How multi segmental patterns deviate in spastic diplegia from typical developed

Matteo Zago, Chiarella Sforza, Alessia Bona, Veronica Cimolin, Pier Francesco Costici, Claudia Condoluci, Manuela Galli

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The relationship between gait features and coordination in children with Cerebral Palsy is not sufficiently analyzed yet. Principal Component Analysis can help in understanding motion patterns decomposing movement into its fundamental components (Principal Movements). This study aims at quantitatively characterizing the functional connections between multi-joint gait patterns in Cerebral Palsy.

METHODS: 65 children with spastic diplegia aged 10.6 (SD 3.7) years participated in standardized gait analysis trials; 31 typically developing adolescents aged 13.6 (4.4) years were also tested. To determine if posture affects gait patterns, patients were split into Crouch and knee Hyperextension group according to knee flexion angle at standing. 3D coordinates of hips, knees, ankles, metatarsal joints, pelvis and shoulders were submitted to Principal Component Analysis.

FINDINGS: Four Principal Movements accounted for 99% of global variance; components 1-3 explained major sagittal patterns, components 4-5 referred to movements on frontal plane and component 6 to additional movement refinements. Dimensionality was higher in patients than in controls (p<0.01), and the Crouch group significantly differed from controls in the application of components 1 and 4-6 (p<0.05), while the knee Hyperextension group in components 1-2 and 5 (p<0.05).

INTERPRETATION: Compensatory strategies of children with Cerebral Palsy (interactions between main and secondary movement patterns), were objectively determined. Principal Movements can reduce the effort in interpreting gait reports, providing an immediate and quantitative picture of the connections between movement components.

Original languageEnglish
Pages (from-to)103-109
Number of pages7
JournalClinical Biomechanics
Volume48
DOIs
Publication statusPublished - Oct 2017

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Cerebral Palsy
Gait
Knee
Principal Component Analysis
Metatarsal Bones
Ankle Joint
Pelvis
Posture
Hip
Joints

Keywords

  • Adolescent
  • Biomechanical Phenomena
  • Cerebral Palsy/physiopathology
  • Child
  • Female
  • Gait/physiology
  • Gait Disorders, Neurologic/physiopathology
  • Hip/physiopathology
  • Humans
  • Knee/physiopathology
  • Knee Joint/physiopathology
  • Male
  • Movement
  • Posture/physiology
  • Principal Component Analysis

Cite this

How multi segmental patterns deviate in spastic diplegia from typical developed. / Zago, Matteo; Sforza, Chiarella; Bona, Alessia; Cimolin, Veronica; Costici, Pier Francesco; Condoluci, Claudia; Galli, Manuela.

In: Clinical Biomechanics, Vol. 48, 10.2017, p. 103-109.

Research output: Contribution to journalArticle

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AU - Zago, Matteo

AU - Sforza, Chiarella

AU - Bona, Alessia

AU - Cimolin, Veronica

AU - Costici, Pier Francesco

AU - Condoluci, Claudia

AU - Galli, Manuela

N1 - Copyright © 2017 Elsevier Ltd. All rights reserved.

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N2 - BACKGROUND: The relationship between gait features and coordination in children with Cerebral Palsy is not sufficiently analyzed yet. Principal Component Analysis can help in understanding motion patterns decomposing movement into its fundamental components (Principal Movements). This study aims at quantitatively characterizing the functional connections between multi-joint gait patterns in Cerebral Palsy.METHODS: 65 children with spastic diplegia aged 10.6 (SD 3.7) years participated in standardized gait analysis trials; 31 typically developing adolescents aged 13.6 (4.4) years were also tested. To determine if posture affects gait patterns, patients were split into Crouch and knee Hyperextension group according to knee flexion angle at standing. 3D coordinates of hips, knees, ankles, metatarsal joints, pelvis and shoulders were submitted to Principal Component Analysis.FINDINGS: Four Principal Movements accounted for 99% of global variance; components 1-3 explained major sagittal patterns, components 4-5 referred to movements on frontal plane and component 6 to additional movement refinements. Dimensionality was higher in patients than in controls (p<0.01), and the Crouch group significantly differed from controls in the application of components 1 and 4-6 (p<0.05), while the knee Hyperextension group in components 1-2 and 5 (p<0.05).INTERPRETATION: Compensatory strategies of children with Cerebral Palsy (interactions between main and secondary movement patterns), were objectively determined. Principal Movements can reduce the effort in interpreting gait reports, providing an immediate and quantitative picture of the connections between movement components.

AB - BACKGROUND: The relationship between gait features and coordination in children with Cerebral Palsy is not sufficiently analyzed yet. Principal Component Analysis can help in understanding motion patterns decomposing movement into its fundamental components (Principal Movements). This study aims at quantitatively characterizing the functional connections between multi-joint gait patterns in Cerebral Palsy.METHODS: 65 children with spastic diplegia aged 10.6 (SD 3.7) years participated in standardized gait analysis trials; 31 typically developing adolescents aged 13.6 (4.4) years were also tested. To determine if posture affects gait patterns, patients were split into Crouch and knee Hyperextension group according to knee flexion angle at standing. 3D coordinates of hips, knees, ankles, metatarsal joints, pelvis and shoulders were submitted to Principal Component Analysis.FINDINGS: Four Principal Movements accounted for 99% of global variance; components 1-3 explained major sagittal patterns, components 4-5 referred to movements on frontal plane and component 6 to additional movement refinements. Dimensionality was higher in patients than in controls (p<0.01), and the Crouch group significantly differed from controls in the application of components 1 and 4-6 (p<0.05), while the knee Hyperextension group in components 1-2 and 5 (p<0.05).INTERPRETATION: Compensatory strategies of children with Cerebral Palsy (interactions between main and secondary movement patterns), were objectively determined. Principal Movements can reduce the effort in interpreting gait reports, providing an immediate and quantitative picture of the connections between movement components.

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SN - 0268-0033

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