Children with cerebral palsy (CP) can sometimes walk without assistance, but this depends heavily on the type and severity of their condition, as well as the interventions they receive. Cerebral palsy is a group of disorders affecting movement and muscle tone caused by damage to the developing brain, often resulting in challenges with walking and balance. Some children with milder forms, especially those with unilateral CP (affecting one side of the body), may achieve independent walking, while others with more severe or bilateral involvement often require assistive devices or therapies to walk safely or at all[1].
Walking ability in children with CP varies widely. Research shows that children with unilateral CP tend to maintain better walking function over time compared to those with bilateral CP, who often experience more significant gait deviations and reduced walking speed as they age[1]. For example, a 16-year follow-up study found that adults with bilateral CP showed increased gait abnormalities and slower walking speeds, although their overall walking capacity did not significantly decline[1]. This suggests that while walking may become more effortful or less efficient, many individuals retain some ability to walk independently.
The nature of walking difficulties in CP often involves spasticity (muscle stiffness), muscle weakness, and impaired motor control. These factors can cause abnormal gait patterns such as crouch gait, toe walking, or scissoring. Advanced biomechanical analyses, such as those using motion capture technology, have helped identify specific muscle groups and nerve pathways contributing to these walking challenges. For instance, in spastic diplegia (a common form of CP affecting the legs), hamstring muscles may misfire, leading to instability and falls[2]. Understanding these details allows clinicians to tailor treatments more effectively.
Treatment options aimed at improving walking ability include physical therapy, orthopedic surgeries, medications like Botox injections to reduce spasticity, and more recently, advanced interventions such as selective dorsal rhizotomy (SDR). SDR is a surgical procedure that selectively cuts nerve roots in the spinal cord to reduce spasticity and improve motor function. This surgery has been shown to help some children with spastic CP walk more steadily and with less effort[2]. Additionally, assistive technologies like ankle exosuits and body weight support treadmill training are being studied for their potential to enhance walking biomechanics and endurance in children with CP[5][7].
Physical therapy programs focusing on endurance and limb strengthening, sometimes combined with electrical muscle stimulation, are also under investigation to improve walking capacity and muscle function in children with CP[4]. These interventions aim to maximize the child’s own walking ability, potentially reducing reliance on assistive devices.
In summary, while many children with cerebral palsy can walk without assistance, this depends on individual factors such as the type of CP, severity of motor impairment, and the effectiveness of medical and therapeutic interventions. Advances in clinical gait analysis and targeted treatments have improved the prospects for independent walking in many cases, but some children will continue to need support to walk safely.
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[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC12447520/
[2] https://www.unomaha.edu/news/2025/09/the-kid-the-scientists-and-the-walk-that-changed-everything.php
[3] https://www.frontiersin.org/journals/bioengineering-and-biotechnology/articles/10.3389/fbioe.2025.1604658/ful
