Effects of contracture on gait kinematics: A systematic review

Attias, Michael; Chevalley, Odile; Bonnefoy‐Mazure, Alice; Coulon, Geraldo De; Chèze, Laurence; Armand, Stéphane

doi:10.1016/j.clinbiomech.2016.02.017

Cited by 31 publications

(21 citation statements)

References 41 publications

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“…The mechanical properties of the passive muscle play an important functional role for the completion of movements (Proske & Morgan, 1999). For instance, muscle contractures, defined as a decrease in muscle length and an increase in passive muscle stiffness (Fergusson et al 2007), dramatically reduce the joint range of motion during walking (Attias et al 2016) or upper-limb tasks (de Groot et al 2011). Plantar flexor muscles are in particular at risk from muscle contractures as a common complication from neurological and musculoskeletal conditions (Farmer & James, 2001;Fergusson et al 2007).…”

Section: Introductionmentioning

confidence: 99%

Stiffness mapping of lower leg muscles during passive dorsiflexion

et al. 2017

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It is challenging to differentiate the mechanical properties of synergist muscles in vivo. Shear wave elastography can be used to quantify the shear modulus (i.e. an index of stiffness) of a specific muscle. This study assessed the passive behavior of lower leg muscles during passive dorsiflexion performed with the knee fully extended (experiment 1, n = 22) or with the knee flexed at 90° (experiment 2, n = 20). The shear modulus measurements were repeated twice during experiment 1 to assess the inter-day reliability. During both experiments, the shear modulus of the following plantar flexors was randomly measured: gastrocnemii medialis (GM) and lateralis (GL), soleus (SOL), peroneus longus (PL), and the deep muscles flexor digitorum longus (FDL), flexor hallucis longus (FHL), tibialis posterior (TP). Two antagonist muscles tibialis anterior (TA), and extensor digitorum longus (EDL) were also recorded. Measurements were performed in different proximo-distal regions for GM, GL and SOL. Inter-day reliability was adequate for all muscles (coefficient of variation < 15%), except for TP. In experiment 1, GM exhibited the highest shear modulus at 80% of the maximal range of motion (128.5 ± 27.3 kPa) and was followed by GL (67.1 ± 24.1 kPa). In experiment 2, SOL exhibited the highest shear modulus (55.1 ± 18.0 kPa). The highest values of shear modulus were found for the distal locations of both the GM (80% of participants in experiment 1) and the SOL (100% of participants in experiment 2). For both experiments, deep muscles and PL exhibited low levels of stiffness during the stretch in young asymptomatic adults, which was unknown until now. These results provide a deeper understanding of passive mechanical properties and the distribution of stiffness between and within the plantar flexor muscles during stretching between them and thus could be relevant to study the effects of aging, disease progression, and rehabilitation on stiffness.

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Section: Introductionmentioning

confidence: 99%

Stiffness mapping of lower leg muscles during passive dorsiflexion

et al. 2017

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“…Muscle/tendon contractures are the most obvious symptoms and are characterized by decreased muscle lengths/tendon lengths and increased passive stiffness values. They can lead to reduced joint ranges of motion (ROM) during walking and running 12 . Traditional metrics used to assess passive mechanical properties include the passive ROM and the global joint torques generated by motion resistance.…”

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confidence: 99%

Influence of different knee and ankle ranges of motion on the elasticity of triceps surae muscles, Achilles tendon, and plantar fascia

Liu

Zhou

Sun

et al. 2020

Sci Rep

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Stiffness is a valuable indicator of the functional capabilities of muscle-tendon-fascia. Twenty healthy subjects participated in this study in which the passive elastic properties of the medial gastrocnemius (MG), lateral gastrocnemius (LG), soleus muscles (SOL), Achilles tendon (AT, at 0 cm, 3 cm and 6 cm proximal to the calcaneus tubercle, corresponding to AT0cm, AT3cm and AT6cm, respectively) and plantar fascia (PF) were quantified when their knee was fully extended or flexed to 90° using shear wave elastography at 25° of dorsiflexion (DF25°), 0° (neutral position) of flexion, and 50° of plantar flexion (PF50°) of the ankle joint. The stiffnesses of the AT, MG, LG, SOL and the fascia with the knee fully extended were significantly higher than those with the knee flexed to 90° (p < 0.05), while the stiffness of the PF showed the opposite relationship (p < 0.05). When the knee was fully extended, the stiffness was higher in the LG than in the MG at PF50° and 0° (p < 0.01), and it was higher in the MG than in the LG at DF25° (p = 0.009). Nevertheless, regardless of the knee angle, the stiffness decreased from AT3cm > AT0cm > AT6cm at PF50° and 0° (p < 0.001), while the stiffness decreased from AT0cm > AT3cm > AT6cm at DF25°. Regardless of the knee and ankle angles, the stiffness of the PF increased in a proximal-to-distal direction (p < 0.001). These insights can be used to gain a more intuitive understanding of the relationships between the elastic properties of the muscle-tendon unit and its function. Achilles tendon (AT) injuries and plantar fasciitis can cause chronic pain and impairment 1. In the clinic, the type of treatment administered depends in part on the region and intensity of pain. For example, eccentric exercises are more effective in the treatment of mid-substance tendinopathy than in the treatment of insertional tendinopathy 1. However, because of the complexity of the anatomy and mechanics of the AT and plantar fascia (PF), it can be challenging to identify the region and severity of the damage. In terms of anatomy, the AT, which is the conjoined tendon of the medial gastrocnemius (MG), the lateral gastrocnemius (LG), and the soleus (SOL), is an important bridge for walking, running and jumping in daily life, and each of the contributing muscles exhibit unique structural features 2,3. The twisted structure of the AT is formed by the MG tendons, LG tendons and SOL tendons. These muscle tendons rotate as they descend but do not run parallel to each other 4. In addition, the superficial layer of the AT is formed by the MG tendons, while the deep layer consists of the LG tendons and SOL tendons 5. Furthermore, the LG is shorter and smaller than the MG, so the MG and LG differ in terms of muscle strength and their contribution to the AT 6. In other words, these regional structural features (including those of the MG, LG, SOL, AT and PF) have great inherent variability, which may affect the position and severity of damage in an individual 6. Therefore, it is necessary to further understand the relati...

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“…The level of contracture was selected as mild, moderate and severe contracture according our clinical experience and the literature [16,20,21]. Hence, PSO was limited at 0°, -20° and -40° of hip extension angle (knee in extension), HAM was limited at 40°, 70° and 100° of unilateral popliteal angle and GAS was limited at 10°, 20° and 30° of ankle plantarflexion.…”

Section: Gait Evaluationmentioning

confidence: 99%

“…Secondary, compensatory strategies should disappear once these primary impairments have been treated [15]. Therefore, an original approach to establish an association between primary impairments and gait deviation is to investigate the impact of one isolated impairment on gait deviations [16].…”

Section: Introductionmentioning

confidence: 99%

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Kinematics can help to discriminate the implication of iliopsoas, hamstring and gastrocnemius contractures to a knee flexion gait pattern

Attias

Bonnefoy‐Mazure²,

Coulon³

et al. 2019

Gait & Posture

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Background: Excessive Knee Flexion Gait Pattern (KFGP) is a common gait deviation in many pathological conditions. The contractures of the muscles that have been identified as being responsible of KFGP are: iliopsoas, hamstring and gastrocnemius. Research question:How do isolated contractures of the iliopsoas, hamstrings and gastrocnemius impact knee flexion during gait?Methods: Three levels of contracture (mild, moderate and severe) were simulated bilaterally using an exoskeleton on 10 healthy participants for iliopsoas, hamstring and gastrocnemius muscles. A gait analysis session was performed to evaluate the joint kinematics according to the different simulated contractures. Thirty one parameters were chosen to analyze the kinematics of the thorax, pelvis, hip, knee and ankle. A principal component analysis (PCA) was used to determine the kinematic parameters influenced by contractures. Results:In addition to a permanent knee flexion observed for the three muscles with contracture: the contracture of the iliopsoas induces a large hip flexion with pronounced anterior pelvis tilt; the contracture of the hamstrings induces an ankle dorsiflexion during the support phase with a posterior pelvis tilt; the contracture of the gastrocnemius induces an absence of first and second rocker of the ankle with a slight flexion of hip and a slight anterior pelvis tilt.Significance: These results support the identification of the muscles responsible for a KFGP.A better knowledge of the interactions between contractures and associated joint kinematics of the same and adjacent joints will support the interpretation of gait analyses by more precisely and faster targeting the concerned muscle.

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Effects of contracture on gait kinematics: A systematic review

Cited by 31 publications

References 41 publications

Stiffness mapping of lower leg muscles during passive dorsiflexion

Stiffness mapping of lower leg muscles during passive dorsiflexion

Influence of different knee and ankle ranges of motion on the elasticity of triceps surae muscles, Achilles tendon, and plantar fascia

Kinematics can help to discriminate the implication of iliopsoas, hamstring and gastrocnemius contractures to a knee flexion gait pattern

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