Gait rehabilitation needs a hand: the inclusion of arm movements in gait rehabilitation training for patients with Cerebral Palsy.

We will investigate whether children with unilateral Cerebral Palsy (CP) are able to intentionally increase arm swing on the hemiplegic side and if there are non-invasive ways to optimize the increase of the swing amplitude by providing auditory feedback. Of particular interest is the effect of this short term training on the gait pattern. Secondly we will evaluate the integrity of brain white matter connections in order to find the neural correlates of the pathological arm swing during gait in CP. An early study did reveal that the location and size of the brain lesion correlates with the severity of hand function deficits (e.g. reaching and grasping) in children with unilateral CP. However, it is unknown whether this pertains also to arm swing in a locomotor context. Moreover, we will test whether the degree of microstructural integrity of these pathways is predictive of gait recovery after arm swing manipulation. This would allow us to pre-select the subset of CP children that would benefit most from the inclusion of arm swing training for future rehabilitation programs, based on the quality of their anatomical connections. For example, it might not be possible to normalize the arm swing in children in which the corticospinal tract is severely damaged.

Keywords:Cerebral Palsy, Arm swing, Gait, White brain matter, Neural correlates, Rehabilitation

Disciplines:Orthopaedics, Human movement and sports sciences, Rehabilitation sciences