Balance and gait of spastic cerebral palsy patients at a selective rehabilitation center in Bangladesh

Abstract

Purpose: To investigate the gait and balance characteristics of children with spastic cerebral palsy who attended a selective rehabilitation facility in Bangladesh. Objectives: To explore the sociodemographic features (age, gender, type of cerebral palsy, parental education, place of delivery), to assess gait parameters (walking speed, cadence, stride length), to evaluate balance using the Pediatric Balance Scale (PBS), and to examine the relationships among balance, gait performance, and other variables such as limb involvement and maternal education. Methods: This cross-sectional study involved 102 children with spastic cerebral palsy at the Pediatric Unit of the Centre for the Rehabilitation of the Paralyzed (CRP), Savar. Data were collected using structured questionnaires and standardized clinical tools including the PBS and observational gait analysis. Descriptive statistics were used to present the demographic and clinical profiles, and inferential statistics such as chi-square and correlation tests were applied to examine associations. Results: Among 102 participants, 48% were quadriplegic, 43.1% diplegic,7.8% triplegic, and 1% monoplegic . The average age was 7.17 years (SD = 2.239). Most children were born after 38 weeks (81.4%), but 57.8% did not cry immediately after birth, indicating potential birth complications. Notably, 69.6% were delivered in hospitals and 52% had normal vaginal delivery. Regarding balance, complex postural tasks like standing on one foot showed a strong correlation with PBS scores (r = 1.000), and placing alternate foot on a stool also showed high correlation (r = 0.679). However, gait parameters such as stride length (r = 0.280) and speed (r = 0.030) showed weaker relationships. There was a borderline association between maternal education and balance outcomes (p = 0.051). The findings highlight that spastic CP children exhibit persistent gait and balance deficits, even after rehabilitation. Conclusion: There is a strong relationship between dynamic balance tasks and overall motor function in children with spastic cerebral palsy. Sociodemographic factors, especially maternal education and early neonatal events, are important in shaping functional outcomes. These results underscore the need for early diagnosis, structured rehabilitation, and parent-focused interventions in low-resource settings like Bangladesh. Keywords: Gait, Balance, Spastic Cerebral Palsy, Pediatric Balance Scale, Rehabilitation, Bangladesh.