title: Changes in Mobility and Muscle Function of Children with Cerebral Palsy after Gait Training: A Pilot Study.
abstract: The goal of this pilot study was to characterize the effects of gait training on the capacity of muscles to produce body accelerations and relate these changes to mobility improvements seen in children with cerebral palsy (CP). Five children (14 years ± 3 y; GMFCS I-II) with spastic diplegic CP participated in a 6-week gait training program. Changes in 10-m fast-as-possible walking speed and 6-minute walking endurance were used to assess changes in mobility. In addition, musculoskeletal modeling was used to determine the potential of lower-limb muscles to accelerate the body's center of mass vertically and forward during stance. The mobility changes after the training were mixed, with some children demonstrating vast improvements, while others appeared to be minimal. However, the musculoskeletal results revealed unique responses for each child. The most common changes occurred in the capacity for the hip and knee extensors to produce body support and the hip flexors to produce body propulsion. These results cannot yet be generalized to the broad population of children with CP, but demonstrate that therapy protocols may be enhanced by modeling analyses. The pilot study results provide motivation for gait training emphasizing upright leg posture, mediolateral balance, and ankle push-off.
authors.affiliation: 1 Colorado School of Mines, University of Nebraska Medical Center.
authors.forename: Amy K
authors.initials: AK
authors.lastname: Hegarty
authors.affiliation: 2 Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center.
authors.forename: Max J
authors.initials: MJ
authors.lastname: Kurz
authors.affiliation: 2 Munroe-Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center.
authors.forename: Wayne
authors.initials: W
authors.lastname: Stuberg
authors.affiliation: 1 Colorado School of Mines, University of Nebraska Medical Center.
authors.forename: Anne K
authors.initials: AK
authors.lastname: Silverman
mesh_terms: D000054:Acceleration; D000293:Adolescent; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000534:rehabilitation*; D002648:Child; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010807:Physical Endurance / Q000502:physiology; D026741:Physical Therapy Modalities; D010865:Pilot Projects
keywords: biomechanics; muscle function; musculoskeletal modeling; physical therapy