Article

Information on altered foot pressures during ambulation would clarify
how far limb deformities modify walking patterns in cerebral palsy (CP), and
whether such data can inform prognosis and guide rehabilitation. OBJECTIVE: To
compare patterns of plantar pressures during walking between children with CP and
their able-bodied (AB) peers. METHODS: Twenty-five children/adolescents (10 with
hemiplegia, 5 with diplegia, and 10 AB, respective ages 13.0 +/- 1.9, 13.0 +/-
0.6 and 14.0 +/- 0.7 years) walked a 12 m line at a self-selected speed.
Spatio-temporal parameters and peak in-shoe plantar pressures were recorded for
both feet, using the Parotec analysis system. RESULTS: Walking speeds (m.-1)
differed significantly between groups (0.65 +/- 0.13, hemiplegia, 0.93 +/- 0.22
diplegia and 1.26 +/- 0.05 AB), with shorter stride lengths in CP. Contact time,
double support time and step duration were also shorter in hemiplegia. Plantar
pressures differed substantially and consistently between AB and CP, with
increased medial heel pressures in hemiplegia, and reduced hallux and lateral
heel pressures but increased lateral, medial mid-foot and first metatarsal
pressures in diplegia. CONCLUSIONS: Substantial alterations in spatio-temporal
parameters (greater in hemiplegia than in diplegia) and plantar pressure
distribution reflect attempts to compensate for poor stability of posture in CP.
Further study of these adaptive changes holds clinical promise in providing data
relevant to the design of orthotics, determinations of prognosis and the planning
of neurorehabilitation.

Langue : ANGLAIS