Reliability Clinical Trial
Official title:
Reliability and Sources of Variability of 3D Kinematics and Muscle Activation Analysis of Newly-acquired Gait in Toddlers With a Typical Development and a Unilateral Cerebral Palsy
gait reliability study of toddlers with typically developing and with unilateral cerebral palsy during the first 6 months of independent walking
This study aim to assess lower limb kinematics and muscle EMG reliability during gait in
typically developing toddlers and in toddlers with unilateral cerebral palsy with less than 6
months of independent walking experience and secondary to determine three sources of
variability (between subjects, between sessions and between trials) using an optoelectronic
system and a surface EMG system. The third aim was to identify the most reliable gait
parameters.
This was a cross-sectional study conducted between January 2016 and May 2018 in the Motion
Analysis Laboratory of the National Rehabilitation Center for Children (NRCC) "Dr. N.
Robanescu", Bucharest (Romania). The toddlers with UCP were recruited among the inpatients
and outpatients of the Pediatric Rehabilitation department. TD toddlers were recruited among
the siblings of the toddlers with UCP and the children of people known to the investigators.
Given the exploratory nature of this study, the target size of each group was set to a
minimum of 10 participants per group.Toddlers from both groups were younger than 3 years old
and independent walking experience of maximum 6 months. Every child was proposed to be
evaluated in two gait analysis sessions within a period of 30 days. The second gait analysis
session was planned approximately at 14 days from the first one. The two sessions were
performed by the same experienced assessor.
The toddlers walked barefoot at self-selected pace. Each toddler was equipped with 19
reflective markers and 8 surface EMG electrodes. Data was collected with a BTS motion capture
system equipped with 8 infrared cameras and 8 channels EMG system. The biomechanical model
used was "Helen Hayes with medial markers".The EMG electrodes were positioned according to
the SENIAM recommendations over the rectus femoris, the medial hamstrings, the tibialis
anterior and the triceps surae.Visual 3D software (C-motion, Rockville, MD, USA) was used to
build the kinematic model and identify gait cycles. A qualitative analysis was conducted for
each gait cycle and each child in order to exclude the cycles during running or non-straight
walking. Data was filtered and normalized. Three sources of variability (between subjects,
between sessions and between trials) for kinematics and EMG data were quantified by
calculating the standard deviations for each source.Standard Error of Measurement (SEM) for
intertrials and intersessions were also calculated. For TD toddlers, a single value was
reported as the quadratic mean for the right and left sides.
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