What is the effect of increased co-activation on gait in cerebral palsy?

• A. It has no impact on gait
• B. It only affects upper limbs
• C. It improves gait efficiency
• D. It can contribute to less efficient movement and gait impairment

Answer: (D)

Increased co-activation means muscles around a joint—normally working in sequences to allow smooth, purposeful movement—are firing together. In cerebral palsy, this simultaneous activation makes joints stiffer, reduces range of motion, and disrupts the timing of muscle activity needed for efficient walking. As a result, gait becomes slower, more energy demanding, and often appears stiff or crouched, reflecting a movement pattern that is less efficient. This is why the effect is described as contributing to less efficient movement and gait impairment. The other options don’t fit because co-activation influences the lower limbs and overall gait, it does not leave gait unchanged, and it does not improve efficiency.