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An Analysis of Factors Affecting Vertical and Horizontal Obstacle Crossing in Independently Ambulatory Children With Spastic Cerebral Palsy  

Lee, Su-Jin (Dept. of Rehabilitation Center, Youseong Wellness Hospital)
Oh, Duck-Won (Dept. of Physical Therapy, College of Natural Science, Daejeon University)
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Physical Therapy Korea / v.18, no.3, 2011 , pp. 16-25 More about this Journal
This study aimed to evaluate factors related to the ability of ambulatory patients with cerebral palsy (CP) to walk over vertical and horizontal obstacles. Twenty patients with spastic CP who were able to walk independently for at least 10 m with or without walking devices were recruited for the study. Participants were required to walk over small obstacles (1, 4, and 8 cm in height or width; total of 6 conditions). A 'fail' was recorded when either the lower limbs or the walking device contacted the obstacle. Linear regression analyses were used to determine the effects of age, sex, walking devices, eyeglasses, subtype (hemiplegia or diplegia), ankle foot orthoses, functional level, and score of body mass index on the ability of obstacle crossing. Fifteen participants (75%) failed to adequately clear the foot or walking device over obstacles in at least 1 condition. The chance of failure in crossing vertical obstacle was affected by the use of ankle foot orthoses, eyeglasses, gender, and CP subtype (p<.05). The failure rate crossing horizontal obstacle was affected by CP subtype. These findings suggest that rehabilitation procedures should (1) consider the clinical characteristics of patients in order to prepare them to be more independent while performing daily activities, and (2) incorporate environmental conditions that patients encounter at home and in the community.
Affecting factor; Ambulation; Cerebral palsy; Obstacle crossing;
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