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Acute changes in gait biomechanics in children with cerebral palsy due to barefoot vs. footwear condition - An
Stanislav Dimitri Siegel1, Steffen Geisendorff2, Peter Huppke2
1Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749 Jena, Germany; Experimental Orthopaedics, University Hospital Jena, Campus Eisenberg, Waldkliniken Eisenberg, Friedrich-Schiller-Universität Jena, Jena, Germany; Orthopaedics, University Hospital Jena, Campus Eisenberg, Waldkliniken Eisenberg, Friedrich-Schiller-University Jena, Jena, Germany.
Insights
Standard sneakers acutely alter gait biomechanics in children with cerebral palsy (CP), affecting cadence, step length, and ankle motion. Further research is needed to determine the clinical relevance of these footwear-induced changes.
Area of Science:
- Biomechanical analysis of human locomotion.
- Pediatric gait analysis.
- Clinical biomechanics.
Background:
- Children with unilateral spastic cerebral palsy (CP) exhibit gait deviations impacting mobility.
- The acute effects of ordinary footwear on CP gait are not well understood.
- This study investigated immediate gait modifications from barefoot vs. cushioned sneakers.
Purpose of the Study:
- To quantify the acute effects of standard cushioned sneakers compared to barefoot walking on gait biomechanics in children with unilateral spastic cerebral palsy.
- To analyze changes in spatiotemporal metrics, 3D kinematics, kinetics, and muscle activity.
Main Methods:
- A randomized crossover study involving 13 children (6-9 years) with unilateral spastic CP.
- Participants completed multiple walking trials barefoot and in standard sneakers.
- Gait analysis utilized motion capture, force plates, and surface electromyography.
Main Results:
- Standard sneakers reduced cadence and increased step/stride length compared to barefoot walking.
- Significant kinematic shifts included greater ankle dorsiflexion and minor knee/hip adjustments.
- Ankle push-off power decreased, while tibialis anterior activity and propulsive forces increased with sneakers.
Conclusions:
- Everyday footwear can induce measurable, acute changes in gait biomechanics, particularly at the ankle.
- The clinical significance and long-term effects of these footwear-induced gait alterations require further investigation.
- Confirmatory and longitudinal studies are recommended to assess persistence and relevance.
Background:
Children with unilateral spastic cerebral palsy (CP) show gait deviations that limit mobility and participation. Whether ordinary footwear can acutely modify gait is underexplored. We quantified the immediate effects of barefoot versus standard cushioned sneakers on spatiotemporal metrics, 3D kinematics/kinetics, and muscle activity.
Methods:
Randomized crossover of 13 children (6-9 years). Each completed multiple trials barefoot and in standard sneakers. Motion capture, force plates, and surface electromyography yielded spatiotemporal metrics, joint angles/moments, powers, and ground-reaction forces.
Findings:
Relative to barefoot walking, standard sneakers were associated with lower cadence (2.12 vs 2.31 steps/s; p < 0.001) and longer steps/strides (step 54 vs 50 cm; stride 107 vs 99 cm; both p < 0.001), while walking speed did not differ between conditions. Distal joint kinematics shifted toward greater ankle dorsiflexion at initial contact (-2° vs -7°; p < 0.001) and during stance (peak 20° vs 15°; p < 0.001). Knee motion showed small, phase-specific adjustments: slightly less flexion at initial contact (13° vs 14°; p = 0.008) but greater flexion in swing (64° vs 62°; p = 0.005). Hip kinematics changed little (toe-off 1° more extension; p = 0.011). Joint moments and powers at the hip and knee were largely unaffected, while ankle push-off power decreased (1.65 vs 2.23 W/kg; p < 0.001). Tibialis anterior activity at initial contact increased (p = 0.007), and propulsive vertical force peaks were modestly higher (p = 0.017).
Interpretation:
These findings indicate that everyday footwear can induce measurable acute changes in gait biomechanics, mainly at the distal level. However, the clinical relevance and persistence of these effects remain uncertain and should be examined in future confirmatory and longitudinal studies.
