Walking-induced muscle fatigue impairs postural control in adolescents with unilateral spastic cerebral palsy

• Walking for 15 min significantly decreased knee extensor strength production in adolescents with CP.
• The postural control of adolescents with CP is negatively impaired by fatigue.
• A cognitive task decreased postural control performances in adolescents with CP.

BackgroundFatigue is likely to be an important limiting factor in adolescents with spastic cerebral palsy (CP).AimsTo determine the effects of walking-induced fatigue on postural control adjustments in adolescents with unilateral CP and their typically developing (TD) peers.MethodsTen adolescents with CP (14.2 ± 1.7 yr) and 10 age-, weight- and height-matched TD adolescents (14.1 ± 1.9 yr) walked for 15 min on a treadmill at their preferred walking speed. Before and after this task, voluntary strength capacity of knee extensors (MVC) and postural control were evaluated in 3 conditions: eyes open (EO), eyes closed (EC) and with dual cognitive task (EODT).ResultsAfter walking, MVC decreased significantly in CP (−11%, P < 0.05) but not in TD. The CoP area was only significantly increased in CP (90%, 34% and 60% for EO, EC and EODT conditions, respectively). The CoP length was significantly increased in the EO condition in CP and TD (20% and 21%) and was significantly increased in the EODT condition by 18% in CP only.ConclusionsUnlike TD adolescents, treadmill walking for 15 min at their preferred speed lead to significant knee extensor strength losses and impairments in postural control in adolescents with unilateral spastic CP.