Clinical and gait analysis of isolated soft tissue release surgery in crouch gait patients

Aim: The aim of this study was to evaluate whether isolated soft tissue release operation provides clinical and kinematic improvement in crouch gait, which is one of the major walking problems in cerebral palsy (CP) patients.Material Methods: This retrospective study included 32 limbs of 16 patients aged between 4 and 12 years with crouch gait walking pattern due to cerebral palsy between January 2004 and December 2013. All patients underwent multilevel isolated soft tissue release surgery. The preoperative and postoperative GMFSC level, clinical findings and gait analysis data of the patients were recorded. Pre-operative and post-operative data, which are obtained at post-op 6th month clinical examination and gait analysis, was compared.Results: A total of 114 lower extremity soft tissue segments (mean 7.1 segments) were operated. The most common surgery was medial hamstring lengthening (22). GMFCS score was 2.38±0.5 before operation, 1.69±0.4 at postoperative controls,and popliteal angle decreased from 65.2±11.9 to 60.15 (p 0.05) and step width (mm)(144.41±50.61 147.94±87.8 p> 0.05) increased in postoperative evaluation.Conclusions: Single-session isolated soft tissue release surgeries have borth positive effect on clinical and functional outcomes in selected CP patients with crouch gait walking disorder. Priority should be to correct bone deformities in patients with bone deformit

Effects of Increased Femoral Anterversion on Gait in Children with Cerebral Palsy

Objective: The aim of this study is to identify the gait deviations due to increased femoral anteversion and to distinguish these deviations from those which are commonly seen in children with spastic diplegic cerebral palsy (SD)

Discrimination of abnormal gait parameters due to increased femoral anteversion from other effects in cerebral palsy

The effects of increased femoral anteversion (IFA) on gait pattern have a complex relationship with other orthopaedic and neurological abnormalities of cerebral palsy (CP). The aim of this study was to differentiate the effects of IFA from other factors in CP. The four groups in this study included: 15 typically developing children (Group: TDC) (age: 9.7 +/- 0.5); 14 TDC with IFA (7.5 +/- 1.7) (Group: TDC-IFA); 8 CP participants with IFA (age: 6.3 +/- 1.7) (Group: CP IFA); and 10 CP participants with nearly normal femoral anteversion (age: 10.3 +/- 4.7) (Group: CP-NFA). Altered peak knee-extension angle and stance-time, increased internal hip-rotation, internal foot-progression (p <= 0.05) were influenced by IFA in both groups of CP-NFA and TDC-IFA. For the TDC groups; pelvic-rotation increased and peak knee and hip-extension, knee flexion-moment, peak knee-power generation in late-stance decreased among children with IFA (p <= 0.05). For CP children; anterior pelvic-tilt, hip-flexion and peak knee-extension, hip power-absorbsion and generation, and peak knee power-absorsion (K3) increased and peak knee-flexion was delayed by IFA (p <= 0.05)

Contributors of stiff knee gait pattern for able bodies: Hip and knee velocity reduction and tiptoe gait

Stiff-knee gait (SKG) is commonly encountered in clinic; many other gait abnormalities are seen together with this pathology. Simulation studies revealed that diminished knee flexion (KF) velocity and increased knee extension moments are strongly related with SKG. This study aimed to determine whether tiptoe walking and hip-knee flexion velocity reduction causes SKG pattern in healthy participants

Weakening iliopsoas muscle in healthy adults may induce stiff knee pattern

Objective: The goal of the present study was to investigate the relationship between iliopsoas muscle group weakness and related hip joint velocity reduction and stiff-knee gait (SKG) during walking in healthy individuals