Lorentzen, J;
Frisk, R;
Willerslev-Olsen, M;
Bouyer, L;
Farmer, SF;
Nielsen, JB;
(2020)
Gait training facilitates push-off and improves gait symmetry in children with cerebral palsy.
Human Movement Science
, 69
, Article 102565. 10.1016/j.humov.2019.102565.
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Abstract
Background: Human walking involves a rapid and powerful contraction of ankle plantar flexors during push-off in late stance. Objective: Here we investigated whether impaired push-off force contributes to gait problems in children with cerebral palsy (CP) and whether it may be improved by intensive gait training. Methods: Sixteen children with CP (6–15 years) and fourteen typically developing (TD) children (4–15 years) were recruited. Foot pressure was measured by insoles and gait kinematics were recorded by 3-dimensional video analysis during treadmill and overground walking. The peak derivative of ground reaction force at push off (dPF) was calculated from the foot pressure measurements. Maximal voluntary plantar flexion (MVC) was measured while seated. Measurements were performed before and after a control period and after 4 weeks of 30 minutes daily inclined treadmill training. Results: dPF and MVC were significantly lower in children with CP on the most affected (MA) as compared to TD children (p < .001). dPF was lower on the MA leg as compared to the less affected (LA) leg in children with CP (p < .05). Following gait training, increases in dPF (p < .001) and MVC (p < .01) were observed for the MA leg. Following gait training children with CP showed similar timing of dPF and similar stance phase duration on both legs indicating improved symmetry of gait. These effects were also shown during overground walking. Conclusion: Impaired ability to voluntarily activate ankle plantar flexors and produce a rapid and powerful push-off during late stance are of importance for impaired gait function in children with CP. Intensive treadmill training may facilitate the drive to ankle plantar flexors and reduce gait asymmetry during both treadmill and overground walking.
| Type: | Article |
|---|---|
| Title: | Gait training facilitates push-off and improves gait symmetry in children with cerebral palsy |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.humov.2019.102565 |
| Publisher version: | https://doi.org/10.1016/j.humov.2019.102565 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Neuroplasticity; Cerebral palsy; Gait training |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10095711 |
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