Children with cerebral palsy (CP) often have gait limitations and this is a key target of rehabilitation. Gait training can be an effective intervention to improve functional outcomes such as walking speed and endurance [1]. Virtual reality (VR) is a valuable tool in gait training to increase engagement, however, games must be therapeutically principled. One advantage of VR is that it allows for addition of augmented biofeedback. Biofeedback can improve communication between patient and therapist, while the implementation of gamification and motor learning principles may increase motivation and skill retention. Therapy may target gait parameters, such as step length, knee extension or ankle power generation, with a functional goal to increase walking speed. These gait parameters are interlinked and the most effective target for biofeedback is unknown.@en

A common gait limitation in cerebral palsy (CP) is a reduced ability to generate power at the ankle during push off. This may be due a number of factors, such as muscle weakness or disrupted neuromuscular control. It has been shown that with the use real-time feedback, children with CP can improve key gait parameters such as knee and hip extension [1]. However, it is not known if children can improve ankle power, or, how they would achieve this change at the neuromuscular level. The use of synergy analysis to describe dynamic motor control (DMC) in CP is growing and has been shown to be predictive of treatment outcomes [2].@en