NOVEL THERAPEUTIC EFFECTS OF MIRACLE SMART SHOES ON DYNAMIC GAIT PERFORMANCE AND ANKLE JOINT KINEMATICS DURING GAIT IN CEREBRAL PALSY: A PRELIMINARY INVESTIGATION

This study aimed to investigate the efficacy of the novel “MIRACLE” smart shoes in improving gait performance, particularly toe-walking and foot clearance, in a child with cerebral palsy (CP) demonstrating limited ankle dorsiflexion during gait. This single-case study conducted observational gait assessments and joint kinematic analysis to compare the effects of the MIRACLE smart shoes with those of the regular shoes during overground walking. One child with CP who exhibited abnormal toe-walking and limited foot clearance participated in the study. The MIRACLE smart shoes were developed to increase tibialis anterior activation and decrease excessive gastrocnemius activation during gait by applying a customized talus strap and BOA ® closure system to promote ankle dorsiflexion. Gait performance was evaluated with the dynamic gait index (DGI), the physician rating scale (PRS), and ankle joint kinematic analysis via ImageJ software. The DGI score improved from 16 (with regular shoes) to 20 (with MIRACLE shoes), an 18.4% increase, with significant improvements observed in the “gait level surface” and “step over obstacle” tasks. Additionally, the PRS demonstrated improvements in overall gait mechanics, specifically in ankle dorsiflexion control. ImageJ analysis confirmed improved dorsiflexion kinematics during the swing phase of gait. The MIRACLE smart shoes effectively enhanced gait performance by resolving toe-walking and poor foot clearance in a child with CP. These results indicate that the MIRACLE shoes provide a promising alternative to conventional interventions, offering immediate improvements in functional mobility and reducing fall risk.