Evaluation of the Applicability and Reliability of the Three Meter Backwalk Test in Children With Cerebral Palsy (CP)
Condition: Cerebral Palsy; Cerebral Palsy Spastic Diplegia; Hemiplegic Cerebral Palsy; Gait, Hemiplegic; Gait, Spastic
MeSH terms: Muscle Spasticity; Paralysis; Cerebral Palsy; Gait Disorders, Neurologic
Study type: Observational [Patient Registry]

Summary: 
      Cerebral palsy (CP) is a non-progressive disturbance in the development of movement and
      posture that occurs in the prenatal or postnatal period, causing activity limitations. Most
      children and adolescents with CP experience limitations in their walking skills. Restrictions
      in the walking ability of children with CP are an important issue for both parents and
      healthcare professionals involved in their treatment.

      The evaluation of walking is of great importance in terms of determining the effectiveness of
      the physiotherapy program, shaping the program, planning orthopedic and surgical
      applications, and determining the effectiveness, especially in children with CP who have
      walking potential. In the literature, easy-to-use, valid and reliable observational gait
      analysis that can evaluate gait pathologies and clinical gait in children with CP are
      emphasized. These measurements are of great importance in clinical practice.The ability of
      backward walking gives the child a different task than normal, allowing the observation of
      body perception, trunk stability provided by anterior-posterior co-contractions, balance,
      correction and protective reactions.
    

Detailed description: 
      The main purpose of CP rehabilitation is to ensure that the child gains maximum functional
      independence by obtaining the optimal development potential. Therefore, walking restrictions
      are one of the important problems in children with CP.

      The most common type in the CP classification is the spastic type. The types with the best
      functional independence level in this group are; hemiparetic and diparetic CP. They do not
      have a good motor coordination due to stability problems caused by deviations in the center
      during walking. This situation affects balance and walking performance. As children get
      older, impairments in their walking ability become more pronounced. In addition to all these
      problems, hypertonus, increased stretching reflex, muscle weakness, coactivation in
      antagonist muscles, posture disorders, loss of proprioception, muscle and joint deformities
      are other factors that cause gait disturbances in children with CP. Therefore, the walking
      problems of the child with CP should be examined more clearly. At this point, it assigns a
      different task to the child with the evaluation of backward walking, and provides observation
      of body perception, trunk stability provided by anterior-posterior co-contractions, balance,
      correction and protective reactions. This observation ensures that the problem that will
      guide the treatment is precisely determined.The only test that can be applied to evaluate the
      ability to walk back is the three meter backward walk test. This test has been found to be
      valid and reliable in both the elderly population and patients with total knee
      arthroplasty.In the literature, there is no study about the three-meter backwalk test in
      children with CP. In this study, it was aimed to evaluate the backward walking skills of
      children with CP with the three meter backward walk test and to examine the applicability and
      reliability of the three meter backward walk test in children with CP.
    

Intervention name(s): assessments
Intervention type(s): Other
Intervention description(s): All assesments will be done by the first physiotherapist. But only 3m backward test will be done by the first and second physiotherapist in the first day and second day.
Other intervention name(s): three meter backward test; Time Up and Go test; Timed Up and Down Stairs Test; Four Square Step Test; Functional Reach Test; Pediatric Berg Balance Scale; demografic information form; gross motor function classification system (GMFCS); modified ashworth scale; Communication Function Classification System
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        - Children aged 8-18 years with a diagnosis of Hemiparetic and Diparetic SP with a Gross
        Motor Function Classification System (GMFCS) Level ≤ 3
      
Keywords: Cerebral Palsy; backward walk; reliability; gait