Article

Foot drop and toe walking are frequent concerns in children with
cerebral palsy (CP). Increased stiffness of the ankle joint muscles may
contribute to these problems. OBJECTIVE: Does four weeks of daily home based
treadmill training with incline reduce ankle joint stiffness and facilitate heel
strike in children with CP? METHODS: Seventeen children with CP (4-14 years) were
recruited. Muscle stiffness and gait ability were measured twice before and twice
after training with an interval of one month. Passive and reflex-mediated
stiffness were measured by a dynamometer which applied stretches below and above
reflex threshold. Gait kinematics were recorded by 3-D video-analysis during
treadmill walking. Foot pressure was measured by force-sensitive foot soles
during treadmill and over-ground walking. RESULTS: Children with increased
passive stiffness showed a significant reduction in stiffness following training
(P = 0.01). Toe lift in the swing phase (P = 0.014) and heel impact (P = 0.003)
increased significantly following the training during both treadmill and
over-ground walking. CONCLUSIONS: Daily intensive gait training may influence the
elastic properties of ankle joint muscles and facilitate toe lift and heel strike
in children with CP. Intensive gait training may be beneficial in preventing
contractures and maintain gait ability in children with CP.

Langue : ANGLAIS