Improved ankle function in children with cerebral palsy after computer-assisted motor learning

The effect of biofeedback training on ankle function was studied in young children with cerebral palsy (CP) during a pilot study and a 6-week follow-up study. Patients underwent range of motion (ROM) and ankle dorsiflexor (DF) strength training in a laboratory 3 days per week, receiving auditory and visual feedback. An at-home programme used portable EMG units to help train DF muscle recruitment on the remaining days. Independent outcome measures included DF strength, active ROM, and tapping ability pretraining and 6 weeks and 14 months posttraining. Tapping ability increased significantly in the trained leg posttraining. It then fell significantly at the 6-weeks posttraining test, but remained significantly higher than pretest levels, and returned to pretraining levels by 14 months. Passive ROM was unchanged, but active ROM increased significantly in the trained leg. DF strength increased in most children posttraining in both the pilot and main study. Increased motor-unit recruitment is believed to explain the increases in DF strength and active ROM. These results suggest that biofeedback training can improve ankle function, and the implications for gait are discussed.