Gait stability in children with Cerebral Palsy

Children with unilateral Cerebral Palsy (CP) have several gait impairments, amongst which impaired gait stability may be one. We tested whether a newly developed stability measure (the foot placement estimator, FPE) which does not require long data series, can be used to asses gait stability in typically developing (TD) children as well as children with CP. In doing so, we tested the FPE's sensitivity to the assumptions needed to calculate this measure, as well as the ability of the FPE to detect differences in stability between children with CP and TD children, and differences in walking speed.Participants were asked to walk at two different speeds, while gait kinematics were recorded. From these data, the FPE, as well as the error that violations of assumptions of the FPE could have caused were calculated.The results showed that children with CP walked with marked instabilities in anterior–posterior and mediolateral directions. Furthermore, errors caused by violations of assumptions in calculation of FPE were only small (∼1.5 cm), while effects of walking speed (∼20 cm per m/s increase in walking speed) and group (∼5 cm) were much larger. These results suggest that the FPE may be used to quantify gait stability in TD children and children with CP.

► Children with Cerebral Palsy (CP) are assumed to have an unstable gait.
► The recently developed foot placement estimator (FPE) may be used to estimate gait stability from short walking trials.
► We used the FPE to assess gait stability in typically developing (TD) and CP children, and assessed its validity.
► The FPE indicated that children with CP walked more unstable than TD children.
► Assumption violations lead to changes in FPE much smaller than effects of pathology, rendering the FPE a useful measure.