Prolonged swing phase rectus femoris activity is not associated with stiff-knee gait in children with cerebral palsy: A retrospective study of 407 limbs

Knuppe, A.E.; Bishop, N.A.; Clark, Aaron J.; Alderink, Gordon J.; Barr, Kory M.; Miller, Adam

doi:10.1016/j.gaitpost.2012.07.034

Cited by 13 publications

(12 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies reported that RF muscle activity is closely associated with stiff-legged (or -knee) gait (Chapman et al, 2008;Kerrigan et al, 1991;Knuppe et al, 2013;Reinbolt et al, 2008;Riley and Kerrigan, 1998;Sung and Bang, 2000). It has been suggested that hyperactivity of the RF muscle during stance-to-swing transition decreases knee flexion and thereby impairs toe clearance.…”

Section: Discussionmentioning

confidence: 99%

Regional neuromuscular regulation within human rectus femoris muscle during gait

Watanabe

Kouzaki

Moritani

2014

Journal of Biomechanics

View full text Add to dashboard Cite

The spatial distribution pattern of neuromuscular activation within the human rectus femoris (RF) muscle was investigated during gait by multi-channel surface electromyography (surface EMG). Eleven healthy men walked on a treadmill with three gait speeds (4, 5, and 6 km/h) and gradients (0°, 12.5°, and 25°). The spatial distribution of surface EMG was tested by central locus activation (CLA), which is calculated from 2-D multi-channel surface EMG with 46 surface electrodes. For all conditions, CLA was around the middle regions during the swing-to-stance transition and moved in a proximal direction during the stance phase and stance-to-swing transition (p<0.05). CLA during the stance-to-swing transition and early swing phase significantly moved to proximal site with increasing gait speed (p<0.05). During the early stance and swing phases, with increasing grade, CLA significantly moved distally (p<0.05). These results suggest that the RF muscle is regionally activated during a gait cycle and is non-uniformly regulated longitudinally.

show abstract

Section: Discussionmentioning

confidence: 99%

Regional neuromuscular regulation within human rectus femoris muscle during gait

Watanabe

Kouzaki

Moritani

2014

Journal of Biomechanics

View full text Add to dashboard Cite

show abstract

“…Some patients complain of their shoes wearing out rapidly. Although there is still controversy, it is now widely accepted that one of the causes of stiff‐knee gait in patients with CP is spasticity of the rectus femoris . Since rectus femoris transfer (RFT) has been recommended for restoring knee motion during the swing phase, it is now the standard surgical treatment for stiff‐knee gait in patients with CP and is frequently performed as part of a single‐event multilevel surgery …”

mentioning

confidence: 99%

Reliability and validity of the Duncan‐Ely test for assessing rectus femoris spasticity in patients with cerebral palsy

Lee

Sung

Chung

et al. 2015

Develop Med Child Neuro

View full text Add to dashboard Cite

3DGAThree-dimensional gait analysis ICC Intraclass correlation coefficient RFT Rectus femoris transfer ROC Receiver operator characteristics AIM The aim of this study was to clarify the method of the Duncan-Ely test and to estimate its interobserver reliability and validity by comparing it with three-dimensional gait analysis (3DGA). METHOD This study included 36 consecutive ambulatory patients with cerebral palsy (CP)who underwent preoperative 3DGA. The Duncan-Ely test was performed during three different velocities (slow, gravity, and fast). The interobserver reliability was assessed by three examiners. The results of the test were compared with kinematic variables derived from the gait analysis to assess the sensitivity and specificity of the test. The cut-off value was determined at the point of trade-off between the highest sensitivity and specificity. RESULTSThe intraclass correlation coefficient measuring interobserver reliability of the Duncan-Ely test was greatest during fast velocity (0.819). The sensitivity and specificity of the test during gravity velocity for knee range of motion total were 63.0% and 100% respectively, with a cut-off value of 78.3°. The sensitivity and specificity of the test during fast velocity for knee range of motion total were 66.7% and 100% respectively, with a cut-off value of 65°. INTERPRETATIONThe Duncan-Ely test shows excellent reliability in fast knee-flexion velocity, and good sensitivity and specificity compared with 3DGA during physical examination as a preoperative assessment of rectus femoris spasticity in patients with CP.Stiff-knee gait, which is defined as a restricted arc in knee motion during swing, 1 is a common gait disorder in ambulatory patients with cerebral palsy (CP), regardless of the anatomical type of CP.2 Stiff-knee gait results in foot clearance problems and reduces gait velocity and step length. Some patients complain of their shoes wearing out rapidly. Although there is still controversy, 3 it is now widely accepted that one of the causes of stiff-knee gait in patients with CP is spasticity of the rectus femoris. [4][5][6][7] Since rectus femoris transfer (RFT) has been recommended for restoring knee motion during the swing phase, it is now the standard surgical treatment for stiff-knee gait in patients with CP and is frequently performed as part of a single-event multilevel surgery. 1,5,8,9 Before single-event multilevel surgery, a physical examination is essential to assess the patient's physical status. The Duncan-Ely test, among others, has been recommended as a clinical tool for assessing rectus femoris spasticity. 10 In the classic Duncan-Ely test, the examiner passively flexes the knee rapidly while the patient lies prone in a relaxed state. The test is considered positive if the patient simultaneously flexes their ipsilateral hip or if resistance is felt by the examiner during passive knee flexion.10,11 A positive test result reflects the velocitydependent spasticity of the rectus femoris muscle during the rapid movement test as well as mu...

show abstract

“…2 However, studies based on musculoskeletal simulation have found that the timing of PKF during swing was more affected by rectus femoris activity during preswing than early swing. 5 Consistent with these simulation studies, a retrospective study 6 of gait analysis in patients with CP found no association between prolonged activity of the rectus in swing and stiff-knee gait but reported that increased rectus femoris activity during early preswing was associated with a decreased magnitude of PKF during swing.…”

Section: ª 2015 By the American Congress Of Rehabilitation Medicinementioning

confidence: 78%

“…2 Decreased total knee flexion excursion during gait, during initial swing, or during both has also been used occasionally to define stiff-knee gait. 6 The magnitude and timing of PKF during swing are thus the primary components of stiffknee gait; however, it is not known whether these components result from the same pathologies, nor is it known which has the greatest influence on foot clearance during gait, which is an essential clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical and Clinical Correlates of Swing-Phase Knee Flexion in Individuals With Spastic Cerebral Palsy Who Walk With Flexed-Knee Gait

Rha

Cahill‐Rowley

Young

et al. 2015

Archives of Physical Medicine and Rehabilitation

View full text Add to dashboard Cite

Prolonged swing phase rectus femoris activity is not associated with stiff-knee gait in children with cerebral palsy: A retrospective study of 407 limbs

Cited by 13 publications

References 17 publications

Regional neuromuscular regulation within human rectus femoris muscle during gait

Regional neuromuscular regulation within human rectus femoris muscle during gait

Reliability and validity of the Duncan‐Ely test for assessing rectus femoris spasticity in patients with cerebral palsy

Biomechanical and Clinical Correlates of Swing-Phase Knee Flexion in Individuals With Spastic Cerebral Palsy Who Walk With Flexed-Knee Gait

Contact Info

Product

Resources

About