Plantarflexor training affects propulsive force generation during gait in children with spastic hemiplegic cerebral palsy: a pilot study

[Purpose] The purpose of this preliminary study was to assess the trade-off relationship between the hip and ankle joints after plantarflexor training in children with spastic hemiplegic cerebral palsy (CP). [Subjects and Methods] Three boys aged 9, 10, and 13 years with spastic hemiplegic CP participated in the study. Gait analysis was performed using a three-dimensional motion analysis device and a floor reaction force detection device before and after plantarflexor training. Data on gait speed and stride length for both sides were collected. Peak hip and ankle powers in the sagittal plane and ankle-to-hip power ratio (A2/H3 ratio) were calculated. Plantarflexor training comprised heel raises and exercise band resistance at the participant's home (3 times/week for 12 weeks). [Results] The A2/H3 ratio increased significantly on both sides in two of three subjects after training. Peak A2 power increased significantly on both sides in subject 3 and on the affected side of subject 2. Peak H3 power decreased significantly on the non-affected side of subjects 1 and 2. [Conclusion] This study confirmed that two of three subjects demonstrated a trade-off relationship between the hip and ankle joints during gait after plantarflexor training.