Study of the Relationships Between Gait Characteristics and Brain Function in Children With Cerebral Palsy During Walking.

Abstract

To investigate gait characteristics and cortical function in children with cerebral palsy (CP) during walking and to explore potential associations between them, providing a theoretical basis for rehabilitation. Observational cross-sectional study. Participants performed an 8-minute walking task by walking back and forth along a corridor ∼50 m. Cerebral hemoglobin oxygenation was recorded using functional near-infrared spectroscopy, and gait parameters, including temporal and kinematic angle measures, were collected. Cortical activation and functional connectivity were analyzed using the wavelet transform, and gait metrics reflecting symmetry, variability, and coordination were extracted. Gait metrics and brain functional metrics were compared between the 2 groups, and a regression model combined with bootstrapping was applied to explore the associations between gait characteristics and brain function. Rehabilitation hospital outpatients (children with CP) and community recruitment (children who are typically developing (TD)) PARTICIPANTS: Twenty-nine children with CP and 24 children who are TD were recruited. After screening, 25 children with CP and 20 children who are TD were included. Not applicable. Gait metrics, brain functional metrics, and the associations between them. The children with CP showed significantly lower wavelet phase coherence than children who are TD and exhibited pronounced gait asymmetry and greater variability. Regression analyses identified 22 gait metrics in children with CP that exhibited stable associations with brain function, most of which were kinematic angle metrics. Among children with CP, lower kinematic angle variability, poorer coordination, and greater asymmetry appeared to be associated with higher wavelet phase coherence. Different gait patterns and cortical activity were observed between the 2 groups. Kinematic angle metrics may play a key role in gait assessment. Association analyses indicated that certain gait metrics may be related to changes in brain activity in children with CP, and the methodology may serve as a means to study the effect of interventions.