Stepping to Understand Lower Limb Impairments in Bilateral Cerebral Palsy

  • End date
    Jun 18, 2025
  • participants needed
  • sponsor
    Northwestern University
Updated on 18 July 2021


The purpose of this study is to investigate lower limb impairments in children with bilateral cerebral palsy during stepping tasks.


Individuals with bilateral cerebral palsy (BCP) sustain a neonatal brain injury that leads to altered neuromuscular control to the lower limbs. One commonly observed motor impairment from this altered control is loss of selective voluntary motor control (SVMC), defined as the ability to independently move the joints intentionally. Loss of SVMC typically manifests as knee and ankle joint impairment and abnormal coupling between the hip adductors and lower limb extensors. This can make stepping up or down a curb or stair challenging, but quantitative investigation in these closed-chain activities has been limited. This is especially important as performance in stair-climbing is associated with limitations to overall mobility and community participation in cerebral palsy.

The overall aim of this proposal is to investigate the altered neuromuscular control that challenges stair walking in individuals with BCP. Participants who consent to the study will be instructed to perform multiple step-ups and step-downs on a single raised platform. The parameters of the stepping task may change by adding weight to the body or subtracting weight from the body. Using standard gait analysis techniques, biomechanical metrics such as joint kinematics and kinetics will be analyzed.

Condition diplegic cerebral palsy, Bilateral Cerebral Palsy, cerebral palsy (cp), Cerebral Palsy, Cerebral Palsy (Pediatric)
Treatment load modulation
Clinical Study IdentifierNCT04957277
SponsorNorthwestern University
Last Modified on18 July 2021


Yes No Not Sure

Inclusion Criteria

aged 5 years to 19 years
typically developing with no diagnosed medical conditions that affect movement, OR with a diagnosis of bilateral cerebral palsy (including diplegia, tetraplegia, and quadriplegia) where the lower limbs are more affected than the upper limbs
ability to independently step up, with or without assistive devices

Exclusion Criteria

lower limb surgery in the past year
botulinum toxin injections to the lower limb muscles in the past 6 months
cognitive dysfunction that would make following directions difficult
comorbidities that would make participation unsafe
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