ABSTRACT
Background: A walker is an assistive device used to provide stability and relieve full or partial weight bearing on a lower extremity. These are frequently prescribed to children with Cerebral Palsy (CP) to provide additional stability during ambulation. Traditionally, anterior and posterior walkers have been used as walking aids but the information about the use of these walkers in terms of gait and energy consumption is lacking.
Aim: The purpose of this study is to compare the efficacy of a novel walker with the traditional posterior walker in terms of gait parameters and energy expenditure in subjects with spastic diplegic CP.
Methods: A novel walker consists of two rigid square frames attached with four wheels and a handle with height adjustment features is constructed. A seat is attached to the upper square frame for sitting provision and reducing fatigue. 30 spastic diplegic CP children (mean age: 6.6 ±1.4 years) with poor trunk control were subjected to a 10-meter walk test for measuring gait parameters (step length, stride length, velocity, cadence, and walking width) and energy expenditure in the form of physiological cost index. The post-test comparison was performed between both walkers and the data was analyzed through an Independent Students t-test with a significance level (α) set at 0.05.
Results: The subjects walked with significantly higher velocity (18%) and improved PCI (58%) using a novel walker compared to the posterior walker (p<0.05). However, other temporal-spatial gait parameters did not show any statistical difference (p˃0.05), although these were improved with the use of novel walker compared to the posterior walker.
Conclusion: The novel walker improves the gait parameters and energy expenditure, and therefore, its use may be encouraged as an adjunct to physical and orthotic therapy in subjects with spastic diplegic CP.
Keywords: Cerebral palsy; efficacy; energy; gait; novel; posterior; walker