Cerebral palsy: improving the understanding of the causes of foot deformity to help alleviate pain and improve mobility

Around 2,000 babies in the UK are diagnosed with cerebral palsy every year.[1,2] Children with the condition will face lifelong difficulties with controlling their limbs and movement. Many children with cerebral palsy will develop foot deformities as they grow – and these can become painful. Dr Caroline Stewart at the Robert Jones and Agnes Hunt Orthopaedic Hospital in Shropshire is using state-of-the-art technologies to develop a new way of examining children’s feet. By improving the understanding of the causes of foot deformities, she hopes this will help identify which children are at risk and lead to tailored treatments that can help improve their quality of life.

How are children’s lives affected now?

Cerebral palsy is the most common serious physical disability in children in the UK. Usually caused by damage to a baby’s brain before, during or soon after birth, a child can face lifelong difficulties with their movement and coordination. 

“Many children with cerebral palsy will have mobility issues – which range from finding it difficult or painful to walk – to being unable to walk at all,” says Dr Stewart.

Those children who do learn to walk will often have an abnormal gait that puts unusual forces through their legs and feet, which can affect their bones and joints.

“As a result, many children with cerebral palsy develop painful foot deformities that can make walking even more difficult, further reducing their quality of life,” says Dr Stewart. “Although there are potential treatments that might help prevent these problems, we currently find it difficult to predict exactly which children will need help.”

How could this research help?

“Our goal is to understand why foot deformity happens and which children with cerebral palsy are most at risk – paving the way for personalised prevention strategies,” says Dr Stewart.

The researchers are developing a new way of examining children’s feet using state-of-the-art technologies. They plan to recruit 15 children with cerebral palsy and 10 children without cerebral palsy, to take part in the study – taking detailed MRI scans and measurements of how they walk.

“By combining these data, we will construct advanced computational models of the muscles and joints of each child’s ankle and foot,” says Dr Stewart.

Using these models, the team will examine – in unprecedented detail – how a child’s foot shape combines with the forces on their bones and joints.

“Ultimately, this study could lead to effective new ways to prevent a child with cerebral palsy from developing foot deformities – reducing their pain, increasing mobility and enabling participation in a wider range of activities,” says Dr Stewart. 

References

1. Wimalasundera, N. & Stevenson, V.L., Cerebral palsy. BMJ Practical Neurology 2016; 16:184-194.
2. Office for National Statistics. Vital statistics in the UK: births, deaths and marriages – 2018 update. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/vitalstatisticspopulationandhealthreferencetables [website accessed 23 July 2019]
    

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