Normalizing step-to-step variability to age in children and adolescents with hemiplegia.

Autor: Prosser LA; Division of Rehabilitation Medicine, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA. Electronic address: prosserl@chop.edu., Atkinson HL; Department of Physical Therapy, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address: atkinsonh@chop.edu., Alfano JM; Department of Physical Therapy, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address: alfanoj@chop.edu., Leff M; University of North Carolina, Chapel Hill, NC, USA; Center for Public Health Readiness and Response, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA., Kessler SK; Division of Pediatric Neurology, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA. Electronic address: kesslers@chop.edu., Gouelle A; Performance, Santé, Métrologie, Société (PSMS), UFR STAPS (University of Sport Sciences), 51100 Reims, France; Gait and Balance Academy, ProtoKinetics, Havertown, PA 19083, USA., Ichord RB; Division of Pediatric Neurology, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA. Electronic address: ichord@chop.edu.
Jazyk: angličtina
Zdroj: Gait & posture [Gait Posture] 2022 Oct; Vol. 98, pp. 6-8. Date of Electronic Publication: 2022 Aug 18.
DOI: 10.1016/j.gaitpost.2022.08.009
Abstrakt: Background: Children with hemiplegia often demonstrate gait deviations including increased variability and asymmetry. Step-to-step gait variability decreases over childhood and increases in the presence of neurologic dysfunction. Gait variability in children with hemiplegia should therefore be interpreted in reference to age-related norms RESEARCH QUESTION: Does conversion of the enhanced gait variability index (eGVI) to age-normalized z-scores improve interpretation of gait variability in children with hemiplegia?
Methods: Ten children (11.2 +/- 4.1 years) with hemiparetic gait due to stroke were recruited for a small prospective pilot intervention study. Participants walked at self-selected speed over an instrumented walkway while barefeet and while wearing shoes. eGVI values from baseline sessions were calculated and converted to age-normalized z-scores (eGVI z ) based on published norms. Differences in gait variability between sides and footwear conditions, and its relationship to walking speed, were examined.
Results: There were no differences in raw eGVI or eGVI z between paretic and nonparetic sides (eGVI p = 0.31; eGVI z p = 0.31) or between footwear conditions (eGVI p = 0.62; eGVI z p = 0.33). Average raw eGVI values were just over two standards deviations above the reference mean of 100 (121.2, 122.1, 120.3 for mean (average of both limbs), nonparetic side and paretic side, respectively), indicating significantly greater step-to-step gait variability than in typical gait. However, when converted to age-normalized z-scores (eGVI z ), variability deviated less from the normative sample, averaging just over one standard deviation above the reference mean (1.2, 1.3, 1.1 for mean, nonparetic side and paretic side, respectively). We also observed a relationship between eGVI z and walking speed in our sample.
Significance: We suggest that eGVI values in children be converted to z-scores or otherwise age-normalized so as not to inflate the degree of variability reported in clinical pediatric populations. Future work with larger samples will offer greater insight into gait variability in various clinical pediatric populations.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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