Relationship between spatiotemporal parameters and clinical outcomes in children with bilateral spastic cerebral palsy: Clinical interpretation proposal

Abstract

Background: Understanding the links between gait disorders, impairments, and activity limitations is essential for correctly interpreting the instrumented gait analysis.We aimed to evaluate the relationships between spatiotemporal parameters and clinical outcomes in children with bilateral spastic cerebral palsy, and find out whether spatiotemporal parameters provide clinical information regarding gait pattern and walking. Methods: Data from 19 children with bilateral spastic cerebral palsy (nine males, ten females, 9.6 ± 2.8 years old) were collected retrospectively. All children underwent an instrumented gait analysis and a standardized clinical assessment. Seven spatiotemporal parameters were calculated: non-dimensional cadence, stride length, step width, gait speed, first double support, single support, and time of toe off. Clinical outcomes included measures of two different components of the International Classification of Functioning, Disability and Health - Children and Youth version: body functions and structures (spasticity, contractures and range of motion, and deformities), and activities and participation (gross motor function, and walking capacity). Pearson correlation, ANOVA, Student’s t, ManneWhitney U, and Kruskal eWallis tests were used to analyze relationships. Spatiotemporal parameters related to clinical outcomes of body functions and structures were interpreted as outcome measures of gait pattern, while those related to clinical outcomes of activities and participation were interpreted as outcome measures of walking. Results: Non-dimensional cadence, stride length, and gait speed showed relationships (p < 0.05) with hip flexors spasticity and hindfoot deformity, ankle plantar flexors spasticity, and hindfoot deformity, respectively. All spatiotemporal parameters except non-dimensional cadence showed correlation (p < 0.05) with gross motor function and walking capacity. Conclusions: Spatiotemporal parameters provide clinical information regarding both gait pattern and walking.