Spastic diparetic does not directly affect the capacity to ascend and descend access ramps: three-dimensional analysis

Abstract Introduction: Diplegic children have difficulties in gait and therefore ramps are used as strategies of accessibility. Objective: The present study investigated the influence of an inclined surface (ascending and descending) on the kinematic characteristics during gait of the diplegic group (DG) when compared to typically developing children of the control group (CG). Methods: Study participants included 20 children (10 with DG and 10 CG) matched by age, which were evaluated in three experimental conditions (horizontal and inclined ascending and inclined descending surfaces of 7º) through an optoelectronic imaging system. Results: Among the linear kinematic variables, only step width differed among groups, however, without influence of the surface. The foot height differed among the groups only in the descending phase, where DG had greater difficulty in raising the foot. The 3-dimensional gait analyses could not provide more evidences of differences in kinematics variables, especially in transverse plane, between DG and CG, but provide some evidence to support that hip range of motion (ROM) during the gait cycle, hip flexion-extension in initial contact, knee ROM and the 2nd anterior-posterior trunk peak amplitude of the DG were influenced on descent by their flexor pattern. Conclusion: The DG was most affected by the inclination plane than CG especially on descent. Although a hip and knee flexor pattern is evident for DG on inclination of 7º, this angle is accessible since it allows independent gait functional activity. Resumo Introdução: Crianças com diplegia apresentam dificuldades na marcha e rampas são utilizadas como estratégia de acessibilidade. Objetivo: O presente estudo investigou a influência da superfície inclinada (subida e descida) sobre as variáveis cinemáticas durante a marcha no grupo com diplegia (GD) comparado ao grupo de crianças com desenvolvimento típico no grupo controle (GC). Métodos: Participaram do estudo 20 crianças (10 GD e 10 GC) pareadas por idade, as quais foram avaliadas em 3 condições experimentais (horizontal, subida e descida de 7º) por meio de um sistema de imagem optoeletrônico. Resultados: Nas variáveis cinemáticas lineares apenas o comprimento do passo diferiu entre os grupos sem influência da inclinação do plano. A altura do pé diferiu entre os grupos na descida, com maior dificuldade do GD em elevar o pé. A análise tridimensional da marcha não permitiu identificar diferenças cinemáticas no plano transverso