Article

Kinematic analysis of the trunk during cerebral palsy (CP) gait has been well
described. In contrast, movement of the lumbar spine is generally ignored. This is most likely due to the complex nature of the spine. As an alternative to using
complex sensor protocols, this study modelled the lumbar region as a single
segment and investigated characteristic patterns of movement during CP gait. In
addition, the impact of functional level of impairment and the relationship with
lower lumbar spinal loading were examined. Fifty-two children with CP (26 GMFCS I
and 26 GMFCS II) and 26 controls were recruited. A full barefoot 3-dimensional
kinematic and kinetic analysis were conducted. Lumbar segment movement
demonstrated increased forward flexion for CP children. This movement became more
pronounced according to GMFCS level with GMFCS II children demonstrating
increases of up to 8 degrees . In addition, a moderate correlation was present
between lumbar flexion/extension and L5/S1 sagittal moments (r=0.427 in the
global frame and r=0.448 with respect to the pelvis, p<0.01). Children with CP
demonstrated increased movement of the lumbar region compared to TD, with
movement becoming more excessive as GMFCS level increased. Excessive forward
flexion and loading at the lumbar spine were linked. However,
the moderate
correlation suggests other contributors to increased loading were present. In
conclusion, this study is a first step at identifying how lumbar segment movement
is altered during CP gait.
CI - Copyright (c) 2017 Elsevier B.V. All rights reserved.

Langue : ANGLAIS