Article

Hamstrings and psoas lengths during normal and crouch gait: implications for muscle-tendon surgery.

Rehabilitation Institute of Chicago, IL 60611, USA.
Journal of Orthopaedic Research (impact factor: 2.81). 02/1996; 14(1):144-51. DOI:10.1002/jor.1100140123 pp.144-51
Source: PubMed

ABSTRACT Crouch gait, one of the most common movement abnormalities among children with cerebral palsy, is characterized by persistent flexion of the knee during the stance phase. Short hamstrings are thought to be the cause of crouch gait; thus, crouch gait is often treated by surgical lengthening of the hamstrings. In this study, a graphics-based model of the lower extremity was used in conjunction with three-dimensional kinematic data obtained from gait analysis to estimate the lengths of the hamstrings and psoas muscles during normal and crouch gaits. Only three of 14 subjects with crouch gait (four of 20 limbs with knee flexion of 20 degrees or more throughout stance) had hamstrings that were shorter than normal by more than 1 SD during walking. Most (80%) of the subjects with crouch gait had hamstrings of normal length or longer, despite persistent knee flexion during stance. This occurred because the excessive knee flexion was typically accompanied by excessive hip flexion throughout the gait cycle. All of the subjects with crouch gait had a psoas that was shorter than normal by more than 1 SD during walking. These results emphasize the need to consider the geometry and kinematics of multiple joints before performing surgical procedures aimed at correcting crouch gait.

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Keywords

14 subjects
 
cerebral palsy
 
common movement abnormalities
 
correcting crouch gait
 
crouch gait
 
crouch gaits
 
excessive hip flexion
 
excessive knee flexion
 
gait analysis
 
gait cycle
 
kinematics
 
knee flexion
 
lower extremity
 
multiple joints
 
persistent flexion
 
persistent knee flexion
 
Short hamstrings
 
surgical lengthening
 
surgical procedures
 
three-dimensional kinematic data