Article

Excessive trunk motion has been shown to be characteristic of cerebral palsy (CP)
gait. However, the associated demands on the lower spine are unknown. This study
investigated 3-dimensional reactive forces and moments at the low back in CP
children compared to healthy controls. In addition, the impact of functional
level of impairment was investigated (GMFCS levels). Fifty-two children with CP
(26 GMFCS I and 26 GMFCS II) and 26 controls were recruited to the study.
Three-dimensional thorax kinematics and reactive forces and moments at the low
back (L5/S1 spine) were examined. Discrete kinematic
and kinetic parameters were
assessed between groups. Thorax movement demonstrated increased range for CP
children in all 3 planes while L5/S1 reactive forces and moments increased with
increasing level of functional impairment. Peak reactive force data were
increased by up to 57% for GMFCS I and 63% for GMFCS II children compared to
controls. Peak moment data were increased by up to 21% for GMFCS II children
compared to GMFCS I and up to 90% for GMFCS II compared to control. In addition,
a strong correlation was demonstrated between thorax side flexion and L5/S1
lateral bend moment (r=0.519,
p<0.01) and medial/lateral force (r=0.352, p<0.01).
Children with CP demonstrated increased lower spinal loading compared to TD.
Furthermore, GMFCS II children demonstrated significantly more involvement.
Intervention should be aimed at reducing excessive thorax movement, especially in
the coronal plane, in order to reduce abnormal loading on the spine in this population.
CI - Copyright (c) 2016 Elsevier B.V. All rights reserved.

Langue : ANGLAIS