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BACKGROUND: Information on altered foot pressures during ambulation would clarify how far limb deformities modify walking patterns in cerebral palsy (CP), and whether such data can inform prognosis and guide rehabilitation. OBJECTIVE: To compare patterns of plantar pressures during walking between children with CP and their able-bodied (AB) peers. METHODS: Twenty-five children/adolescents (10 with hemiplegia, 5 with diplegia, and 10 AB, respective ages 13.0 ± 1.9, 13.0 ± 0.6 and 14.0 ± 0.7 years) walked a 12 m line at a self-selected speed. Spatio-temporal parameters and peak in-shoe plantar pressures were recorded for both feet, using the Parotec analysis system. RESULTS: Walking speeds (m·s −1 ) differed significantly between groups (0.65 ± 0.13, hemiplegia, 0.93 ± 0.22 diplegia and 1.26 ± 0.05 AB), with shorter stride lengths in CP. Contact time, double support time and step duration were also shorter in hemiplegia. Plantar pressures differed substantially and consistently between AB and CP, with increased medial heel pressures in hemiplegia, and reduced hallux and lateral heel pressures but increased lateral, medial mid-foot and first metatarsal pressures in diplegia. CONCLUSIONS: Substantial alterations in spatio-temporal parameters (greater in hemiplegia than in diplegia) and plantar pressure distribution reflect attempts to compensate for poor stability of posture in CP. Further study of these adaptive changes holds clinical promise in providing data relevant to the design of orthotics, determinations of prognosis and the planning of neurorehabilitation.

The purpose of this investigation was to determine whether changes in surface electromyography (EMG) data during an isometric muscle protocol, in combination with maximal voluntary isometric force, provide information on fatigue occurrence and exercise limitation in children with cerebral palsy. Twelve children with cerebral palsy and 10 age-matched controls completed an assessment of quadriceps muscle fatigue on an isokinetic device with surface EMG measurements, during a sustained isometric contraction at 50% of the maximal voluntary isometric force. The EMG data collected in participants with cerebral palsy suggest that muscle fatigue occurred sooner in children with cerebral palsy relative to the age-matched controls. However, the results demonstrate that no difference was found in time to exhaustion between the able-bodied and participants with cerebral palsy. These contrasting results may be the result of spasticity and co-contraction during maximal testing, which may play an important role in exercise limitation in children with cerebral palsy.

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