The effects of dual tasks on gait in children with cerebral palsy.

ABSTRACT

AIM: To assess the gait and cognitive performances of children with cerebral palsy (CP) during dual tasks (DT) in comparison to typically developing (TD) children. METHOD: This prospective, observational, case-control study included 18 children with CP (7 girls, 11 boys; median age 12 [1013] years and 19 controls (9 girls, 10 boys; median age 12 [1013y6mo] years). Performances were recorded during a simple walking task, 5 DT (walking + cognitive tasks with increasing cognitive load), and 5 simple cognitive tasks (while sitting). Gait parameters were computed using an optoelectronic system during walking tasks. Six parameters were selected for analysis by a principal component analysis. Cognitive performance was measured for each cognitive task. The dual-task cost (DTC) was calculated for each DT. RESULTS: Gait performance decreased in both groups as DT cognitive load increased (e.g., walking speed normalized by leg length, in simple task 1.25 [1.151.46] s-1 for CP, 1.53 [1.381.62] s-1 for TD; DT with highest load 0.64 [0.530.80] s-1 for CP, 0.95 [0.751.08] s-1 for TD). The CP group performed significantly worse than TD group in every task (including the simple task), but DTC were similar in both groups. A task effect was found for the majority of the gait parameters. INTERPRETATION: The reduced gait performance induced by DT may generate underestimated difficulties for children with CP in daily-life situations, where DT are common. This should be considered in clinical assessments.