Passive range of motion changes in young children with spastic diplegia. A study during the initial stages of independent walking

Abstract

PURPOSE: To investigate how the onset of independent walking in children with Cerebral Palsy (CP) influences the Passive Range of Motion (PROM) of lower limb joints. METHOD: Sixteen children with CP, GMFCS levels I and II, and 16 Typical Development (TD) children who had just begun independent walking participated in the study. The PROM of the hip abduction and external rotation, knee extension, popliteal angle, and ankle dorsiflexion was recorded with a goniometer at the onset of independent walking and 8 months later. A repeated-measures two-way ANOVA was conducted to compare the main effects of 'walking experience' and 'group of children' and the interaction effect between them on PROM of lower extremities' joints. RESULTS: The effect of 'group of children' in the PROM was significant; differences were observed between children with CP and TD children for all joints (p< 0.05). The effect of 'walking experience' did not have a significant impact on PROM changes and the interaction effect of 'group of children' and 'walking experience' was also not significant for all the variables. CONCLUSIONS: The alternative gait pattern spontaneously adopted by children with CP does not significantly impact their PROM during the initial stages of walking development. The lower PROM in highly functional children with CP compared to TD children cannot be attributed to gait initiation with an 'atypical' pattern, but possibly to other factors such as reduced voluntary movement and age.