Towards an Understanding of the Intersegmental Coordination and Variability of Upper and Lower Extremities During Walking in Children with Cerebral Palsy and Typically Developing Controls

Understanding the communication patterns between body segments of individuals can help us recognize the effects of neuromuscular deficiencies and the coordination challenges accompanying them, such as those likely to affect children with cerebral palsy. Intersegmental coordination can be influenced in cerebral palsy patients. This study compares the whole-body intersegmental coordination patterns observed in the sagittal plane in typically developing controls and patients with cerebral palsy (CP) during free-speed walking. There were ten age-matched children in each group walking at their preferred speed. Motion data were collected using the Vicon 3D motion capture system. The continuous relative phase was calculated using segment angles and angular velocities for each point in the sagittal plane. The relative phase analysis method was utilized to quantify coordination and stability by considering the mean absolute relative phase (MARP) and deviation phase (DP). The coordination and stability indices were determined for each side of the body and the gait swing and stance phases. Whole-body intersegmental analysis includes the relation between clavicle-thorax, thorax-pelvis, pelvis-femur, femur-tibia, tibia-foot, and foot-toe on either side. The Mann-Whitney U test was utilized to evaluate the mean values of DP and MARP between two groups on each side. The statistical analysis results demonstrated less coordination and stability in the CP group. Still, the difference between the CP and TD groups' variability index is insignificant compared to the difference in the coordination index.