Article

Asymmetry between limbs in people with spastic hemiplegic cerebral palsy (HEMI)
adversely affects limb coordination and energy generation and consumption. This
study compared how the affected leg and the unaffected leg of children with HEMI
would differ based on which leg trails. Full-body gait analysis data and
force-plate data were analyzed for 31 children (11.9 +/- 3.8 years) with HEMI and
23 children (11.1 +/- 3.1 years) with typical development (TD). Results showed
that peak posterior center of mass-center of pressure (COM-COP) inclination
angles of HEMI were smaller than TD when the affected leg trailed but not when
the unaffected leg trailed. HEMI showed greater peak medial COM-COP inclination
angles and wider step width than TD, no matter which leg trailed. More
importantly, when the affected leg of HEMI trailed, it did not perform enough
positive work during double support to propel COM motion. Consequently, the
unaffected leg had to perform additional positive work during the early portion
of single support, which costs more energy. When the unaffected leg trailed, the
affected leg performed more negative work during double support; therefore, more
positive work was still needed during early single support, but energy efficiency
was closer to that of TD. Energy recovery factor was lower when the affected leg
trailed than when the unaffected leg trailed; both were lower than TD. These
findings suggest that the trailing leg plays a significant role in propelling COM
motion during double support, and the 'unaffected' side of HEMI may not be
completely unaffected. It is important to strengthen both legs.
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Langue : ANGLAIS