Research Suggests New Methods of Improving Walking Ability for Children with Spastic CP

A new study from Northwestern University Medical School may have found a new method of helping children with spastic cerebral palsy learn how to be more mobile.   

What is Spastic Cerebral Palsy?

Spastic cerebral palsy is the most common form of cerebral palsy (CP). It is associated with motor control problems, including spasticity, caused by damage to the motor cortex of the brain.

Spasticity affects reactive reflexes and sensitive muscle control. It manifests differently in different areas of the body but does exhibit common patterns, including:

  • Effect on the arms and hands (elbow is bent, wrist is bent, fingers are fisted), which can lead to difficulties with eating and drinking, getting dressed, using the bathroom, writing, manipulating objects and using arms for balance;
  • Effect on the legs, including flexion at the hips or knees, “scissoring” of the thighs, equinovarus foot posture (where toes point downwards and inwards and the heel is off the ground) which can result in difficulties with standing upright, sitting upright, walking, running, and moving and repositioning;
  • Effect on the tongue, facial muscles, or vocal cords, which can result in slurred speech and can affect eating and drinking.

Cerebral Palsy and Walking

As researchers noted in their study, “walking plays a central role in healthy bone development and cardiopulmonary endurance, and children who are able to ambulate are more independent in activities of daily living and the participation in social roles than children who use a wheelchair.”

Yet, up to 90% of children diagnosed with cerebral palsy have difficulties walking. As such, one of the major goals of any rehabilitation therapy is to try and improve children’s walking ability.

The Purpose of the Study

Improvement of motor function in children with CP requires a deep understanding of motor learning mechanisms.

One of the methods that can be used to evaluate motor learning in children is the analysis of movement “errors” and their subsequent aftereffects. These errors often arise when the brain detects a discrepancy between a predicted leg movement and an actual leg movement. Once this discrepancy is detected, the brain then attempts to adjust its motor commands to reduce the discrepancy, generally resulting in a noticeable aftereffect such as taking a larger step.

The purpose of the study was to investigate whether the size and variability of these errors could play a role in motor learning.

How the Study Was Carried Out

Eleven children and adolescents with spastic CP took part in the study. Three were quadriplegic (they had muscle impairment in all limbs) and eight were diplegic (they had impairment of the leg muscles).

All participants were asked to wear a monitor on their right leg above the ankle while walking on a treadmill. Three different types of forces (abrupt, gradual, and noisy) were then applied over three separate testing sessions, and gait parameters were recorded.

Initial results suggested that children with spastic CP adapted to force perturbations by developing an aftereffect in which the length of their steps increased after the force was applied. When a gradual load was applied, the aftereffect lasted longer and the error size was smaller. When an abrupt load was applied, the aftereffect was lesser and the error size was larger.

Results also indicated that higher error variability, achieved by applying different magnitudes of force, seemed to facilitate motor learning in children with spastic CP.

Conclusions

Researchers concluded that:

Results from this study suggest that gradual application of a swing phase resistance load may be more effective in inducing long-term retention of increased step length in children with CP. [These findings] may be used to develop a robotic training paradigm [to improve] walking function of children with CP [in the future]

Why Should You Speak with a Medical Malpractice Lawyer?

A common misconception is that CP is genetic and, therefore, inevitable. In fact, in a very large number of cases, CP is caused by a specific brain injury, usually at birth. If you had complications during your pregnancy, labour and delivery, or birth, and your child suffered a brain injury such as cerebral palsy, you may have legal recourse.

At Sommers, Roth & Elmaleh, our goal is to obtain compensation and financial security for families whose lives have been impacted by cerebral palsy. Over the years, we have won some of the largest medical malpractice awards in Canadian history for our clients. As one of the oldest medical malpractice firms in Toronto, we are well-established and highly respected in the medical malpractice field and have helped clients from all across Canada, including Ontario, Alberta, British Columbia, Saskatchewan, Quebec and Newfoundland.

Compensation for Cerebral Palsy

Parents of a child with cerebral palsy may seek damages (compensation) if a doctor or other medical professional did not:

  • Properly monitor a fetus during childbirth;
  • Predict and respond to probable emergencies during childbirth (e.g. if the umbilical cord is compromised);
  • Respond to fetal distress, asphyxia, or hypoxic-ischemic insult;
  • Perform a timely c-section;
  • Resuscitate an asphyxiated neonate;
  • Treat seizures in a newborn.

In addition to damages that may be awarded to victims and families in recognition of the injuries suffered, families may also be eligible to receive other compensation, including:

  • Funds for medical equipment and supplies not completely covered by the Ontario Assistive Device Program (ADP);
  • Funds for home accessibility modifications (such as the addition of an elevator, therapy pool, therapy room or modified bathroom);
  • Attendant care services (including those that are in addition to any covered by the provincial government, such as private nursing care, personal support workers (PSW), disability support workers (DSW) or rehabilitation support workers (RSW).

Unlike most other personal injury firms, medical malpractice is virtually all we do at Sommers Roth & Elmaleh. We are often successful in cases that other law firms refuse to take or believed will be unsuccessful. Having 40+ years of trial experience, when we are retained by clients we are ready to go with them all the way. If you would like to hear more about how we can help, call us at 1-416-961-1212 or contact us online for a free consultation.

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