Skip to main content
Bulletin of Faculty of Physical Therapy
Download PDF
  • Original article
  • Open access
  • Published:

Effect of using visual cognitive task on gait in children with spastic diplegia

Bulletin of Faculty of Physical Therapy volume 20, pages 176–180 (2015)Cite this article

Abstract

Background

Cognitive processing plays an important role in motor performance; thus, the aim of this study was to evaluate the effect of concurrent use of visual cognitive task and gait training task on gait in children with spastic diplegic cerebral palsy.

Participants and methods

Fifteen spastic diplgic cerebral palsied children selected from out patient clinic Faculty of Physical Therapy Cairo University (nine boys and six girls) participated in this study. Children with a mean age of 8.15 ± 1.21 years, with a degree of spasticity 2 according to the modified Ashworth scale, with level II according to the Gross Motor Function Classification System, and having a trunk lurching pattern during gait were selected. They received the physical therapy program for an hour and visual cognitive task during gait training for another hour per day. The treatment program was conducted three times per week for 3 successive months. The lateral trunk lurching and gait parameters (spatial and temporal) were assessed, before and after treatments with the proreflex system.

Results

The results revealed a significant decrease in lateral trunk lurching angle before and after treatment (P < 0.001), a significant decrease in gait speed and cadence, and a significant increase in stride length and time of double limb support before and after treatment (P < 0.001).

Conclusion

The concurrent use of visual cognitive task during gait training in conjunction with physical program improves the stability of trunk and measured gait parameters for children with diplegic cerebral palsy

References

  1. Miller P, Osmotherly P. Does scapula taping facilitate recovery for shoulder impingement symptoms? A pilot randomized controlled trial. J Man Manipulative Ther 2007; 17:6–13.

    Article  Google Scholar 

  2. Rosenbaum P, Paneth N, Leviton A. A report: the definition and classification of CP. Dev Med Child Neurol Suppl 2007; 109:8–14.

    PubMed  Google Scholar 

  3. Reddihough DS, Collins KJ. The epidemiology and causes of cerebral palsy. Aust J Physiotherapy 2003; 49:7–12.

    Article  Google Scholar 

  4. Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N. Proposed definition and classification of cerebral palsy. Dev Med Child Neurol 2005; 47:571–576.

    Article  PubMed  Google Scholar 

  5. Berger W. Characteristics of locomotor control in children with cerebral palsy. Neurosci Biobehav Rev 1998; 22: 579–582.

    Article  CAS  PubMed  Google Scholar 

  6. Panteliadis, C.P. Classification. in: C.P. Panteliadis, H.M. Strassburg (Eds.) Cerebral palsy: principles and management. Thieme, Stuttgart (Germany); 2004.

  7. Tecklin JS. The infant and child with cerebral palsy. In: Pediatric physical therapy. 5th ed. edited by Beaman J, Kalisperis FR, Skomorucha KM. Philadelphia: Lippincott Williams & Wilkins, a Wolters Kluwer business; 2015. 196–246.

  8. Morton, R, Benton, S, Bower, E. Multidisciplinary appraisal of the British Institute for Brain Injured Children, Somerset, UK. Dev Med Child Neurol 1999; 41: 211–212.

    Article  CAS  PubMed  Google Scholar 

  9. Berker N, Yalçin S. The help guide to cerebral palsy. 2nd ed. Seattle, WA: Global Help Organization. Avrupa Medical Bookshop & Publishing, Istanbul (Turkey); 2010.

    Google Scholar 

  10. Dobson F, Morris ME, Baker R. Gait classification in children with cerebral palsy: a systematic review. Gait Posture 2007; 25:140–pp152.

  11. Degelaen M, Leurs F, De Borre L, Kerckhofs E, De Meirleir L. Effect of ankle-foot orthoses in gait in typically developing children: development trend in segmental coordination. J Ped Rehab Med 2010; 3: 163–170.

    Google Scholar 

  12. Warren M. A hierarchical model for evaluation and treatment of visual perceptual dysfunction in adult acquired brain injury, part1. Am J Occup Ther 1993; 47:42–54.

    Article  CAS  PubMed  Google Scholar 

  13. Schneck C. Visual perception. In Case-Smith J. & O’Brien J. (Eds.), Occupational therapy for children (6th ed.). Maryland Heights, MO: Mosby/Elsevier; 2010; 375–433.

  14. Huang HJ. Effects of different concurrent cognitive tasks on temporal-distance gait variables in children. Pediatr Phys Ther 2003; 15: 105–113.

    Article  PubMed  Google Scholar 

  15. Wright DL, Kemp TL. The dual-task methodology and assessing the attentional demands of ambulation with walking devices. Phys Ther 1992; 72: 306–315.

    Article  CAS  PubMed  Google Scholar 

  16. Reilly DS, Woollacott MH, Donkelaar PV. The interaction between executive attention and postural control in dual-task conditions: children with cerebral palsy. Arch Phys Med Rehabil 2008; 89: 834–842.

    Article  PubMed  Google Scholar 

  17. Diamond A, Taylor C. Development of an aspect of executive control: development of the abilities to remember what I said and “do as I say, not as I do.” Dev Psychobiol 1996; 29: 315–334.

  18. Assainte C. Development of locomotor balance control in healthy children. Neurosci Biobehav Rev 1998; 22: 527–532.

    Article  Google Scholar 

  19. Mezzacappa E. Alerting, orienting, executive attention: develop-mental properties and sociodemographic correlates in an epidemiological sample of young, urban children. Child Dev 2004; 75:1373–1386.

    Article  PubMed  Google Scholar 

  20. Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther 1987; 67: 206–207.

    Article  CAS  PubMed  Google Scholar 

  21. Palisano RJ, Rosenbaum P, Bartlett D. Content validity of the expanded and revised gross motor function classification system. Dev Med Child Neurol 2008; 50:744.

  22. Hsue BJ, Miller F, Su FS. The dynamic balance of the children with cerebral palsy and typical developing during gai. Part 1: spatial relationship between COM and COP trajectories. Gait Posture 2009; 3: 465–470.

    Google Scholar 

  23. Mulavara AP, Ruttley T, Cohen HS, Peters BT. Vestibular-somatosensory convergence in head movement control during locomotion after long-duration space flight. J Vestib Res 2012; 22: 153–166.

    Article  CAS  PubMed  Google Scholar 

  24. Sethi V, Raja R. Effects of dual task training on balance & activities of daily livings (adls). Int J Biol Med Res 2012; 3:1359–1364.

    Google Scholar 

  25. Marshall SC, Grinnell D, Heisel B, Newall A, Hunt L. Attentional deficits in stroke patients: a visual dual task experiment. Arch Phys Med Rehabil 1997; 78:7–12.

    Article  CAS  PubMed  Google Scholar 

  26. Bensoussan L, Viton JM, Schieppati M, Collado H. Changes in postural control in hemiplegic patients after stroke performing a dual task. Arch Phys Med Rehabil 2007; 88:1009–1015.

    Article  PubMed  Google Scholar 

  27. O’Connor SM, Kuo AD. Direction-dependent control of balance during walking and standing. J Neurophysiol 2009; 102:1411–1419.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Reynolds RF. Visual guidance of the human foot during a step J Physiol 2005; 569: 677–684.

  29. Hallemans A, Ortibus E, Meire F, Aerts P. Low vision affects dynamic stability of gait. Gait Posture 2010; 32: 547–551.

    Article  PubMed  Google Scholar 

  30. Levitt S. Treatment of cerebral palsy and motor delay. 5th ed. Blackwell Oxford; 2010. 73–74.

  31. Cromwell RL, Pidcoe PE, Griffin LA, Sotillo T. Adaptations in horizontal head stabilization in response to altered vision and gaze during natural walking. J Vestib Res 2004; 14:367–pp373.

  32. Harris LR. Visual–vestibular interactions. In: Squire LR, editor. Encyclopedia of neuroscience. Academic Press, Oxford 2009; 10: 381–387.

  33. Chen R, Hsieh W, Wei S, Kao C. Interactive wiimote gaze stabilization exercise training system for patients with vestibular hypofunction. J Neuroeng Rehabil 2012; 9:77.

  34. Schweigart G, Mergner T, vdokimidis I, Morand S. Gaze stabilization by optokinetic reflex (OKR) and vestibulo-ocular reflex (VOR) during active head rotation inman. Vision Res 199737:1643–1652.

  35. Bruijn SM, Meyns P, Jonkers MI, Kaat D, Duysens J. Control of angular momentum during walking in children with cerebral palsy. Res Dev Disabil 2011; 32:2860–2866.

    Article  PubMed  Google Scholar 

  36. Simoneau GG. Kinesiology of Walking. In: Neumann DA, editor. Kinesiology of the musculoskeletal system: foundations for physical rehabilitation. St Louis, Missouri: Mosby; 2002. 523–569.

  37. Schmidt RA, Wrisberg GA. Motor learning and performance: a problem-based learning approach. Champaign, IL: Human Kinetics; 2008.

    Google Scholar 

  38. Massion J. Postural control system. Curr Opin Neurobiol 1994; 4. 877–887.

  39. Larin H. Quantifying instructional interventions in pediatric physical therapy with themotor teaching strategies coding instrument (MTSCI-1): a pilot study. Internet J Allied Health Sci Pract 2007; 5:1–9.

    Google Scholar 

  40. Van Iersel MB, Ribbers H, Munneke M, Borm GF. The effect of cognitive dual tasks on balance during walking in physically fit elderly people. Arch Phys Med Rehabil 2007; 88: 187–191.

    Article  PubMed  Google Scholar 

  41. Brauer SG, Woollacott MH, Lamont R, Clewett S. Single and dual task gait training in people with Parkinson’s disease: a protocol for a randomised controlled trial (2011)

  42. Brauer SG, Broome A, Stone C, Clewett S, Herzig P. Simplest tasks have greatest dual task interference with balance in brain injured adults. Hum Mov Sci 2004; 23:489–502.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric, Faculty of Physical Therapy, Cairo University, 7 Ahmed Elzayad, Dokki, 12613, Cairo, Egypt

    Zeinb A. Hussein

Authors
  1. Zeinb A. Hussein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zeinb A. Hussein.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hussein, Z.A. Effect of using visual cognitive task on gait in children with spastic diplegia. Bull Fac Phys Ther 20, 176–180 (2015). https://doi.org/10.4103/1110-6611.174716

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1110-6611.174716

Keyword