Impact d'un exercice de marche continu sur la démarche «crouch gait»: analyse biomécanique et effet d'un entraînement chez les enfants avec une paralysie cérébrale

 

Audrey Parent

Centre de recherche du CHU Ste-Justine

 

Domaine : Appareil locomoteur et arthrite

Programme : Formation de doctorat

Concours 2016-2017

Partenaire:

Fondation des Étoiles

Cerebral palsy is the most frequent motor disorder in pediatrics, and is related to abnormal motor control resulting in posture and movement disorders, such as reduced walking function. Crouch gait is one of the most common walking pattern reported in children with bilateral cerebral palsy. This gait results in an increase of the joint constraint due to excessive knee flexion, and may lead to long-term degradation of walking ability. Decreased muscle strength generation of the extensor muscle groups during continuous walking exercise representative of daily mobility could lead to a more severe crouch gait pattern.

The first aim of this study is to determine predictive factors concerning the crouch gait deterioration during a walking exercise representative of daily mobility. We suppose that weakness of the knee extensor muscles and the increased knee constraints influence the deterioration of the crouch gait. The second objective of the study is to evaluate the impact of a training program on the deterioration of the crouch gait. We suppose that the improved knee extensor force will lead to a greater fatigue resistance, and therefore a decreased knee flexion during the walking exercise. A gait analysis will be performed to measure joint angles and constraints as well as the muscle activity and fatigue.

Furthermore, a training program will be developed in order to improve muscle force in the lower limbs. At the end, a better knowledge of the progression of crouch gait during daily mobility will give the opportunity to improve therapeutic decisions for children with cerebral palsy who walk with a crouch gait, and to develop walking aids to extend their walking ability.