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RESEARCH PRODUCT

The gait is less stable in children with cerebral palsy in normal and dual-task gait compared to typically developed peers

subject

description

There is limited evidence about gait stability and its alteration by concurrent motor and cognitive tasks in children with cerebral palsy (CP). We examined gait stability and how it is altered by constrained cognitive or motor task in CP and their typically developed (TD) controls. Gait kinematics were recorded using inertial-measurement units (IMU) from 18 patients with hemiplegia (13.5 +/- 2.4 years), 12 with diplegia (13.0 +/- 2.1 years), and 31 TD controls (13.5 +/- 2.2 years) during unconstrained gait, and motor (carrying a tray) and cognitive (word naming) task constrained gait at preferred speed (similar to 400 steps/task). Step duration, its standard deviation and refined-compound-multiscale entropy (RCME) were computed independently for vertical and resultant horizontal accelerations. Gait complexity was higher for patients with CP than TD in all tasks and directions (p 0.586), but its variation was higher in CP than TD (p <0.001-0.05), and during the constrained than unconstrained gait in all groups (p <0.01-0.001). The gait in children with CP was more complex and the dual-task cost was higher primarily for children with diplegic CP than TD during cognitive task, indicating that attentional load hinders their gait more. This raises the hypothesis that more attention and cortical resources are needed to compensate for the impaired gait in children with CP. (c) 2021 The Author(s). Published by Elsevier Ltd. Peer reviewed