Abstract.[Purpose] The purpose of this preliminary study was to assess the trade-off relationship between the hip and ankle joints after plantarflexor training in children with spastic hemiplegic cerebral palsy (CP). [Subjects and Methods] Three boys aged 9, 10, and 13 years with spastic hemiplegic CP participated in the study. Gait analysis was performed using a three-dimensional motion analysis device and a floor reaction force detection device before and after plantarflexor training. Data on gait speed and stride length for both sides were collected. Peak hip and ankle powers in the sagittal plane and ankle-to-hip power ratio (A2/H3 ratio) were calculated. Plantarflexor training comprised heel raises and exercise band resistance at the participant's home (3 times/week for 12 weeks).[Results] The A2/H3 ratio increased significantly on both sides in two of three subjects after training. Peak A2 power increased significantly on both sides in subject 3 and on the affected side of subject 2. Peak H3 power decreased significantly on the non-affected side of subjects 1 and 2. [Conclusion] This study confirmed that two of three subjects demonstrated a trade-off relationship between the hip and ankle joints during gait after plantarflexor training.

[Purpose] The purpose of this study was to evaluate kinetic relationships between the ankle and hip joints during gait, in the late stance, in children with spastic cerebral palsy (CP). [Subjects] The subjects were 3 ambulant children with spastic hemiplegic CP (aged 10, 13, and 14: CP group) and 3 typically developing children with the same ages (control). [Methods] A three-dimensional gait analysis including force data was performed to compare the peak moment, power, and ankle/hip power ratio between the hemiplegic (uninvolved and hemiplegic) and the control groups. In the statistical analysis, mean values from 5 gait cycles for each of 3 conditions (uninvolved, hemiplegic and control) were used. The three conditions were compared by performing a Kruskal-Wallis test and Steel-Dwass multiple comparisons. [Results] The peak moments of ankle plantar flexors in the 10-year-old case, were significantly lower on the uninvolved and hemiplegic sides compared with the control group, respectively. The peak flexion moments of the hip on the hemiplegic side were significantly higher compared with the control in the 14- and 13-year-old cases. The peak of ankle power generation (A2) in the 13- and 10-year-old cases were significantly lower on the uninvolved and hemiplegic sides, respectively, compared with the control. The peaks of hip flexor power generation (H3) in the 14- and 13-year-old cases were significantly higher on the uninvolved and hemiplegic sides, respectively. The A2/H3 ratios were significantly lower on the uninvolved and hemiplegic sides compared with the control, and the ratio for the hemiplegic side was lower than that for the uninvolved side. [Conclusion] This study shows that propulsion of walking is generated by hip, rather than the ankle, on both the hemiplegic and involved sides.

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