Pediatric Physical Therapy:
Section Information: Abstracts of Poster and Platform Presentations for the 2004 Combined Sections Meeting: Poster Presentations
PERFORMANCE ON THE STANDARDIZED WALKING OBSTACLE COURSE (SWOC) FOR MATCHED PAIRS OF CHILDREN WITH CEREBRAL PALSY AND TYPICAL DEVELOPMENT.
K. Kott, Physical Therapy Education, SUNY Upstate Medical University, Syracuse, NY, S. Held, M. Franjoine, Physical Therapy, Daemen College, Amherst, NY B. Engbretson, Health Science and Human Studies, SUNY Upstate Medical University, Syracuse, NY.
PURPOSE/HYPOTHESIS: The purpose was to examine the normative data on the Standardized Walking Obstacle Course (SWOC), supporting its construct validity (known groups) as a test of functional ambulation and balance in children with and without disabilities.
NUMBER OF SUBJECTS: Children with cerebral palsy (CP) and typical development (n = 17 pairs) were matched for age (range 5–15 years; mean 8 years, 8 months), gender (9 female pairs, 8 male pairs), and body mass index (range 14.66–26.31 kg/m2; mean 18.14 kg/m2).
MATERIALS/METHODS: The SWOC is a 39.5 foot long and 36 inch wide angled path with chairs at each end, surface changes (shag rug, very colorful mat), and obstacles (large trash can, standard crutch). Children were randomly assigned a start condition on the SWOC: arms free, carrying a lunch tray with place setting, and wearing shaded glasses walking for a total of six trials. The time and number of steps to complete the course, stumbles, and steps off the path were recorded. ANOVA was used to analyze the effects of group and condition on the SWOC on time and number of steps. Chi-Square was used to determine whether stumbles and steps off were associated with both group and condition. RESULTS: For time and number of steps, there were significant main effects for group and condition (F 24.6, P < 0.0001; F 73.9, P < 0.0001, respectively) and an interaction effect (F 13.2, P > 0.0001). There were average increases in time and number of steps (46% and 35%, respectively) for children with CP across all three conditions. Chi-Square Tests of Independence were significant for steps off ( 2 42.5, P < 0.0001) and stumbles ( 2 40.5, P < 0.0001). Only 10% of the children with CP had no steps off compared to 71% of their peers. 57% of the children with CP had one or more stumbles compared to 100% of their peers with no stumbles.
CONCLUSIONS: There were highly significant differences on all measures of the SWOC between children with CP and typical development. The interaction effect, while highly significant, showed no differences in the relative ranking of the groups for the different conditions of the SWOC. Therefore, children with CP on all conditions of the SWOC took longer, used more steps, and had more stumbles and more steps off the path than their peers.
CLINICAL RELEVANCE: For this group of children, the SWOC was able to distinguish the children with CP from those developing typically on functional gait and balance.