Reliability of Newly-acquired Gait in Toddlers With a Typical Development and a Unilateral Cerebral Palsy
Condition: Gait, Spastic; Reliability
MeSH terms: Cerebral Palsy; Gait Disorders, Neurologic
Study type: Interventional

Summary: 
      gait reliability study of toddlers with typically developing and with unilateral cerebral
      palsy during the first 6 months of independent walking
    

Detailed description: 
      This study aim to assess lower limb kinematics and muscle EMG reliability during gait in
      typically developing toddlers and in toddlers with unilateral cerebral palsy with less than 6
      months of independent walking experience and secondary to determine three sources of
      variability (between subjects, between sessions and between trials) using an optoelectronic
      system and a surface EMG system. The third aim was to identify the most reliable gait
      parameters.

      This was a cross-sectional study conducted between January 2016 and May 2018 in the Motion
      Analysis Laboratory of the National Rehabilitation Center for Children (NRCC) "Dr. N.
      Robanescu", Bucharest (Romania). The toddlers with UCP were recruited among the inpatients
      and outpatients of the Pediatric Rehabilitation department. TD toddlers were recruited among
      the siblings of the toddlers with UCP and the children of people known to the investigators.
      Given the exploratory nature of this study, the target size of each group was set to a
      minimum of 10 participants per group.Toddlers from both groups were younger than 3 years old
      and independent walking experience of maximum 6 months. Every child was proposed to be
      evaluated in two gait analysis sessions within a period of 30 days. The second gait analysis
      session was planned approximately at 14 days from the first one. The two sessions were
      performed by the same experienced assessor.

      The toddlers walked barefoot at self-selected pace. Each toddler was equipped with 19
      reflective markers and 8 surface EMG electrodes. Data was collected with a BTS motion capture
      system equipped with 8 infrared cameras and 8 channels EMG system. The biomechanical model
      used was "Helen Hayes with medial markers".The EMG electrodes were positioned according to
      the SENIAM recommendations over the rectus femoris, the medial hamstrings, the tibialis
      anterior and the triceps surae.Visual 3D software (C-motion, Rockville, MD, USA) was used to
      build the kinematic model and identify gait cycles. A qualitative analysis was conducted for
      each gait cycle and each child in order to exclude the cycles during running or non-straight
      walking. Data was filtered and normalized. Three sources of variability (between subjects,
      between sessions and between trials) for kinematics and EMG data were quantified by
      calculating the standard deviations for each source.Standard Error of Measurement (SEM) for
      intertrials and intersessions were also calculated. For TD toddlers, a single value was
      reported as the quadratic mean for the right and left sides.
    

Intervention name(s): gait analysis
Intervention type(s): Other
Intervention description(s): gait analysis with 3D optoelectronic system and surface EMG
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: cross-sectional study with 2 groups of toddlers (with typical developing and with unilateral cerebral palsy) recorded twice in gait analysis within 30 days interval
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: toddlers; 3D motion analysis; EMG; reliability