{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:28:12Z","timestamp":1785414492425,"version":"3.56.0"},"reference-count":30,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001822","name":"Austrian Academy of Sciences","doi-asserted-by":"publisher","award":["25940"],"award-info":[{"award-number":["25940"]}],"id":[{"id":"10.13039\/501100001822","id-type":"DOI","asserted-by":"publisher"}]},{"award":["25940"],"award-info":[{"award-number":["25940"]}],"id":[{"id":"https:\/\/ror.org\/03anc3s24","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Neurological impairments in children with Cerebral Palsy (CP) often lead to altered muscle architecture and function, resulting in calf muscle contractures. Orthotic immobilization aims to promote muscle\u2013tendon unit lengthening through sustained stretch but may also induce disuse atrophy. This study investigated whether combining immobilization with daily activity yields different effects on muscle strength and gait function compared with immobilization alone. Methods: Fourteen ambulant children with spastic CP and equinus deformity (8 unilateral, 6 bilateral; mean age 9.93 \u00b1 3.0 years; GMFCS I: 10, GMFCS II: 4) participated in a 12-week randomized controlled trial. Participants were assigned to either continuous immobilization (23 h\/day) using a dynamic ankle\u2013foot orthosis or a combined protocol consisting of 14 h\/day immobilization and 10 h\/day of activity involving ankle mobility and calf muscle activation. Outcomes included isometric muscle strength, joint range of motion, gait parameters, and functional measures (Gait Outcomes Assessment List (GOAL) and the Paediatric Outcome Data Collection Instrument (PODCI)). Data were analyzed using linear mixed models with Bonferroni correction. Results: Significant time effects were observed for the knee angle at initial contact (IC), the ankle angle at IC, maximum dorsiflexion, and maximum dorsiflexion during swing. A significant group \u00d7 time interaction was found only for hindfoot-tibia angle at IC. Within-group improvements were noted in activities of daily living, body image and self-esteem, and basic mobility. No significant changes were found for muscle strength or for most questionnaire subscales. Conclusions: The findings indicate time-related improvements in gait, with no consistent advantage of the combined intervention. Further studies with larger samples are needed to evaluate potential long-term effects.<\/jats:p>","DOI":"10.3390\/jcm15103869","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T12:36:40Z","timestamp":1779107800000},"page":"3869","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of Immobilization, Stretching, and Activity on Isometric Muscle Strength and Gait in Young People with Spastic Cerebral Palsy"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0248-3275","authenticated-orcid":false,"given":"Martin","family":"Svehlik","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5546-9090","authenticated-orcid":false,"given":"Andreas","family":"Habersack","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria"},{"name":"Department of Human Movement Science, Sport and Health, University of Graz, Aigner-Rollett-Allee 39, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2826-2999","authenticated-orcid":false,"given":"Bernhard","family":"Guggenberger","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria"},{"name":"Institute of Physiotherapy, JOANNEUM University of Applied Sciences, Alte Poststra\u00dfe 149, 8020 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Mosser","sequence":"additional","affiliation":[{"name":"Department of Human Movement Science, Sport and Health, University of Graz, Aigner-Rollett-Allee 39, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6644-2712","authenticated-orcid":false,"given":"Markus","family":"Tilp","sequence":"additional","affiliation":[{"name":"Department of Human Movement Science, Sport and Health, University of Graz, Aigner-Rollett-Allee 39, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Kraus","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6754-1253","authenticated-orcid":false,"given":"Annika","family":"Kruse","sequence":"additional","affiliation":[{"name":"Department of Human Movement Science, Sport and Health, University of Graz, Aigner-Rollett-Allee 39, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/j.1469-8749.2008.03186.x","article-title":"Selective Control Assessment of the Lower Extremity (SCALE): Development, validation, and interrater reliability of a clinical tool for patients with cerebral palsy","volume":"51","author":"Fowler","year":"2009","journal-title":"Dev. 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