Influence of Hawthorne Effect and Dual-tasks on Gait in CP

Study design: Observational study

Study population: Patients with cerebral palsy, bilateral spastic, knee flexion gait pattern, GMFCS classification I-III, age 4-16 years.

Objective: To determine the effect of observational awareness (the Hawthorne effect) and dual-tasks on spatiotemporal and kinematic variables during a clinical 3D gait analysis.

Primary research question:

Does reduced observational awareness and/or introduction of a dual-task influence knee flexion in stance phase in children with spastic diplegie cerebral palsy and knee flexion gait?

Secondary research questions:

• Does reduced observational awareness and/or introduction of a dual-task increase toe walking in children with spastic diplegie cerebral palsy and knee flexion gait?
• In children with spastic diplegic cerebral palsy and knee flexion gait, do spatiotemporal gait parameters change when observational awareness is reduced and/or a dual-task is introduced?

Conditions in which gait data will be gathered:

• With awareness of observation + without Dual-task
• With awareness of observation + with Dual-task
• Without awareness of observation + without Dual-task
• Without awareness of observation + with Dual-task

Inclusion criteria

• Cerebral palsy, bilateral spastic, GMFCS classification I-III
• Age <16 years
• Use of bilateral AFO's (rigid or ground reaction AFO's) to improve knee extension in stance

Exclusion criteria

• Behavioural issues or poor instructability which might affect participation in the protocol
• Significant visual disorders
• Other diagnoses influencing gait
• Not willing to sign informed consent before inclusion