Understanding How Children with Hemiparetic Cerebral Palsy Anticipate Gait

项目摘要/摘要 在美国所有出生时患有脑瘫(CP)的儿童中，30%-40%将被诊断为偏瘫CP (HCP)，表现为身体的一侧比另一侧更弱。由此产生的不对称阻碍了 慢性肥厚性肺囊炎患儿平均分配体重的能力。这通常会导致贫困 平衡时的姿势控制和对健侧的偏爱(增加健侧的负荷) 步态。虽然许多研究已经检查了步态和平衡，但我们的项目是迈向 了解步态和平衡是如何相互影响的。 我们建议一名40人的未来参与者(20名患有HCP的儿童和20名典型的发育中儿童(TD)) 儿童)一次访问研究，以定位和跟踪站立和行走任务中的压力中心(COP)。这 这项工作试图确定步态预期(GA，即开始一步的期望)对平衡和 与TD儿童相比，HCP儿童安静站立时的负荷对称性。这一目标使我们能够填补 关于遗传算法和安静站立平衡之间关系的知识差距。完成这项工作 将首次确定负载对称性对患有HCP儿童的平衡的影响。 这项工作还将确定改变站姿肢体(主导/非主导)对COP的影响 与TD同龄人相比，HCP儿童在步态启动(GI)时的位移和反应时间。 虽然肢体之间的能力有明显的差异(特别是对于患有HCP的儿童)，但没有人 试图对这些差异进行量化或比较分析。评估每条肢体的功能 GI过程中的前肢提供了一个框架，用于评估当完成其他肢体时每个肢体的表现 日常活动，如爬楼梯或翻越障碍物。我们可以将我们的发现应用于揭示 恢复目标不仅侧重于加强更多参与的一方，而且还改善双边关系 才能。

PROJECT SUMMARY/ABSTRACT Of all children in the US born with Cerebral Palsy (CP), 30-40% of them will be diagnosed with Hemiparetic CP (HCP), presenting with one side of the body being weaker than the other. The resulting asymmetries impede the ability of children with HCP to distribute weight evenly between their lower limbs. This, often, contributes to poor postural control and `favoring' of their uninvolved side (increased load on the uninvolved leg) during balance and gait. While many studies have examined gait and balance, our project serves as a foundational first step toward understanding how gait and balance influence one another. We're proposing a prospective, 40 participant (20 children with HCP and 20 typically developing (TD) children) one-visit study to locate and track the center of pressure (COP) during standing and walking tasks. This work seeks to determine the impact of gait anticipation (GA, i.e., expectation of initiating a step) on balance and load symmetry during quiet standing for children with HCP in comparison to TD peers. This aim allows us to fill the gap in knowledge concerning the relationship between GA and quiet standing balance. Completion of this will define for the first time the impact of load symmetry on balance for children with HCP. This work will also determine the impact of changing stance limb (dominant/non-dominant) on COP displacement and reaction time during gait initiation (GI) in children with HCP when compared with TD peers. While there is a clear difference in ability between limbs (especially for children with HCP), no one has attempted to quantify or comparatively analyze these differences. Assessing the ability of each limb to be the leading limb during GI provides a framework for evaluating how each limb performs when completing other daily activities, such as climbing stairs or stepping over obstacles. We can apply our findings toward revealing rehabilitation targets that not only focus on strengthening the more involved side, but also improve bilateral ability.