PTOTCohortJournal of physical therapy science2019

Relationship between walking efficiency and muscular strength of the lower limbs in children with cerebral palsy.

Minoru Kimoto, Kyoji Okada, Hitoshi Sakamoto and 2 others

PMID 30936637

WHAT IT FOUND

For children with cerebral palsy who walk inefficiently, stronger leg muscles linked to better walking efficiency.

For those already walking efficiently, muscle strength showed no link to efficiency. Check a child's current walking efficiency before prescribing strength training.

Key findings

01Across all participants, walking efficiency correlated significantly with the strength of all tested lower limb muscles.

02In the group with low walking efficiency, strength correlated with efficiency for all muscles except hip extensors.

03In the group with high walking efficiency, there was no relationship between strength and efficiency for any muscle.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study used a cross-sectional design, so it cannot prove that increasing strength causes better walking efficiency. Isometric strength was only measured at specific angles, not through the full range of motion, which may miss functional strength deficits. The hip extensor strength was measured with hips flexed at 90 degrees, a position that may not reflect functional strength during walking and could explain the lack of correlation in the low efficiency group. The sample size was small (26 children), limiting the generalizability of the findings.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not assume that strengthening exercises will improve walking efficiency for every child with cerebral palsy. The study found no link between strength and efficiency in children who already walked efficiently, suggesting strength training may be unnecessary for improving energy cost in this subgroup.

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