# Mechanics of overground, dry, and aquatic treadmill walking in children & adolescents with cerebral palsy

> **NIH NIH R15** · UNIVERSITY OF NEBRASKA OMAHA · 2022 · $448,118

## Abstract

Abstract
This project will determine biomechanical mechanisms to optimize walking rehabilitation in
overground, dry treadmill, and wet treadmill environments for children with cerebral palsy (CP).
Cerebral palsy is a neurological disorder caused by brain damage in early development that
impairs motor control and overall mobility. Common gait issues in children with CP are excessive
knee flexion, excessive hip flexion/adduction, and high muscular demand. Additionally, children
with CP have lower-limb muscle weakness and low joint ranges of motion (ROM). These are
speculated as key mechanisms decreasing walking endurance, independence, and quality of life.
Less understood is how lower limb kinematics and muscle activity are modified amongst different
walking environments commonly used in rehabilitation. In addition, post-operative tolerance to
various walking speeds has not been rigorously examined in children with CP. Through
descriptive studies, we will perturb walking speed amongst diverse walking environments,
characterize within-subject changes to spatiotemporal walking parameters, and establish a
fulsome evidence base to design future clinical trials. We hypothesize that walking environment
will impact lower limb kinematics and muscle activity due to hydrodynamic drag and altered
walking strategies. Furthermore, we hypothesize that the impact of walking environment will vary
base on speed. Aim 1: Determine the effects of walking speed and environment on lower body
kinematics and muscular demand in children with CP. Aim 2: Link overground walking function
with lower body kinematics and muscular demand in diverse walking rehabilitation conditions. Aim
3: Establish post-operative functional differences for walking rehabilitation in children with CP that
receive Distal Femoral Extension Osteotomy (DFEO) or Anterior Distal Femoral
Hemiepiphysiodesis (ADFH). Considering the ubiquity of post-operative rehabilitation, the clinical
importance of data-driven interventions for children with CP is difficult to overstate.

## Key facts

- **NIH application ID:** 10514226
- **Project number:** 1R15HD109666-01
- **Recipient organization:** UNIVERSITY OF NEBRASKA OMAHA
- **Principal Investigator:** David C Kingston
- **Activity code:** R15 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $448,118
- **Award type:** 1
- **Project period:** 2022-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10514226

## Citation

> US National Institutes of Health, RePORTER application 10514226, Mechanics of overground, dry, and aquatic treadmill walking in children & adolescents with cerebral palsy (1R15HD109666-01). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10514226. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*