Walking ability is related to muscle strength in children with cerebral palsy

The purpose of this study was to assess the relation between muscle strength and walking ability in children with bilateral spastic cerebral palsy at GMFCS levels I–III. 55 children (mean age 10.7, range 5–15) were tested for muscle strength in eight lower limb muscle groups with a handheld myometer. They were also tested with the Gross Motor Function Measure domains for standing and walking, running and jumping. Muscle strength in the legs was below normative predicted value in most of the children, with muscle weakness most pronounced around the ankle, followed by the hip muscles. There was a significant difference in muscle strength between GMFCS levels. There was also a moderate to high correlation between muscle strength and the GMFM, indicating that muscle weakness affects walking ability. Independently walking children had more than 50% of predicted muscle strength values.