Understanding How Children with Hemiparetic Cerebral Palsy Anticipate Gait

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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.