Posterior walker assisted on gait performance in children with spastic diplegic cerebral palsy

To make children who may lose some basic skills to accomplish walking or may have delayed in walking development is a very important issue. Gait in these children may exhibit the following characteristics: poor motor control, poor balance, muscle strength insufficiently, and muscle incoordination. Their mobility may depend upon the use of assistive devices such as canes, walkers, etc. These aids can improve balance and stability or provide body-weight support. They also facilitate forward progression of gait. However, selection and adjustment of walkers are often based on a subjective impression of the children’s gait observed by the physician and therapists. There seem not enough information regarding proper selection in choosing the walker design to best suit the children or in comparing the effects on gait load and stability of one design versus the others. Previous researches have studied children with CP and walker usage about lower extremity movement. However, these studies have not quantified upper extremity motions. From the viewpoint of biomechanics, the weight bearing of whole body and the force of upper extremity may influence the usage of walker. So, walker selection requires further study on the full range of upper and lower extremity. The purpose of this study is to analyze the effects of different gait performances of spastic diplegic CP who use different heights of posterior walkers for ambulation. Four spastic diplegic cerebral palsies, of average age 6.75 years, were enrolled in this study. They are all familiarized themselves with posterior walkers. Gait characteristics were evaluated and observed by computer-based kinematics gait analysis using EVaRT 4.6 Motion Analysis, and force analysis by AMTI force plate and force transducers. The conclusion of this study is the different heights of posterior walker would have different effect on gait performance while spastic diplegic cerebral palsy ambulated with walker. In clinic, we should adapt the walkers according to different goals and different abilities of users.