Temporal changes in gait parameters and muscle activation during sustained walking in children with spastic cerebral palsy.

Objective: Temporal changes in spatiotemporal gait parameters and muscle activation may reflect progressive gait deterioration during prolonged walking in children with spastic cerebral palsy. Methods: A portable gait analysis system and surface electromyography were used to evaluate gait characteristics during a 3-minute walking protocol in 15 children with SCP and 15 age-matched healthy controls. Participants walked at a self-selected speed on a level surface. Spatiotemporal gait parameters, energy expenditure, and bilateral gastrocnemius and tibialis anterior muscle activation were assessed at predefined time points. Linear mixed-effects models were applied to examine group-by-time interactions while accounting for repeated measurements within participants. Results: Linear mixed-effects model analysis revealed significant Group × Time interactions for stance phase, swing phase, step length, lower-limb forward acceleration, foot clearance angle, and walking velocity (all Conclusion: Children with SCP may exhibit gradual changes in spatial-temporal gait parameters and muscle activation patterns during the later stages of a long walking task. These findings suggest that selected gait and EMG parameters in children with SCP begin to change after approximately 2 min of continuous walking, indicating a potential time window for closer monitoring or structured rest breaks during rehabilitation. Further studies incorporating direct fall-risk assessment and validated fatigue measures are warranted before definitive clinical recommendations can be made.