Clinical Factors Associated With Walking Speed in Individuals With Cerebral Palsy at GMFCS Level II

Purpose: This study investigated the clinical factors associated with the walking speed of individuals with cerebral palsy classified as Gross Motor Function Classification System (GMFCS) level II.Methods: This cross-sectional study included 67 participants with cerebral palsy at GMFCS level II.The walking speed, lower-extremity muscle strength, joint range-of-motion limitations, balance ability, and gross motor function were assessed.Spearman correlation analyses with false discovery rate correction were performed.Hierarchical multiple linear regression was used to identify the factors independently associated with the walking speed after adjusting for age, height, and cerebral palsy type.Results: The walking speed was positively correlated with the hip extensor strength (ρ = 0.442, p < 0.001), hip abductor strength (ρ= 0.373, p= 0.002), and Berg Balance Scale score (ρ= 0.474, p< 0.001), and negatively correlated with the hip extension limitation (ρ= -0.462, p< 0.001) and knee extension limitation (ρ= -0.477, p< 0.001).All associations remained significant after a false discovery rate correction.In the adjusted regression model, greater hip extension limitation was independently associated with a slower walking speed (B = -0.018,β = -0.408,p = 0.001), whereas a higher Berg Balance Scale score was associated with a faster walking speed (B= 0.016, β= 0.412, p= 0.020).Conclusion: Hip extension limitation and balance ability were independently associated with walking speed in individuals with cerebral palsy at GMFCS level II.These findings suggest that hip mobility and balance should be considered when assessing and planning interventions to improve the walking performance.