Gait adaptations of individuals with cerebral palsy on irregular surfaces: A scoping review.
Study Goal
The researchers aimed to describe gait adaptations to irregular surfaces in individuals with cerebral palsy (CP) and compare these adaptations to those of healthy individuals.
Results Summary
The study found that individuals with CP exhibit different gait adaptations on irregular surfaces compared to flat surfaces and across CP subtypes, with both typical and pathology-specific adaptations relative to healthy individuals. The review also highlighted the need for more ecologically valid data collection approaches in future studies.
Population
152 individuals with CP (117 with diplegia, 35 with hemiplegia) and 159 healthy individuals.
Effective Dosage
Not applicable
Duration
Not applicable
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
walking on irregular surfaces | no change | stability | individuals with cerebral palsy | - | require adaptations | #1 |
walking on irregular surfaces | no change | avoid falls | individuals with cerebral palsy | - | require adaptations | #2 |
laboratory gait assessments under ideal conditions | no change | gait problems | individuals with cerebral palsy | - | may overlook subtle problems | #3 |
increased knowledge of adaptations to navigate irregular surfaces | no change | everyday walking barriers | individuals with cerebral palsy | - | may contribute to a better understanding | #4 |
walking on irregular surfaces | no change | gait adaptations | individuals with cerebral palsy | - | adaptations differ from flat surface walking | #5 |
walking on irregular surfaces | no change | gait adaptations | individuals with cerebral palsy | - | adaptations differ across CP subtype | #6 |
walking on irregular surfaces | no change | gait adaptations | individuals with cerebral palsy | - | present with typical and pathology-specific adaptations | #7 |
BACKGROUND: Individuals with cerebral palsy (CP) have a reduced ability to perform motor tasks such as walking. During daily walking, they are confronted with environmental constraints such as irregular surfaces (e.g., relief and uneven surfaces) which may require adaptations to maintain stability and avoid falls. Laboratory gait assessments are conventionally conducted under ideal conditions (e.g., regular and even surfaces) and may overlook subtle problems which may only present in challenging walking environments. Increased knowledge of adaptations to successfully navigate irregular surfaces may contribute to a better understanding of everyday walking barriers. RESEARCH QUESTION: This scoping review aims to describe gait adaptations to irregular surfaces in individuals with CP and contrast adaptations with those of healthy individuals. METHODS: This review followed the 6-stage Joanna Briggs Institute methodology and respected the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews statement. The MEDLINE, EMBASE, CINAHL, SPORTDiscus, and Web of Science databases were searched on March 2021. RESULTS: The research strategy identified 1616 studies published between 2014 and 2020, of which 10 were included after abstract and full-text screening. This review reported on 152 individuals with CP (diplegia: n = 117, hemiplegia: n = 35) and 159 healthy individuals. The included studies focused on spatial-temporal, kinematic, kinetic, and muscle activity parameters over relief, inclined, and staircase surfaces. 7/10 studies were conducted in laboratories, often using surfaces that are not representative of the real-world. The results suggest that for individuals with CP, adaptations on irregular surfaces differ from flat surface walking and across CP subtype. Moreover, individuals with CP present with typical and pathology-specific adaptations to irregular surfaces compared to healthy individuals. SIGNIFICANCE: This review highlights the clinical and research interest of focusing future studies on more ecologically valid data collection approaches and provides important recommendations to overcome research gaps in the existing literature.