title: Level versus inclined walking: ambulatory compensations in children with cerebral palsy under outdoor conditions.
abstract: OBJECTIVE
  To investigate how children with cerebral palsy (CP) adapt their gait to inclined outdoor walking conditions.
  
  
  METHODS
  Ten children with CP, Gross Motor Function System level II, and 10 children with typical development participated. Walking velocity, stride length and ankle, knee, hip, and trunk sagittal plane angles were calculated for 4 conditions: indoor walkway, outdoor walkway, and walking up and down a 7° inclined ramp.
  
  
  RESULTS
  Gait patterns were unchanged between indoor and outdoor level walking. During up-slope walking, both groups increased hip and knee flexion at foot strike to accommodate the slope. During down-slope walking, both groups increased knee flexion in midstance to lower the body down the slope. Children with CP had greater forward trunk lean (P < .005) during up-slope walking and greater posterior trunk lean during down-slope walking (P < .0001).
  
  
  CONCLUSIONS
  Children with CP adapt to inclined walking conditions similarly to peers but use greater postural adaptations.
authors.affiliation: Starship Children's Hospital (Dr Stott), Auckland, New Zealand; Health and Physical Rehabilitation Research Centre (Ms Reynolds and Dr McNair), Auckland University of Technology, Auckland, New Zealand.
authors.forename: N S
authors.initials: NS
authors.lastname: Stott
authors.forename: N
authors.initials: N
authors.lastname: Reynolds
authors.forename: P
authors.initials: P
authors.lastname: McNair
mesh_terms: D000220:Adaptation, Biological; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D005260:Female; D005684:Gait; D006801:Humans; D035002:Lower Extremity / Q000502:physiology; D008297:Male; D016138:Walking / Q000502:physiology*