Related Experiment Video
Updated: Apr 22, 2026
Evaluating Postural Control and Lower-extremity Muscle Activation in Individuals with Chronic Ankle Instability
Published on: September 18, 2020
Gait training reduces ankle joint stiffness and facilitates heel strike in children with Cerebral Palsy
Maria Willerslev-Olsen1, Jakob Lorentzen1, Jens Bo Nielsen2
1Department of Nutrition, Exercise and Sport & Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark Helene Elsass Center, Charlottenlund, Denmark.
Insights
Daily intensive treadmill training reduced ankle stiffness and improved heel strike in children with cerebral palsy (CP). This home-based approach may enhance gait ability and prevent contractures.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Foot drop and toe walking are common in children with cerebral palsy (CP).
- Increased ankle joint muscle stiffness is a potential contributing factor to these gait abnormalities.
Purpose of the Study:
- To investigate if four weeks of daily home-based treadmill training with incline can reduce ankle joint stiffness.
- To assess if this training facilitates heel strike in children with CP.
Main Methods:
- Seventeen children (4-14 years) with CP participated.
- Muscle stiffness and gait kinematics were measured before and after a one-month training period.
- A dynamometer assessed passive and reflex-mediated stiffness, while 3-D video-analysis and foot pressure sensors evaluated gait.
Main Results:
- Significant reduction in passive ankle stiffness was observed post-training (P = 0.01).
- Training led to significant increases in toe lift during swing phase (P = 0.014) and heel impact (P = 0.003).
- Improvements were noted in both treadmill and over-ground walking.
Conclusions:
- Daily intensive gait training can positively influence ankle muscle elasticity in children with CP.
- This type of training may facilitate improved toe lift and heel strike, aiding in gait ability.
- Intensive gait training shows potential for preventing contractures and maintaining functional mobility in children with CP.
Background:
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.
