Changes in the range of motion in children with cerebral palsy during the early stages of gait development

Abstract

OBJECTIVE To investigate the effect of the onset of walking on the passive and dynamic range of motion (PROM, DROM) in children with cerebral palsy (CP). METHOD Study was made of 16 children with CP, GMFCS levels I or II, who had just begun independent walking. Knee and ankle PROM was evaluated using a goniometer, and DROM was recorded by means of a 3D gait analysis system, at two points in time, i.e., at the onset of independent walking and 8 months later. RESULTS No significant differences in PROM were observed between the two measurements. A significant increase (p<0.05) was observed in DROM for maximum ankle plantarflexion during the stance phase of gait. CONCLUSIONS PROM is not significantly affected by the use of “atypical” walking patterns during the initial stage of gait development. The changes observed in DROM and joint kinematics probably develop as a result of the efforts of the neuromuscular system to adjust to the increased need for stability and motion required during gait initiation. © Athens Medical Society.