How is daily performance associated with gross motor capacity in children with cerebral palsy?

Materials/Methods: All biomechanics data were gathered during a single visit to the medical center's motion analysis laboratory.Loading patterns were collected during 5 walking trials in the UpSee, using the Pedar insole pedobarography system (Novel GMBH).Trial data were averaged and compared to loading patterns collected during 5 "typical" gait trials, which included the use of orthotics and/or assistive devices when required.Novel software was used to calculate weight distribution in different regions of the foot (hindfoot, midfoot, forefoot) and the total foot, with data reported as maximum force normalized to percent body weight.Results: Analysis with the Wilcoxon signed rank test found that total foot force was significantly lower when participants were in the UpSee system (M=54.2,SD=15.7) vs. in typical walking conditions (M=62.7,SD=23.1;z=À2.0251,p<0.05).This appears to be due to a significant decrease in force occurring in the midfoot during UpSee-assisted gait (M=13.8,SD=8.4; typical walking M=17.1, SD=14.5;z=À2.3084,p<0.05).Trends toward decreased hindfoot force and increased forefoot force were also observed in the UpSee condition relative to typical walking condition, but did not meet thresholds for statistical significance.Conclusions/Significance: Typical walking conditions appear to be associated with greater total force and a pattern of forces that more closely approximate a physiologically "healthy" walking pattern (i.e.heel-toe gait).However, the UpSee also promoted active participation during ambulation, as participants did accept load through the lower extremities during UpSee-assisted stepping.Accordingly, this system affords a weight-bearing opportunity in the home/community that may provide a muscle and bone loading benefit over sedentary behavior.