The first specific aim is to quantify improvement in ankle muscle function and functional mobility following targeted ankle resistance gait training in ambulatory children with cerebral palsy (CP). The primary hypothesis for the first aim is that targeted ankle resistance training will produce larger improvements in lower-extremity motor control, gait mechanics, and clinical measures of mobility assessed four- and twelve-weeks post intervention compared to standard physical therapy and standard gait training. The second specific aim is to determine the efficacy of adaptive ankle assistance to improve capacity and performance during sustained, high-intensity, and challenging tasks in ambulatory children with CP. The primary hypothesis for the second aim is that adaptive ankle assistance will result in significantly greater capacity and performance during the six-minute-walk-test and graded treadmill and stair stepping protocols compared to walking with ankle foot orthoses and walking with just shoes.
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Change in preferred walking speed
Timeframe: Immediately after the intervention
Change in preferred walking speed
Timeframe: 2 weeks after the intervention
Change in preferred walking speed
Timeframe: 12 weeks after the intervention
Change in similarity of plantarflexor muscle activity
Timeframe: Immediately after the intervention
Change in similarity of plantarflexor muscle activity
Timeframe: 2 weeks after the intervention
Change in similarity of plantarflexor muscle activity
Timeframe: 12 weeks after the intervention
Change in 6-minute-walk-test distance
Timeframe: Immediately after the intervention
Change in 6-minute-walk-test distance
Timeframe: 2 weeks after the intervention
Change in 6-minute-walk-test distance
Timeframe: 12 weeks after the intervention
Change in variance in muscle activity
Timeframe: Immediately after the intervention
Change in variance in muscle activity
Timeframe: 2 weeks after the intervention
Change in variance in muscle activity
Timeframe: 12 weeks after the intervention
Change in stride length
Timeframe: Immediately after the intervention
Change in stride length
Timeframe: 2 weeks after the intervention
Change in stride length
Timeframe: 12 weeks after the intervention
Change in stride-to-stride variability stride length
Timeframe: Immediately after the intervention
Change in stride-to-stride variability stride length
Timeframe: 2 weeks after the intervention
Change in stride-to-stride variability stride length
Timeframe: 12 weeks after the intervention
Change in walking posture
Timeframe: Immediately after the intervention
Change in walking posture
Timeframe: 2 weeks after the intervention
Change in walking posture
Timeframe: 12 weeks after the intervention
Change in Gross Motor Function Measure-66 sec. D&E
Timeframe: Immediately after the intervention
Change in Gross Motor Function Measure-66 sec. D&E
Timeframe: 2 weeks after the intervention
Change in Gross Motor Function Measure-66 sec. D&E
Timeframe: 12 weeks after the intervention
Change in plantar-flexor strength
Timeframe: Immediately after the intervention
Change in plantar-flexor strength
Timeframe: 2 weeks after the intervention
Change in plantar-flexor strength
Timeframe: 12 weeks after the intervention
Distance traveled
Timeframe: 1 day
Metabolic cost of transport from indirect calorimetry
Timeframe: 1 day
Subject perceived exertion
Timeframe: 1 day
Average muscle activity
Timeframe: 1 day
Heart Rate
Timeframe: 1 day