Mechanisms contributing to gait speed and metabolic cost in children with unilateral cerebral palsy.
Tatiana Pessoa Silva Pinto, Sérgio Teixeira Fonseca, Rejane Vale Gonçalves and 4 others
PMID 28728959WHAT IT FOUND
Gait speed in children with unilateral cerebral palsy was linked to elastic energy return and knee co-contraction, while higher metabolic cost tracked knee co-contraction.
This suggests training push-off power and eccentric control within task-specific gait work, not strength alone.
Key findings
01Elastic torque and knee co-contraction were positive predictors of gait speed, vertical stiffness was a negative predictor, and together they explained 89.4% of speed variability.
02Knee co-contraction was the sole positive predictor of metabolic cost.
03Elastic torque was positively associated with impulsive torque of the non-affected leg, vertical stiffness was negatively associated with eccentric leg work, and knee co-contraction was not related to any variable.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 14 children were analysed; 3 of 17 were excluded for technical problems, and the authors note the small sample may reduce power and reproducibility. The study was cross-sectional, so it shows associations, not that changing elastic torque, stiffness, or co-contraction will change gait speed or metabolic cost. All participants could walk independently at GMFCS level I or II, so findings may not apply to children with more limited mobility. Children were tested barefoot without orthoses, which may change their usual gait pattern. The regression models used stepwise selection in a small sample, and the authors state the chain of associations needs validation.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that training push-off power or eccentric control will improve gait speed. The study measured 14 children at one time and tested no intervention, so these are associations only.