Cerebral palsy (CP) is the most common neuromotor disability in children, with a neonatal prevalence between 1.5 and 2.5 per 1000 live births. One of the main goals of the multidisciplinary team caring for the child with CP is to pinpoint the adequate indications and improve the efficiency of these procedures. Currently, patient’s gait is measured in motion analysis labs with optometric cameras & force plates, a setup where children are sometimes tempted to show their best performance, compared to their movements in real-life. These measurements are made in well equiped hospitals and mobilise lots of resources. They are therefore difficult to use as a routine tool.
At the occasion of the World Cerebral Palsy Day, we would like to share a study which validates the use of wearable systems for gait measurement: a game changing technology in the routine care of children with this condition.
Recent development & validation of new systems will change the current routine subjective visual observation into objective. These easy-to-use and affordable tools allow to measure cohorts of children with this condition, in order to objectivise motion impairments, set clear therapeutic goals and improve health outcomes.
This study compares Gait Up’s Gait Analysis, using wearable foot-worn Physilog® sensors, to a reference optical motion capture system. Inertial sensors and validated algorithms enable the ecological gait spatio-temporal analysis outside of a laboratory environment with good accuracy and precision.
Bourgeois, A.B., Mariani, B., Aminian, K., Zambelli, P.Y. and Newman, C.J.
Spatio-temporal gait analysis in children with cerebral palsy using foot-worn inertial sensors
Gait & Posture (2014)
Keywords: Gait analysis, Inertial sensors, Cerebral palsy, Child
Abstract“A child’s natural gait pattern may be affected by the gait laboratory environment. Wearable devices using body-worn sensors have been developed for gait analysis. The purpose of this study was to validate and explore the use of foot-worn inertial sensors for the measurement of selected spatio-temporal parameters, based on the 3D foot trajectory, in independently walking children with cerebral palsy (CP).We performed a case control study with 14 children with CP aged 6–15 years old and 15 age-matched controls. Accuracy and precision of the foot-worn device were measured using an optical motion capture system as the reference system. Mean accuracy +/- precision for both groups was 3.4 +/- 4.6 cm for stride length, 4.3 +/- 4.2 cm/s for speed and 0.5 +/- 2.98 for strike angle. Longer stance and shorter swing phases with an increase in double support were observed in children with CP (p = 0.001). Stride length, speed and peak angular velocity during swing were decreased in paretic limbs, with significant differences in strike and liftoff angles. Children with cerebral palsy showed significantly higher inter-stride variability (measured by their coefficient of variation) for speed, stride length, swing and stance. During turning trajectories speed and stride length decreased significantly (p < 0.01) for both groups, whereas stance increased significantly (p < 0.01) in CP children only. Foot-worn inertial sensors allowed us to analyze gait spatiotemporal data outside a laboratory environment with good accuracy and precision and congruent results with what is known of gait variations during linear walking in children with CP.