Strategies for unplanned gait termination at comfortable and fast walking speeds in children with cerebral palsy

Collision avoidance while walking is necessary for safe living, and faster walking speeds tend to increase collision risk. However, gait termination strategies for patients with cerebral palsy (CP), from comfortable to faster speed, remain unexplored. This study aimed to analyze these strategies in children with CP compared to typically developing (TD) children at two different speeds. Study participants included 10 children with CP (mean age, 12.5; five females; mean height, 147.8 cm; mean weight, 41.7 kg) and 10 TD children (mean age, 11.4; nine females; mean height, 142.0 cm; mean weight, 38.1 kg). Effects of walking speed on spatial, force, and temporal parameters were assessed at 100 % (WS1) and 125 % (WS2) speeds of comfortable walking. The TD group exerted a more pronounced braking force at the first step after the stop line appeared on the floor until the contralateral step at both WS1 (P = 0.006) and WS2 (P = 0.019); however, the CP group exerted a more potent force after the second step (WS1: P = 0.026, WS2: P = 0.023) in the anterior-posterior (AP) direction. Additionally, an increase in the center of mass (COM)-center of pressure (COP) divergence in the AP direction (P = 0.032), which decreased in the mediolateral (ML) direction (P = 0.036) at faster walking speeds, influenced the kinetic characteristics of the CP group from WS1 to WS2. The complex adaptations, such as unique braking forces and changes in the COM-COP divergence, suggest that gait interventions should consider the distinctive forces and adopt dynamic balancing strategies to avoid collisions during walking.