Abstract：
This longitudinal study investigated the impact of the first independent steps on harmonic gait development in unilateral cerebral palsy (CP) and typically developing (TD) children. We analysed the gait ratio values (GR) by comparing the duration of stride/stance, stance/swing and swing/double support phases. Our investigation focused on identifying a potential trend towards the golden ratio value of 1.618, which has been observed in the locomotion of healthy adults as a characteristic of harmonic walking. Locomotor ability was assessed in both groups at different developmental stages: before and after the emergence of independent walking. Results revealed that an exponential fit was observed only after the first unsupported steps were taken. TD children achieved harmonic walking within a relatively short period (approximately one month) compared to children with CP, who took about seven months to develop harmonic walking. Converging values for stride/stance and stance/swing gait ratios, averaged on the two legs, closely approached the golden ratio in TD children (R2 = 0.9) with no difference in the analysis of the left vs right leg separately. In contrast, children with CP exhibited a trend for stride/stance and stance/swing (R2 = 0.7), with distinct trends observed for the most affected leg which did not reach the golden ratio value for the stride/stance ratio (GR = 1.5), while the least affected leg exceeded it (GR = 1.7). On the contrary, the opposite trend was observed for the stance/swing ratio. These findings indicate an overall harmonic walking in children with CP despite the presence of asymmetry between the two legs. These results underscore the crucial role of the first independent steps in the progressive development of harmonic gait over time.
摘要：
这项纵向研究调查了第一个独立步骤对单侧脑瘫（CP）和典型发育（TD）儿童的谐波步态发育的影响。我们通过比较步幅/站立的持续时间来分析步态比率值(GR)，姿态/摆动和摆动/双支撑阶段。我们的调查重点是确定黄金比率值为1.618的潜在趋势，这在健康成年人的运动中被观察到是谐波行走的特征。在独立行走出现之前和之后的不同发育阶段，对两组的运动能力进行了评估。结果表明，仅在采取第一个不受支持的步骤后才观察到指数拟合。与CP儿童相比，TD儿童在相对较短的时间内（大约一个月）实现了谐波行走，他们花了大约七个月的时间才发展出谐波行走。步幅/站立和站立/挥杆步态比率的收敛值，平均在两条腿上，TD儿童的黄金比例接近（R2=0.9），左腿和右腿的分析没有差异。相比之下,患有CP的儿童表现出跨步/站立和站立/摆动的趋势（R2=0.7），观察到受影响最严重的腿的明显趋势，但未达到跨步/站立比的黄金比值（GR=1.5），而受影响最小的腿超过了它（GR=1.7）。相反,相反的趋势观察到的立场/摆动比。这些发现表明，尽管两条腿之间存在不对称，但CP儿童的步行总体上是谐波。这些结果强调了第一个独立步骤在随着时间的推移逐渐发展谐波步态中的关键作用。
