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Updated: Jul 4, 2026
Lower Limb Biomechanical Analysis of Healthy Participants
Published on: April 15, 2020
Walking ability is related to muscle strength in children with cerebral palsy
Meta Nyström Eek1, Eva Beckung
1Department of Paediatrics, Queen Silvia Children's Hospital, Göteborg University, Sweden. meta.nystrom-eek@vgregion.se
Insights
Muscle weakness in children with cerebral palsy significantly impacts walking ability. Even moderate weakness, especially in leg and ankle muscles, correlates with poorer motor function.
Area of Science:
- Pediatric Rehabilitation
- Neuromuscular Disorders
- Biomedical Engineering
Background:
- Bilateral spastic cerebral palsy (CP) is a common childhood motor disorder.
- Impaired muscle strength is a known challenge for children with CP, affecting gross motor function.
- Understanding the relationship between specific muscle groups and functional mobility is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between lower limb muscle strength and walking ability in children with bilateral spastic cerebral palsy.
- To identify which muscle groups are most affected by weakness in this population.
- To explore differences in muscle strength across Gross Motor Function Classification System (GMFCS) levels.
Main Methods:
- Assessed lower limb muscle strength in 55 children (ages 5-15) with bilateral spastic CP (GMFCS levels I-III) using a handheld myometer.
- Evaluated functional mobility, including standing, walking, running, and jumping, using the Gross Motor Function Measure (GMFM).
- Compared muscle strength data with normative values and correlated strength with GMFM scores.
Main Results:
- Most children exhibited below-normative muscle strength, particularly in ankle and hip muscles.
- Significant differences in muscle strength were observed between different GMFCS levels.
- A moderate to high correlation was found between muscle strength and GMFM scores, indicating muscle weakness negatively impacts walking.
- Independently walking children demonstrated over 50% of predicted muscle strength.
Conclusions:
- Lower limb muscle weakness is prevalent in children with bilateral spastic CP and directly affects their walking ability.
- Ankle and hip muscle strength are key indicators of functional mobility in this population.
- Targeted strengthening of specific muscle groups may improve gross motor function and walking in children with CP.
Abstract:
The purpose of this study was to assess the relation between muscle strength and walking ability in children with bilateral spastic cerebral palsy at GMFCS levels I-III. 55 children (mean age 10.7, range 5-15) were tested for muscle strength in eight lower limb muscle groups with a handheld myometer. They were also tested with the Gross Motor Function Measure domains for standing and walking, running and jumping. Muscle strength in the legs was below normative predicted value in most of the children, with muscle weakness most pronounced around the ankle, followed by the hip muscles. There was a significant difference in muscle strength between GMFCS levels. There was also a moderate to high correlation between muscle strength and the GMFM, indicating that muscle weakness affects walking ability. Independently walking children had more than 50% of predicted muscle strength values.
