Associations between gait kinematics, gross motor function and physical activity among young people with cerebral palsy: A cross sectional study

Abstract

Introduction: The aim of this study was to investigate the association between gait parameters, gross 25 motor function and physical activity (PA) in young people with cerebral palsy (CP). 26 Methods: Thirty-eight adolescents aged between 10-19 years with spastic CP in GMFCS levels I-III (mean 27 [standard deviation] age 13.7 [2.4] yr; 53% female) were included in this cross-sectional study. Hip, knee 28 and ankle joint excursion and stance time was assessed using 3D gait analysis. Self-selected walking 29 speed was assessed during a timed 10m overground walk and treadmill walking. Gross motor function 30 was assessed using dimensions D and E of the Gross Motor Function Measure (GMFM-66). Moderate-to 31 vigorous PA, light PA and step-count were assessed using an accelerometer. Linear regression was used 32 to examine associations. 33 Results: After adjusting for age, sex and GMFCS level, percentage stance time was associated with 34 dimension E of the GMFM-66 (β=-0.29, 95% CI -0.54 to -0.05). There was no evidence that any other gait 35 parameters were associated with GMFM-66 dimensions D or E. There was also no evidence that gait 36 parameters or GMFM-66 dimensions D or E were associated with step-count or time in PA after 37 adjusting for age, sex and GMFCS level. 38 Discussion: The findings provide an insight into the complexity of the relationship between gait quality 39 or ability at the impairment level, function as measured in a controlled environment, and the 40 performance of habitual PA, which is essential for health among children with CP.