Introduction:
Children with diplegia have considerably larger hip flexion excursion during the gait cycle than normal developing children. There have been few studies that look at the effect of ankle loading on gait in children with hemiparesis, but none that look at the effect of ankle loading on hip flexion angles during gait in children with diplegia, to our knowledge. The purpose of the study is to evaluate the effect of using a weight around the ankle on the degree of hip flexion excursion in children with diplegia.

Methods:
Fifty children with spastic diplegia were assigned into 2 groups at random (A, B). Both groups received the same prescribed exercise program with gait training for group A and gait training while using a weight around the ankle for group B. Treatment was conducted for 1 hour 3 sessions/week for 3 successive months. Two-dimensional (2D) gait analysis was used to evaluate hip excursion throughout the gait cycle before and after the 3 months of therapy.

Results:
Mixed design MANOVA was used to study the effect within each group and between the 2 groups. A comparison of both groups after treatment demonstrated a significant decrease in right and left hip flexion excursion in the initial swing, mid-swing, terminal swing, initial contact, mid-stance, and pre-swing (p > 0.01). There was no significant difference in loading response between groups after treatment (p = 0.3).

Conclusions:
Using weight around the ankle during gait helped to decrease the degree of excessive hip flexion excursion during gait in children with diplegia.