Kinetics In Children Research Articles

Features of motor stereotype kinematics and kinetics in children with achondroplasia: a comparative cross-sectional study

Introduction The study of the kinematic and kinetic parameters of gait in children with achondroplasia would allow a more detailed understanding of the features of their locomotion and determine the strategy of planned treatment.Purpose To evaluate features of locomotor kinematics and kinetics in children with achondroplasia and compare with peers without orthopedic pathology.Materials and methods The locomotor profile was assessed by video gait analysis. Kinematic data were recorded by Qualisys7+ optical cameras (8 cameras) with passive marker video capture technology synchronized with six dynamic platforms KISTLER (Switzerland). The analysis of kinematics and kinetics was carried out in the QTM (Qualisys) and Visual3D (C-Motion) programs with automated calculation of the values of indicators of the total peak power in the joints. Three groups were formed for gait analysis: 1) children 6–7 years old, achondroplasia (6 subjectsle, n = 12 limbs); 2) their peers, children without orthopedic pathology, 6–7 years old (8 subjects, n = 16 limbs); 3) children without orthopedic pathology 3–4 years old similar in height (8 subjects, n = 16 limbs).Results In children with achondroplasia, statistically significant disorder in locomotor kinetics and kinematics were found. The former are associated with a longitudinal deficiency of limb segments and decreased walking speed. The latter are not associated with a longitudinal deficit, but manifested in all planes, namely: an increase in the maximum forward inclination of the pelvis, a flexion position in the hip and knee joints, and dorsal flexion of the ankle joint; increased maximum angle of hip abduction and varus deformity of the knee joint; increased rotational range of motion of the pelvis.Discussion Since the characteristic features of the main gait profile begin to appear in children by the age of 4–5 years, and is associated with the formation of the activity of central and spinal generators that induce the self-organization of motor stereotypes, we believe that the deviations detected in the locomotor kinematics are secondary pathogenetic manifestations of the kinetics due to the longitudinal deficit in limb segments.Conclusion Features of locomotor kinetics in children with achondroplasia are due to the longitudinal deficit of the limb length and are associated with low walking speed. Significant deviations of the locomotor kinematics were not associated with the longitudinal deficit of the segments, but were detected in all planes and are related to the entire biomechanical chain.

Accelerated mineralization kinetics in children with osteogenesis imperfecta type 1.

Not much is known about the time course of mineralization in newly formed bone from healthy individuals nor in patients with bone disease. To investigate the early phase of mineral accumulation in human bone, we measured the mean mineralization content between double fluorescence labels (CaYoung) with quantitative backscattered electron imaging (qBEI) in human transiliac biopsy samples. Fluorescent labels for histomorphometric evaluation were administered over two 2-day periods separated by a 10-day-free interval, 4–5 days before biopsy procedure. We compared n = 19 children with osteogenesis imperfecta type I (OI, 6 girls/13 boys, age-range 2.2–14.1 years) with both a reference group of n = 38 healthy children (REF, 24 girls/14 boys, age-range 1.5–20.9 years) and an age-matched subgroup ( n = 17) of the latter (CON, 5 girls/12 boys, age-range 2.0–14.7 years). We observed significantly higher levels of CaYoung in OI type I compared to CON and REF in both cortical bone (Ct.CaYoung, +8.3 % and +7.0 %, respectively) and cancellous bone (Cn.CaYoung, +6.5 % and +4.9 %, all p < 0.001). When comparing cortical and cancellous compartments intra-individually, we found a significantly higher Cn.CaYoung than Ct.CaYoung in REF (2.3 ± 2.9 %, p < 0.001), but not in the OI group (0.6 ± 1.6 %, not significant). In the REF group, n = 7 samples also contained double labels in primary woven bone (which is deposited at the external cortex during growth/lateral drift of the iliac crest). This primary woven bone in REF had a higher CaYoung than secondary osteonal bone (4.9 ± 2.7 %). Our findings suggest that bone in OI has an accelerated mineral accumulation compared to healthy bone. This is reflecting the overall increased bone mineralization in OI as reported previously, and indicates that the higher levels of mineralization than those seen in healthy individuals are already achieved in OI type I early after onset of mineralization. • We measured mineralization kinetics by the combination of qBEI and CLSM imaging. • The mineral content of bone between the double labels (CaYoung) was analyzed. • CaYoung was increased in young patients with OI compared to healthy children. • In healthy children but not in OI, CaYoung was higher in spongiosa than in cortex.

Nuclear Cell-Free DNA Predicts Adverse Events After Pediatric Cardiothoracic Surgery

BackgroundPreoperative risk stratification in cardiac surgery includes patient and procedure factors that are used in clinical decision-making. Despite these tools, unidentified factors contribute to variation in outcomes. Identification of latent physiologic risk factors may strengthen predictive models. Nuclear cell-free DNA (ncfDNA) increases with tissue injury and drops to baseline levels rapidly. The goal of this investigation is to measure and to observe ncfDNA kinetics in children undergoing heart operations with cardiopulmonary bypass (CPB), linking biomarkers, organ dysfunction, and outcomes. MethodsThis is a prospective observational study of 116 children <18 years and >3 kg undergoing operations with CPB. Plasma ncfDNA samples were collected and processed in a stepwise manner at predefined perioperative time points. The primary outcome measure was occurrence of postoperative cardiac arrest or extracorporeal membrane oxygenation. ResultsData were available in 116 patients (median age, 0.9 years [range, 0-17.4 years]; median weight, 7.8 kg [range, 3.2-98 kg]). The primary outcome was met in 6 of 116 (5.2%). Risk of primary outcome was 2% with ncfDNA <20 ng/mL and 33% with ncfDNA >20 ng/mL (odds ratio, 25; CI, 3.96-158; P = .001). Elevated ncfDNA was associated with fewer hospital-free days (P < .01). ConclusionsThis study analyzes ncfDNA kinetics in children undergoing operations with CPB for congenital heart disease. Elevated preoperative ncfDNA is strongly associated with postoperative arrest and extracorporeal membrane oxygenation. Further studies are needed to validate this technology as a tool to predict morbidity in children after cardiac surgical procedures.

Multi-segment foot kinetics in children with cerebral palsy who have planovalgus, cavovarus and equinovarus feet

Multi-segment foot kinetics in children with cerebral palsy who have planovalgus, cavovarus and equinovarus feet

Long-term Immune Response to SARS-CoV-2 Infection Among Children and Adults After Mild Infection

Understanding the long-term immune response against SARS-CoV-2 infection in children is crucial to optimize vaccination strategies. Although it is known that SARS-CoV-2 antibodies may persist in adults 12 months after infection, data are limited in the pediatric population. To examine long-term anti-SARS-CoV-2 spike receptor-binding domain (S-RBD) IgG kinetics in children after SARS-CoV-2 infection. In this single-center, prospective cohort study, patients were enrolled consecutively from April 1, 2020, to August 31, 2021, at the COVID-19 Family Cluster Follow-up Clinic, Department of Women's and Children's Health, University Hospital of Padua. A cohort of 252 COVID-19 family clusters underwent serologic follow-up at 1 to 4, 5 to 10, and more than 10 months after infection with quantification of anti-S-RBD IgG by chemiluminescent immunoassay. SARS-CoV-2 infection. Among 902 study participants, 697 had confirmed SARS-CoV-2 infection, including 351 children or older siblings (mean [SD] age, 8.6 [5.1] years) and 346 parents (mean [SD] age, 42.5 [7.1] years). Among 697 cases, 674 (96.7%) were asymptomatic or mild. Children had significantly higher S-RBD IgG titers than older patients across all follow-up time points, with an overall median S-RBD IgG titer in patients younger than 3 years 5-fold higher than adults (304.8 [IQR, 139.0-516.6] kBAU/L vs 55.6 [24.2-136.0] kBAU/L, P < .001). Longitudinal analysis of 56 study participants sampled at least twice during follow-up demonstrated the persistence of antibodies up to 10 months from infection in all age classes, despite a progressive decline over time. In this cohort study of Italian children and adults following SARS-CoV-2 infection different kinetics of SARS-CoV-2 antibodies were found across several age classes of individuals with asymptomatic or mild COVID-19, which could help in optimizing COVID-19 vaccination strategies and prevention policies. This work provides further evidence of sustained immune response in children up to 1 year after primary SARS-CoV-2 infection.

Pen-grip kinetics in children with and without handwriting difficulties.

Handwriting difficulty (HD) is a widely discussed issue. Previous researchers have revealed many valuable kinematics related to the handwriting performance. However, a clear understanding of the kinetics of handwriting performance in children with HD is still lacking. Therefore, this study investigated the writing performance of children with HD via a force acquisition pen (FAP), which detects the force applied from the digits and pen tip. Data from 64 school-age children were divided into control (36 children without HD; mean age: 7.97 years) and HD (28 children with HD; mean age: 8.67 years) groups. The participants were asked to perform a tracing task using the FAP at their usual writing pace. Compared with the control group, the HD group had significantly less pen-tip force, an average amount of force (in-air) from all three digits, higher force variations (whole task) in the index finger, less force fluctuations with the index and middle fingers and a smaller force ratio. The findings of this study suggest that an understanding of the handwriting kinetics and the role of digits in handwriting may be crucial for further planning strategies for handwriting training for children with HD.

Overview of Albumin Physiology and its Role in Pediatric Diseases.

Albumin plays a critical role in a wide range of disease processes; however, the role of albumin in pediatric patients has not been well described. This article aims to review albumin physiology and kinetics in children, albumin's impact on pediatric diseases, and the utility of albumin as a predictor of clinical outcome. Hypoalbuminemia is seen in a wide range of conditions, including protein-losing enteropathy, hepatic synthetic failure, malnutrition, inflammatory states, and renal disease. While the impact of hypoalbuminemia has been more extensively studied in adult patients, there is a relative paucity of literature in the pediatric population. Hypoalbuminemia is a marker of poor outcome in critically ill children and those undergoing a wide range of medical interventions. Albumin infusions may be an effective therapy for fluid resuscitation and for patients with severe hypoalbuminemia.

Normative Achilles and patellar tendon shear wave speeds and loading patterns during walking in typically developing children.

Motion analysis is commonly used to evaluate joint kinetics in children with cerebral palsy who exhibit gait disorders. However, one cannot readily infer muscle-tendon forces from joint kinetics. This study investigates the use of shear wave tensiometry to characterize Achilles and patellar tendon forces during gait. How do Achilles and patellar tendon wave speed and loading modulate with walking speed in typically developing children? Twelve typically developing children (9-16 years old) walked on an instrumented treadmill with shear wave tensiometers over their Achilles (n = 11) and patellar (n = 9) tendons. Wave speeds were recorded at five leg length-normalized walking speeds (very slow to very fast). Achilles and patellar tendon moment arms were measured with synchronized ultrasound and motion capture. The tendon wave speed-load relationship was calibrated at the typical walking speed and used to estimate tendon loading at other walking speeds. Characteristic Achilles and patellar tendon wave speed trajectories exhibited two peaks over a gait cycle. Peak Achilles tendon force closely aligned with peak ankle plantarflexor moment during pushoff, though force exhibited less modulation with walking speed. A second peak in late swing Achilles loading, which was not evident from the ankle moment, increased significantly with walking speed (p < 0.001). The two peaks in patellar tendon loading occurred at 12 ± 1% and 68 ± 6% of the gait cycle, matching the timing of peak knee extension moment in early stance and early swing. Both patellar tendon load peaks increased significantly with walking speed (p < 0.05). This is the first study to use shear wave tensiometry to characterize Achilles and patellar tendon loading during gait in children. These data could serve as a normative comparison when using tensiometry to identify abnormal tendon loading patterns in individuals who exhibit equinus and/or crouch gait.

Patella Alta in Ambulatory Children With Cerebral Palsy: Prevalence and Functional Significance.

Gait dysfunction associated with patella alta (PA) in subjects with cerebral palsy (CP) has been presumed but not objectively established clinically or through biomechanical modeling. It is hypothesized that PA is associated with increasing level of motor impairment, increasing age, obesity, and worse stance phase knee kinematics and kinetics in children with CP. Retrospective case series of 297 subjects with CP studied in our Motion Analysis Center. Data analyzed included patient demographics (age, body mass index, CP classification), patella height (Koshino-Sugimoto Index), and knee kinematics and kinetics. PA was present in 180 of 297 subjects (61%), in 68 of the 146 (47%) with unilateral CP, and 112 of 151 subjects (74%) with bilateral CP. For unilateral CP, the prevalence of PA was not significantly different between Gross Motor Function Classification System (GMFCS) I and II (P=0.357). For bilateral CP, the prevalence of PA in GMFCS III was significantly greater than in GMFCS I and II (P=0.02). Regression analysis showed a significant trend between increasing age and PA in unilateral and bilateral groups (P<0.001 and 0.001, respectively). The prevalence of PA was not significantly different across body mass index categories for either unilateral or bilateral groups. There were only 2 of 10 significant correlations between PA and gait parameters for subjects with unilateral CP functioning at the GMFCS I and II levels. There were 8 of 12 significant correlations between PA and gait parameters for subjects with bilateral CP functioning at the GMFCS I, II, and III levels. PA is common in ambulatory children with CP across topographic types and motor functional levels. PA is well tolerated with respect to gait dysfunction in unilateral CP, but may contribute to crouch gait in bilateral CP. Gait dysfunction cannot be inferred from the radiographic assessment of patellar height, and radiographic evidence of PA by itself does not justify surgical correction with patellar tendon advancement or shortening. Level III-prognostic, retrospective series.

Deviations in gait kinetics in children and adolescents with Dravet Syndrome

Deviations in gait kinetics in children and adolescents with Dravet Syndrome

The effect of body size on countermovement jump kinetics in children aged 7–11 years

The purpose this study was to examine the effect of body size on countermovement jump (CMJ) kinetics in children. Participants (n = 160) aged 7–11 years, divided equally by sex and into primary school year groups (years 3, 4, 5 and 6), each performed one CMJ on a force platform. The variables bodyweight (BW), peak force (Fmax), in-jump minimum force (IMF), in-jump vertical force range (IFR) and basic rate of force development (BRFD) were attained from the force-time history and then subsequently scaled to account for body size. A significant age, sex and interaction effect were found for the absolute variables BW, IMF, Fmax and IFR (P < 0.05) between school year groups 3 and 4 against year’s 5 and 6. Simple main effects highlighted no significant sex differences between the boys and girls for all variables (P > 0.05). No significant age or sex differences were observed for normalised or allometrically scaled values (P > 0.05). The results indicate that girls and boys can be grouped together but that body size must be accounted for to enable accurate conclusions to be drawn independent of growth. Body size significantly effects the representation of CMJ kinetic results and therefore, future studies should report both absolute and scaled values. Future research should develop an age-appropriate criterion method for children in order to determine processed CMJ variables to further investigate the neuromuscular performance of children.

A Population-Based (Super-Child) Approach for Predicting Vitamin A Total Body Stores and Retinol Kinetics in Children Is Validated by the Application of Model-Based Compartmental Analysis to Theoretical Data

BackgroundPublic health nutritionists need accurate and feasible methods to assess vitamin A status and to evaluate efficacy of interventions, especially in children. The application of population-based designs to tracer kinetic data is an effective approach that reduces sample burden for each child. ObjectivesObjectives of the study were to use theoretical data to validate a population-based (super-child) approach for estimating group mean vitamin A total body stores (TBS) and retinol kinetics in children and to use population-based data to improve individual TBS predictions using retinol isotope dilution (RID). MethodsWe generated plasma retinol kinetic data from 6 h to 56 d for 50 theoretical children with high vitamin A intakes, assigning values within physiologically reasonable ranges for state variables and kinetic parameters (“known values”). Mean data sets for all subjects at extensive (n = 36) and reduced (n = 11) sampling times, plus 5 data sets for reduced numbers (5/time, except all at 4 d) and times, were analyzed using Simulation, Analysis and Modeling software. Results were compared with known values; population RID coefficients were used to calculate TBS for individuals. ResultsFor extensive and reduced data sets including all subjects, population TBS predictions were within 1% of the known value. For 5 data sets reflecting numbers and times being used in ongoing super-child studies, predictions were within 1–17% of the known group value. Using RID equation coefficients from population modeling, TBS predictions at 4 d were within 25% of the known value for 66–80% of subjects and reflected the range of assigned values; when ranked, predicted and assigned values were significantly correlated (Rs = 0.93, P < 0.0001). Results indicate that 7 d may be better than 4 d for applying RID in children. For all data sets, predictions for kinetic parameters reflected the range of known values. ConclusionThe population-based (super-child) approach provides a feasible experimental design for quantifying retinol kinetics, accurately estimating group mean TBS, and predicting TBS for individuals reasonably well. Curr Dev Nutr 2018;2:nzy071.

The long-term use of foot orthoses affects walking kinematics and kinetics of children with flexible flat feet: A randomized controlled trial.

BackgroundDue to inconclusive evidence on the effects of foot orthoses treatment on lower limb kinematics and kinetics in children, studies are needed that particularly evaluate the long-term use of foot orthoses on lower limb alignment during walking. Thus, the main objective of this study was to evaluate the effects of long-term treatment with arch support foot orthoses versus a sham condition on lower extremity kinematics and kinetics during walking in children with flexible flat feet.MethodsThirty boys aged 8–12 years with flexible flat feet participated in this study. While the experimental group (n = 15) used medial arch support foot orthoses during everyday activities over a period of four months, the control group (n = 15) received flat 2-mm-thick insoles (i.e., sham condition) for the same time period. Before and after the intervention period, walking kinematics and ground reaction forces were collected.ResultsSignificant group by time interactions were observed during walking at preferred gait speed for maximum ankle eversion, maximum ankle internal rotation angle, minimum knee abduction angle, maximum knee abduction angle, maximum knee external rotation angle, maximum knee internal rotation angle, maximum hip extension angle, and maximum hip external rotation angle in favor of the foot orthoses group. In addition, statistically significant group by time interactions were detected for maximum posterior, and vertical ground reaction forces in favor of the foot orthoses group.ConclusionsThe long-term use of arch support foot orthoses proved to be feasible and effective in boys with flexible flat feet to improve lower limb alignment during walking.

Supracondylar femoral rotation osteotomy affects frontal hip kinetics in children with bilateral cerebral palsy.

To evaluate the influence of supracondylar femoral derotation osteotomy (FDO) on hip abduction muscle force and frontal hip moments in children with bilateral cerebral palsy. For this retrospective cohort study 79 children (36 females, 43 males; mean age at surgery 11y [SD 3y]; range 4-17y) with bilateral cerebral palsy and preoperatively and 1-year postoperatively documented frontal hip moments who received supracondylar FDO in 134 limbs were included. The control group consisted of eight children (two females, six males; mean age 11y [SD 4y]; range 5-17y) who received single-event multi-level surgery without FDO. Hip joint impulse (p<0.001) and the first peak of frontal hip moments (p=0.003) increased, whereas the second peak decreased (p<0.001) from preoperatively to postoperatively. Hip abductor strength improved (p=0.001) from preoperatively to postoperatively. Despite the compensatory mechanism, frontal hip moments are decreased preoperatively. Supracondylar FDO results in increased frontal hip moments. Changes in anteversion directly influence hip kinetics, although no direct change of the proximal bony geometry is performed. Internal rotation gait cannot fully restore the frontal hip moment. Supracondylar femoral derotation osteotomy (FDO) influences frontal hip kinetics in children with bilateral cerebral palsy. Supracondylar FDO changes the curve progression of frontal hip moments. Supracondylar FDO restores the hip abductor moment arm. Supracondylar FDO leads to an increase in hip abductor muscle force.

Y-Balance Test Performance and Leg Muscle Activations of Children with Developmental Coordination Disorder

This study compared Lower Quarter Y-Balance Test (YBT-LQ) performance and leg muscle kinetics between children with and without developmental coordination disorder (DCD), and investigated the association between YBT-LQ performance and muscle kinetics in children with DCD. Forty-eight children with DCD and 51 children without DCD participated in the study. Leg muscle kinetics were measured using surface electromyography when performing YBT-LQ. Children with DCD exhibited an overall lower YBT-LQ scores than controls. They had a lower peak gastrocnemius medialis activation for YBT-LQ posteromedial direction and shorter duration for the muscle to reach peak torque for YBT-LQ anterior direction. No relationship was found between YBT-LQ performance and leg muscle activations in children with DCD. Children with DCD exhibited a less competent YBT-LQ performance with atypical neuromuscular control.

Number of Synergies Is Dependent on Spasticity and Gait Kinetics in Children With Cerebral Palsy

Children with cerebral palsy have motor dysfunctions, which are mainly associated with the loss of motor coordination. For the assessment of motor coordination, muscle synergies calculated by nonnegative matrix factorization have been investigated. However, the characteristics of muscle synergies in children with cerebral palsy are not understood. This study compared the number of muscle synergies during gait between children with cerebral palsy and children with typical development and clarified whether certain clinical parameters differed according to the number of synergies. Children with cerebral palsy had significantly fewer synergies than children developing typically. The extent of spasticity and gait kinetics differed according to the number of synergies. Increases in the number of synergies are limited by severe spasticity. The muscle synergies calculated by nonnegative matrix factorization have the potential to enable the quantification of motor coordination during gait.

Commentary on “Number of Synergies Is Dependent on Spasticity and Gait Kinetics in Children With Cerebral Palsy”

Commentary on “Number of Synergies Is Dependent on Spasticity and Gait Kinetics in Children With Cerebral Palsy”

Prolonged stretching of the ankle plantarflexors elicits muscle-tendon adaptations relevant to ankle gait kinetics in children with spastic cerebral palsy

Tissue related ankle hyper-resistance has been reported to contribute to equinus gait in children with spastic cerebral palsy. Hence, ankle plantarflexor stretching programs have been developed in order to restore passive ankle dorsiflexion. Despite high quality evidence on the limited effects of stretching on passive joint mobility, further muscle-tendon adaptations have been reported which may impact gait performance. As such, children with spastic cerebral palsy subject to long-term manual static stretching achieved dorsiflexion gains through the reduction of muscle and fascicle strain whilst preserving tendon strain, and prolonged use of ankle-foot orthoses achieved similar dorsiflexion gains through increased tendon strain whilst preserving muscle and fascicle strain. The latter concurred with normalization of early stance plantarflexor moment yet reductions in push-off plantarflexor moment given the increase in tendon compliance. Therefore, similar limited gains in passive ankle joint mobility in response to stretching may be achieved either by preserving/restoring optimal muscle-tendon function, or at the expense of muscle-tendon function and thus contributing gait impairments. The largest increase in ankle passive joint mobility in children with SCP has been obtained through prolonged plantarflexor stretching through ankle casting combined with botulinum neurotoxin type A. However, to our knowledge, there are no published studies on muscle-tendinous adaptations to ankle casting combined with botulinum toxin type A and its effect on ankle joint gait kinetics. Therefore, we hypothesized that ankle casting elicits muscle-tendon adaptations which concur with altered ankle joint kinetics during the stance phase of gait in children with SCP. More information is needed about the relationships between muscle structure and function, and the effect of specific interventions designed to alter muscle properties and associated functional outcomes in children with spastic cerebral palsy.

A comparison of running kinetics in children with and without genu varus: A cross sectional study.

IntroductionVarus knee alignment has been identified as a risk factor for the progression of medial knee osteoarthritis. However, the underlying mechanisms have not been elucidated yet in children. Thus, the aims of the present study were to examine differences in ground reaction forces, loading rate, impulses, and free moment values during running in children with and without genu varus.MethodsThirty-six boys aged 9–14 volunteered to participate in this study. They were divided in two age-matched groups (genu varus versus healthy controls). Body weight adjusted three dimensional kinetic data (Fx, Fy, Fz) were collected during running at preferred speed using two Kistler force plates for the dominant and non-dominant limb.ResultsIndividuals with knee genu varus produced significantly higher (p = .01; d = 1.09; 95%) body weight adjusted ground reaction forces in the lateral direction (Fx) of the dominant limb compared to controls. On the non-dominant limb, genu varus patients showed significantly higher body weight adjusted ground reaction forces values in the lateral (p = .01; d = 1.08; 86%) and medial (p < .001; d = 1.55; 102%) directions (Fx). Further, genu varus patients demonstrated 55% and 36% greater body weight adjusted loading rates in the dominant (p < .001; d = 2.09) and non-dominant (p < .001; d = 1.02) leg, respectively. No significant between-group differences were observed for adjusted free moment values (p>.05).DiscussionHigher mediolateral ground reaction forces and vertical loading rate amplitudes in boys with genu varus during running at preferred running speed may accelerate the development of progressive joint degeneration in terms of the age at knee osteoarthritis onset. Therefore, practitioners and therapists are advised to conduct balance and strength training programs to improve lower limb alignment and mediolateral control during dynamic movements.

Therapeutic effects of an anti-gravity treadmill (AlterG) training on gait and lower limbs kinematics and kinetics in children with cerebral palsy.

We aimed to investigate the effects of the lower body weight support treadmill (AlterG) training on kinetics and kinematics of the lower extremities in children with cerebral palsy (CP). We provided a 45-minute training program, 3 times a week for 8 weeks. AlterG can support the subject's weight up to 70% so that the subject will be able to walk more comfortably to reach a more correct walking pattern. The kinematics and kinetics were evaluated using an isokinetic dynamometer. The locomotion parameters were assessed in the gait laboratory. Subjects performance was evaluated at four time points: baseline (prior to training), 1 and 2 months after the beginning of training, and one month after the end of the training (as a follow-up evaluation). The results showed that the major gait, kinematic, and kinetic parameters improved after the AlterG training and were persistent. These findings suggest that the AlterG training can be considered as a therapeutic tool for improving the lower limb performance and locomotion in children with CP.