Impaired gait function in adults with cerebral palsy is associated with reduced rapid force generation and increased passive stiffness

Objective: It is still not clarified whether spasticity contributes to impairments of gait function. Here we compared biomechanical measures of muscle weakness and stiffness of ankle muscles to impairments of gait function in adults with cerebral palsy (CP). Methods: Twenty-four adults with CP (mean age 34.3, range 18-57 years) and fifteen healthy agematched controls were biomechanically measured for passive and reflex-mediated stiffness of the ankle plantarflexors at rest, maximal voluntary plantarflexion and dorsiflexion effort (MVCpf, df) and rate of force development (RFDpf, df). Kinematic analysis of the ankle joint during treadmill walking was obtained by 3D motion analysis. Results: Passive stiffness was significantly increased in adults with CP compared to controls. Passive stiffness and RFDdf were correlated to reduced toe lift. RFDpf provided the best correlation to push-off velocity, range of movement in the ankle joint and gait speed. Reflex-mediated stiffness was not correlated to any parameters of impaired gait. Conclusions: Impaired gait function in adults with CP is associated with reduced RFD and increased passive stiffness of ankle muscles. Significance: These findings suggest that reduced rapid force generation and increased passive stiffness of ankle muscles rather than increased reflex-mediated stiffness (spasticity) likely contributes to impaired gait function in adults with CP. (C) 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.