Analysis of Joint Power and Work During Gait in Children With and Without Cerebral Palsy

Purpose To compare joint work in the lower limb joints during different sub-phases of the gait cycle between Cerebral Palsy (CP) and healthy children. Methods Eighteen CP and 20 healthy children's gait data were collected. The CP group included orthoses, intra-muscular injection of botulinum toxin and surgery groups. A motion capture system was used to collect gait data. Joint work was calculated as positive and negative components in six subphases during gait and normalised by speed when comparing the groups. Results The CP group had a slower walking speed, smaller stride length and longer stance phase than the healthy group. Hip max positive work was 0.12 +/- 0.02 Jkg(-1)/ms(-1) for the CP group in pre-mid-stance but 0.07 +/- 0.01 Jkg(-1)/ms(-1) for the healthy group during the terminal phase. In terminal stance, ankle positive work was significantly lower in the CP group (0.12 +/- 0.01) than in the healthy group (0.18 +/- 0.01). The knee showed a similar distribution of positive work in the stance phase for the two groups. In the ankle and hip, the CP group had energy generation mainly in midstance while the healthy group was mainly in terminal stance. In the ankle, the CP group had larger energy absorption in mid-stance than the healthy children group, while the CP group showed lower energy generation in the terminal stance phase than seen in the healthy group. Conclusion The qualitative and quantitative analysis of joint work provides useful information for clinicians in the treatment and rehabilitation of CP patients.