Changes in lower extremity kinematics with free and restricted arm swings in children with unilateral cerebral palsy.

BACKGROUND

Children with unilateral cerebral palsy (UCP) often exhibit asymmetry, which significantly impacts gait function. Arm swing plays a crucial role in gait mechanics and asymmetric arm movements are hypothesized to influence lower extremity kinematics.

RESEARCH QUESTION: How does restricting arm swing in children with unilateral cerebral palsy affect the kinematic parameters of lower extremity?

METHODS

A prospective cohort study was conducted with 19 children aged 5-18, diagnosed with UCP, who were able to walk independently. Participants underwent 3D gait analysis under four conditions: no arm restriction (NAR), healthy arm restricted (HAR), affected arm restricted (AAR), and both arms restricted (BAR). Comparative analysis was conducted using the Friedman Test and multiple pairwise comparisons with bootstrapping.

RESULTS

Pelvic rotation and obliquity showed significant improvements with HAR compared to NAR, with the pelvis moving closer to neutral alignment. Knee flexion during the swing phase increased with BAR, addressing a common deficit in UCP patients. Ankle dorsiflexion improved with both arm restrictions but remained impaired with only HAR.

CONCLUSION

In conclusion, arm restriction has an influence on lower extremity gait kinematic in children with UCP. Restriction of the unaffected arm movement has a corrective effect on pelvic kinematics. Similarly, restricting both arms improve swing phase knee flexion. These results can be useful for gait rehabilitation strategies of UCP children.