To ensure that results from a treadmill walking protocol do not simply reflect learning, subjects must be habituated to walking on a treadmill. PURPOSE: To determine, for children and adolescents with mild cerebral palsy (CP), if: i) lower limb antagonist muscle co-activation during treadmill walking is affected by repeated walking bouts on different days, and ii) the effects of repeated walking bouts vary according to walking speed, co-activation site (thigh or lower leg) or lower limb dominance. METHODS: Following 12–15 minutes of treadmill walking practice during an introductory visit, 3 girls and 5 boys (11.9 ± 2.5 y) with mild spastic CP (n=5 diplegic CP, n=3 hemiplegic CP) walked on a treadmill for 3 minutes at three different speeds; 60, 75, and 90% of their previously determined fastest treadmill walking speed (FWS), on three different days. Electromyographic (EMG) activity for antagonist muscles at the thigh (quadriceps and hamstrings) and at the lower leg (tibialis anterior and triceps surae), bilaterally, was collected for the entire 3 minutes of each walk. Antagonist muscle co-activation at the thigh and lower leg was subsequently quantified using a co-activation measure (CM, where 100 = peak EMG activity). RESULTS: Repeated treadmill walks on different days did not affect the CM at any site, or at any speed. Independent of day, speed, and lower limb dominance, the thigh CM was on average 20% higher (P = 0.02) than the lower leg CM. There was also a trend (P = 0.06) for co-activation to be on average 16% higher for the non-dominant compared to the dominant leg, independent of the day, speed or site. Between-day reliability of the CM was high (intraclass correlation coefficient, R = .99). Variability (co-efficient of variation) of the CM was greatest for the dominant thigh (13.8%) and least for the non-DOM thigh (9.2%). CONCLUSIONS: An initial treadmill walking practice session of 12–15 minutes may be sufficient for obtaining stable and reliable between-day lower limb CM values. Stability of CM with this walking practice protocol is further suggested by the similarity of the present inter-site and inter-dominance patterns, across days and across speeds, to previous findings which used the same treadmill walking practise protocol, for one speed (90% FWS), on one day.
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