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The partial weight-bearing protocol after lower limb fracture is an important issue in postoperative rehabilitation. Because it is difficult to quantify the actual weight load and provide a constant weight, the protocol is unestablished. By training with a lower-body positive-pressure treadmill and using an in-shoe pressure-measuring device, partial weight-bearing exercise can be performed with quantified loads. This case series illustrates the applicability of an early quantitative partial weight-bearing rehabilitation program using lower-body positive-pressure treadmill with an in-shoe pressure-measuring device after periarticular tibial fractures, which provides a quantitatively predetermined constant load.

Objective: The purpose of this study was to evaluate the efficacy of gastrocnemius and soleus muscle length measured by gait analysis for characterizing the spastic calf muscles in ambulant cerebral palsy. Methods: A total of 20 limbs in the 16 children with diplegic or hemiplegic cerebral palsy showing spasticity of the calf muscle were analyzed by three-dimensional gait analysis before and after botulinum toxin injection. Results: The mean maximal ankle dorsiflexion angle, the minimal knee flexion angle in stance, and the dynamic gastrocnemius and soleus muscle lengths increased after the block. Paradoxically the dynamic gastrocnemius muscle lengths decreased in the eight patients after the block, all of whom had a common characteristic of the genu recurvatum. In contrast, dynamic soleus length, knee angle, and ankle angle improved after the injection. Conclusion: Gastrocnemius length and soleus length are useful variables to evaluate the antispastic effect of botulinum toxin in patients with cerebral palsy. When the genu recurvatum is present, the soleus muscle length is more informative than gastrocnemius length.