Comparative Rehabilitation Analysis of Anterior and Posterior Walkers Used by Children with Cerebral Palsy

Kelly M. Baker, MS,¹ Kathy Reiners,³ Lucy Lu,⁴ Sahar Hassani, MS,³ Jeffrey D. Ackman, MD,³ Jeffrey P. Schwab, MD,² John P. Klein, PhD,⁴ Gerald F. Harris, PhD, PE^1,2,3

¹Orthopaedic and Rehabilitation Engineering Center (OREC), Milwaukee, WI
²Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI
³Motion Analysis Laboratory, Shriners Hospital for Children, Chicago, IL
⁴Department of Biostatistics, Medical College of Wisconsin, Milwaukee, WI

ABSTRACT

Walkers are an essential rehabilitative aid to children with spastic diplegic cerebral palsy. Two types of walkers assist in children's ambulation: anterior and posterior. Due to the important role of walkers' in the quality of life, clinicians must carefully consider how patients move with both types of walkers during prescription. Kinematic analyses of patients quantify motion more clearly than visual assessment, and aid in improving patient prescription and rehabilitation. This paper characterizes upper extremity motion in 25 children with spastic diplegic cerebral palsy who use anterior and posterior walkers for ambulation. Results show that patients who use anterior walkers have a lower walking heart rate, but a higher energy expenditure index. Torso and shoulder results reveal significant differences between the two walkers. There are no significant differences in elbow or wrist motions, but there is increased anterior tilt of the torso and decreased shoulder extension with anterior walker usage.

KEYWORDS

Cerebral palsy; kinematics; rehabilitation; upper extremity; walker