J Neurol 11(Suppl 1):S23–S28. <>/Metadata 769 0 R/ViewerPreferences 770 0 R/PageLabels 771 0 R>> Ye Ma and Yanxin Zhang contributed to the conception and design, as well as the drafting of the article. Brain Dev 18:299–303, Jozsa L, Kannus P, Jarvinen TA, Balint J, Jarvinen M (1996) Number and morphology of mechanoreceptors in the myotendinous junction of paralysed human muscle. Dev Med Child Neurol 51:429–435, Mockford M, Caulton JM (2008) Systematic review of progressive strength training in children and adolescents with cerebral palsy who are ambulatory. Uphill walking requires more knee flexion and ankle dorsiflexion during the stance phase and increased the severity of the pathological gait. The classifications are used as a biomechanical basis, linking spasticity, musculoskeletal pathology in the lower limbs, and the appropriate intervention strategies. Problems caused by CP, such as muscle tightness, weakness, or spasticity, could impede musculoskeletal development and thus result in abnormal gait patterns [3]. Ten spastic cerebral palsy (CP) children and ten typically developing (TD) children were asked to walk at their comfortable speed on a treadmill at a ground level and 10° inclined. The authors would like to thank Jing Zhang and Ruisong Liao for their assistance in the data collection. Sports Med 43:483–512, Ito J, Araki A, Tanaka H, Tasaki T, Cho K, Yamazaki R (1996) Muscle histopathology in spastic cerebral palsy. Mac Keith Press, London Gordon DA, Enoka RM, Stuart DG (1990) Motor-unit This service is more advanced with JavaScript available, Cerebral Palsy Gait Characteristics of Children with Spastic Cerebral Palsy during Inclined Treadmill Walking under a Virtual Reality Environment, The Research Academy of Grand Health, Faculty of Sport Science, Ningbo University, Ningbo, China, Bayi Rehabilitation Center, Chengdu, Sichuan, China, Department of Exercise Sciences, The University of Auckland, New Zealand, Definition of the segment coordination system, Unit vector parallel to the line from S1/L5 to the midpoint between left and right shoulder joint centers, Unit vector perpendicular to the plane formed by the, Unit vector from knee joint center to hip joint center, Unit vector from ankle joint center to knee joint center, Unit vector from toe joint center to subtalar joint center, R. Palisano, P. Rosenbaum, S. Walter, D. Russell, E. Wood, and B. 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Shields, “A systematic review of the effectiveness of treadmill training for children with cerebral palsy,”, M. Willerslev-Olsen, T. H. Petersen, S. F. Farmer, and J. The of 0.01, 0.06, and 0.14 means the small effect, moderate effect, and large effect, respectively [31]. SRC – GoogleScholar, Damiano DL, Arnold AS, Steele KM, Delp SL (2010) Can strength training predictably improve gait kinematics? Significant between-group differences are observed for peak hip abduction moment in the stance phase (, ). To investigate gait characteristics in children with spastic cerebral palsy during inclined treadmill walking under a virtual reality environment. This study was supported by the Zhejiang Provincial Natural Science Foundation of China (Grand Number LQ19A020001), Ningbo Natural Science Foundation (Grand Number 2018A610193), Sichuan Bayi Rehabilitation Centre, and Motekforce Link. Kinetics provides an indication of the causes of the gait abnormalities and the underlying muscle function pathology [10]. %���� stream B. Nielsen, “Gait training facilitates central drive to ankle dorsiflexors in children with cerebral palsy,”, M. Galli, V. Cimolin, M. Crivellini, and G. Albertini, “Gait analysis before and after gastrocnemius fascia lengthening in children with cerebral palsy,”, A. Ancillao, M. M. van der Krogt, A. I. Buizer, M. M. Witbreuk, P. Cappa, and J. Harlaar, “Analysis of gait patterns pre- and post- single event multilevel surgery in children with cerebral palsy by means of offset-wise movement analysis profile and linear fit method,”, F. Camerota, M. Galli, V. Cimolin et al., “Neuromuscular taping for the upper limb in cerebral palsy: a case study in a patient with hemiplegia,”, A. N. Lay, C. J. Hass, and R. J. Gregor, “The effects of sloped surfaces on locomotion: a kinematic and kinetic analysis,”, T. R. Mélo, A. T. B. Guimarães, and V. L. 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The exclusion criteria for both CP and TD children are the absence of (1) severe heart and lung diseases and (2) visual or auditory system disorders. As shown in Table 3, a significant difference is identified in walking speed between CP and TD children (, ). Not affiliated To investigate gait characteristics in children with spastic cerebral palsy during inclined treadmill walking under a virtual reality environment. SLACK, Thorofare, Perry J, Thorofare NJ (1992) Gait analysis: normal and pathologic function. Service, and S. A. Reini, “Improvements in gait speed and weight shift of persons with traumatic brain injury and vestibular dysfunction using a virtual reality computer-assisted rehabilitation environment,”, S. E. Kruger, J. C. Bell, and B. L. Schnall, “Virtual reality enhanced rehabilitation for a service member with bilateral lower extremity amputations: a case study,” in, P. M. McAndrew Young, J. M. Wilken, and J. 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This study is aimed at comprehensively investigating gait adjustment strategies of CP children in level treadmill and uphill treadmill walking under a virtual reality environment (a default setting for a computer-assisted rehabilitation environment (CAREN) system; Motekforce Link, the Netherlands). Cerebral palsy (CP) children present complex and heterogeneous motor disorders that cause gait deviations. Dev Med Child Neurol 40:100–107. both qualitative and quantitative analysis has been used to describe gait; quantitative evaluation (kinematic/kinetic/EMG analysis) have changed how we understand, classify, and treat this condition. A biomechanical study shows that the peak knee joint force could be greater than six times the body-weight for severe crouch gait [35]. Compared to level treadmill walking, uphill walking has a significantly less COM-COP distance in the anterior direction. Abbreviations: GMFCS = Gross Motor Function Classification System; L = left; R = right. The HBM solves the inverse kinematics problem using a nonlinear least squares problem (1). endobj Previous research shows that compared with level treadmill walking condition, the peak hip extension moment, peak knee extension moment, and peak ankle plantar flexion moment are significantly higher when walking uphill at the same speed [13]. These positive values reflect the distance of the feet which were being placed on either side of the COM in the ML direction. Peak knee flexion moment and extension moment during the stance phase do not show significantly main effects in the group and walking condition. Phys Ther 90:269–279, Davids JR, Oeffinger DJ, Bagley AM, Sison-Williamson M, Gorton G (2015) Relationship of strength, weight, age, and function in ambulatory children with cerebral palsy. Ten spastic CP children (age: years old; height: ; weight: ) and ten TD children (age: years old; height: ; weight: ) were included. [9] investigated the effect of inclined treadmill training on CP children. In general, CP children show similar gait adjustments as TD children during uphill walking. To the best of the authors’ knowledge, this is the first time a comprehensive 3D kinematics and kinetics as well as the dynamic stability analysis (except for some angles in the transverse planes) performed for CP children during slope walking under a virtual reality environment. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 25 0 R 38 0 R 46 0 R] /MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Further research is expected to investigate the contributing factors for trunk motion strategies during slope walking. We will be providing unlimited waivers of publication charges for accepted research articles as well as case reports and case series related to COVID-19. These parameters were not included in this study. x��=M��6r��?��^������7�� $k99��9�:����*�X$%u��^�~���b}W�X:}�������ӧ��|���I|��?���雟}���=�O����?~���M�(O�dg;hu��fu���?��N�~�p����ȓ�9�����$OV�����N?�m��ߏ�_�o��K�6��?~��ߜ���������e������ϷөT����i age, and function in ambulatory children with cerebral palsy. The average COP-COM separation in the AP and ML directions is normalized to each participant’s leg length to allow for a comparison between subjects. The review suggested that treadmill training is a safe and feasible method for CP children and can improve walking speed and general gross motor skills.
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