Exercise group

Bilateral gastrosoleus stretching, iliopsoas and hamstring stretching (if a shortness is detected), foot intrinsic and extrinsic muscle strengthening, lower extremity muscle strengthening and parkour walking training will be performed. Therapeutic exercises will be performed once a week for 12 weeks under the supervision of a physiotherapist. Parents will be asked to follow a 12-week home exercise program at home during the five days. The home exercise program will include the exercises performed in the pediatric physiotherapy and research laboratory. Parents will be instructed to perform each exercise twice a day at home. Children will be given a weekly exercise diary to increase adherence to the exercise program.

The following assessments will be carried out before starting the exercise program. Then the children will be positioned at the beginning of the prepared 5-meter walking path with their underwear on. First, they will be asked to take trial walks and then they will be asked to walk 5 times on this path at their normal walking pace. Video recordings will be taken from frontal (antero-posterior) and sagittal (lateral) planes with a camera placed on a tripod. The same assessments and video recordings will be repeated at the end of the 12-week physiotherapy program. Observational gait analysis will be performed by scoring with the Edinburg Observational Gait Scoring using the frame-by-frame tracking feature of the video. Video recordings of the children obtained from 3 different angles (anterior-posterior-lateral) will be monitored and scored in slow motion with Kinovea ® software

The Edinburgh Observational Gait Score is an easy-to-use, reliable visual scoring system. In 2003, Read et al. developed this scoring system by identifying the key points of pathologic gait in CP. It has 17 parameters evaluating gait in sagittal, coronal and transverse planes, selected in association with computerized gait analysis. It allows the evaluation of archived gait videos for trunk, pelvis, hip, knee, ankle and foot according to the phases of gait.

It is a test completed by the parents to assess health-related quality of life. It includes some activities that require the use of the foot and leg in daily life. The degree of difficulty of the child with isolated gastrocnemius muscle tightness to perform these activities is scored between 0 (not difficult) and 4 (unable). As the test score gets closer to 0 (zero), the functional level of the child increases.

It is a practical method that provides information about the alignment disorders of the foot and allows evaluation in multiple plans. FPI-6 is a scoring system in the range of -12 and +12 obtained by scoring the data in the range of +2 and -2 for 6 separate analyzes. The evaluation will be performed in the position in which the children feel comfortable, with their arms at their sides, in a standing posture while looking straight ahead. Each analysis will be scored on a 5-point scale (+2, +1, 0, -1, -2) with positive values indicating pronation and negative values indicating supination.