27 (4), p.641-647
Main Authors: Riad, Jacques, Haglund-Akerlind, Yvonne, Miller, Freeman
Format: Article
Language:English
Subjects:
Adolescent
Adult
Ankle Joint - physiopathology
Case-Control Studies
Cerebral Palsy - physiopathology
Child
Child, Preschool
Classification
Female
Gait - physiology
Gait analysis
Hemiplegia - physiopathology
Hemiplegic cerebral palsy
Hip Joint - physiopathology
Humans
Lower Extremity - physiopathology
Male
Orthopedics
Power generation
Symmetry
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Summary:Abstract Background Spastic hemiplegic cerebral palsy is a challenging disorder often affecting children with high functional and cognitive level, who are good candidates for physiotherapy treatment, including co-ordination and muscle strengthening exercises. The goal of this study was to investigate hip and ankle power generation on both the hemiplegic and uninvolved sides in children with spastic hemiplegic cerebral palsy and no previous surgery. Methods Ninety-nine patients with spastic hemiplegic CP with a mean age of 8.4 years were included. Medical records and gait analysis data were reviewed. Patients were classified using Winter's criteria and an independent sample t -test was used to compare groups. Results The hip extensor power generation was higher in all Winter classification groups on both the hemiplegic and uninvolved sides, compared to age matched normal subjects. Comparing the power generation at the ankle, all groups had less power generation on both the hemiplegic and non-involved side. Conclusions We found a major power generation shift from the ankle to the hips in children with spastic hemiplegic cerebral palsy both on the hemiplegic and the uninvolved sides. This could be interpreted, as a way of compensating for decreased ankle power generation on the hemiplegic side. The results may suggest that muscle strengthening physiotherapy should be directed toward the hip power generators and co-ordination exercises should be focused distally to the knee and ankle. This may also suggest that power loss at the ankle, such as after tendon-Achilles lengthening, may be of less importance.
ISSN:0966-6362
1879-2219
DOI:10.1016/j.gaitpost.2007.08.010