Influence of Trunk Control on Gait Characteristics and Capacity in Children with Spastic Diplegic Cerebral Palsy

Abstract

Aim: This study was conducted with the aim of to determine the relationship between trunk control and walking with time-distance characteristics and walking capacity in children with spastic diplegic cerebral palsy. Method: The study included 14 children with spastic diplegic cerebral palsy, aged between 7-13 years, who were Level I-II according to Gross Motor Function Classification System. Trunk control was assessed with the Trunk Control Measurement Scale (TCMS; static, dynamic, reach, and total score). Temporo-spatial characteristics of gait were evaluated with a posturography device NeuroCom Inc. by means of a force-plate, and step length (cm), step width (cm), walking speed (cm/s) and right-left symmetry in walking (%) were evaluated. Walking capacity was evaluated with the modified timed get up and go test (mTUG). Relationships between variables were evaluated with Spearman’s Correlation and linear regression analysis. Results: According to the correlation analysis, there was a significantly negative good relationship between the static subscale of TCMS and mTUG (r: -0.754; p<0.01), and a significantly negative excellent relationship between dynamic and reaching subscales and total TCMS scores (respectively r=-0.837; -0.861; -0.872 p<0.01). Additionally, there were significantly good positive correlations between the static subscale of TCMS and step length, step wide and symmetry (respectively 0.624; 0.690; 0.720 p<0.01); a good positive correlation between the dynamic subscale of TCMS and step length, good positive correlation between reaching subscale of TCMS and step length; moderate to good positive correlations between total score of TCMS and step length, step wide and gait symmetry (respectively r:-0.872; 0.677; 0.585; 0.626 p<0.01). According to the regression analysis, the total TCMS score was a predictor of all gait characteristics except gait velocity; and mTUG (R2 = 0.796; 0.394; 0.303; 0.027; 0.320). Conclusion: The results of this study show the importance of trunk control on gait characteristics and capacity in children with spastic diplegic CP.