Important findings about spasticity and weakness
This study by Melbourne physiotherapist Brooke Adair characterised the gait patterns of children with HSP. Important questions have emerged about the relative influence of spasticity (muscle spasms or contraction) and muscle weakness to the gait patterns examined. These questions are worthy of further examination.
This study received support funding from the HSP Research Foundation.
To examine the kinematic gait deviations at the trunk and pelvis of children with hereditary spastic paraplegia (HSP).
This exploratory observational study quantified gait kinematics for the trunk and pelvis from 11 children with HSP (7 males, 4 females) using the Gait Profile Score and Gait Variable Scores (GVS), and compared the kinematics to data from children with typical development using a Mann-Whitney U test.
Children with HSP (median age 11y 4mo, interquartile range 4y) demonstrated large deviations in the GVS for the trunk and pelvis in the sagittal and coronal planes when compared to the gait patterns of children with typical development (p=0.010-0.020). Specific deviations included increased range of movement for the trunk in the coronal plane and increased excursion of the trunk and pelvis in the sagittal plane. In the transverse plane, children with HSP demonstrated later peaks in posterior pelvic rotation.
The kinematic gait deviations identified in this study raise questions about the contribution of muscle weakness in HSP. Further research is warranted to determine contributing factors for gait dysfunction in HSP, especially the relative influence of spasticity and weakness.
SOURCE: Dev Med Child Neurol. 2016 Feb 22. doi: 10.1111/dmcn.13082. [Epub ahead of print] © 2016 Mac Keith Press. PMID: 26910787 [PubMed – as supplied by publisher]
Kinematic gait deficits at the trunk and pelvis: characteristic features in children with hereditary spastic paraplegia.
Adair B1, Rodda J2, McGinley JL3, Graham HK4, Morris ME5,6.
1 Centre for Disability and Development Research, Australian Catholic University, Fitzroy, Vic., Australia.
2 Hugh Williamson Gait Laboratory, The Royal Children’s Hospital, Parkville, Vic., Australia.
3 Department of Physiotherapy, University of Melbourne, Carlton, Vic., Australia.
4 Department of Orthopaedic Surgery, The Royal Children’s Hospital, Parkville, Vic., Australia.
5 School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Vic., Australia.
6 Department of Physiotherapy, Cabrini Healthcare, Malvern, Vic., Australia.