Clinical gait analysis and physical examination don't correlate with physical activity of children with cerebral palsy. Cross-sectional study

Abstract

Gait analysis and physical clinical measures are usually performed in children with cerebral palsy to help the surgeons make therapeutic decision. However, the level of physical activity in daily life is not systematically assessed. The aim of this cross sectional study was to examine the correlations between: three-dimensional gait analysis kinematic and spatiotemporal parameters, clinical measures and physical activity. Participants were 30 children with cerebral palsy (10-18 y), with GMFCS I-III. Daily physical activity was measured with an Actigraph GT3X accelerometer in free living environment during seven consecutive days. The percent of time spent in sedentary, in moderate to vigorous physical activity and the number of steps per day were computed from the accelerometer data. Kinematics parameters did not correlate with physical activity. Moderate correlations were found between spatio-temporal parameters and physical activity, for instance timing of toe-off (r = -0.40, p = 0.03). Few physical examination parameters were correlated with physical activity, such as the hip flexors selective motor control (r = 0.69 with moderate to vigorous activity and r = 0.70 with steps per day, p < 0.05). The physical activity profile cannot be sufficiently determined by a combination of clinical measures.

Keywords: Cerebral palsy; biomechanics; daily activity; gait analysis; physical activity.

Figure 1.

Flow diagram presents detailed information on the process of recruiting study participants

Figure 2.

Example of daily diary, steps and intensity of physical activity (PA) for one child on one day. A previous verification was made between daily diary and data recorded by accelerometer to validate the wear time. We noticed high level of PA during break time and sport activities, paradoxically moderate to vigorous activity is recorded during videogame, dinner and TV at home. The daily diary was completed by the patient, and it does not discriminate the activities (maybe the child played with active videogame, and they did not specify). Globally, this child spent 18% of his week in MVPA and he made an average of 7187 steps per day