Smart AFO and 5-Azacitidine to Enhance Mobility in Children With Cerebral Palsy

Inclusion Criteria:

* Diagnosis of cerebral palsy classified as Gross Motor Function Classification System (GMFCS) levels I to III
* Between 8 and 17 years and 8 months of age at the time of enrollment/consent. Participants that will turn 18 during the course of the study will not be included as pausing the at-home protocol until re-consenting is possible could interfere with intervention results.
* Stable medical condition as determined by the investigator.
* Adequate caregiver support to be able to participate in training and assessment sessions for the duration of the study, at the discretion of the PI.
* Height/weight/BMI between the 5th - 95th percentile of children with cerebral palsy
* Able to walk for at least 6 minutes (assisted or unassisted)
* Able to understand and follow simple directions
* Able to safely fit into a device configuration and tolerate assistance without knee hyperextension while walking
* At least 20 degrees of passive ankle plantar flexion range of motion
* Physician approval for participation

Exclusion Criteria:

* Knee extension or ankle dorsiflexion contractures greater than 15 degrees
* Immunodeficiency or hematologic condition
* Allergy to AZA or mannitol
* Plans to receive a vaccine within 30 days of the planned AZA or placebo injection to take place at week 5
* Pregnancy
* Orthopedic surgery on the lower limbs completed in the prior 12 months
* New implanted device (e.g., baclofen pump) and/or active intrathecal medication titration that may affect muscle spasticity
* Botulinum toxin treatment within 3 months preceding enrollment unless given approval by the study physician
* Severe osteoporosis unless given approval by the study physician
* Current enrollment in a conflicting research study
* Any other health condition or diagnosis not listed above that may put the participant at risk as determined by the PI or study physician