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Can toe-walking contribute to stiff-legged gait?
D C Kerrigan1, D T Burke, T J Nieto
1Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts 02114, USA.
American Journal of Physical Medicine & Rehabilitation
|January 4, 2001
Summary
Toe-walking significantly reduces knee flexion during gait, similar to stiff-legged gait patterns. This suggests toe-walking itself, not just quadriceps spasticity, may cause reduced knee flexion in some patients.
Area of Science:
- Biomechanics
- Gait Analysis
- Neurology
Background:
- Stiff-legged gait, characterized by reduced knee flexion during swing, is often attributed to spastic quadriceps.
- Previous research suggests indirect factors like poor hip flexion and abnormal foot-ankle function contribute to this gait pattern.
Purpose of the Study:
- To investigate if toe-walking, a common co-occurring gait deviation, independently contributes to reduced knee flexion in the swing phase.
- To differentiate the effects of toe-walking from intrinsic spasticity or abnormal muscle activity around the knee.
Main Methods:
- Analysis of three-dimensional kinematic data from able-bodied subjects.
- Comparison of gait patterns during voluntary toe-walking versus normal heel-toe walking.
Main Results:
- Peak knee flexion was significantly reduced during toe-walking (42.2±8.9°) compared to normal heel-toe walking (59.2±5.7°).
- This reduction was observed while controlling for walking speed (P < 0.00001).
Conclusions:
- Reduced knee flexion in stiff-legged gait may be partly explained by the presence of toe-walking.
- This finding has clinical implications for gait rehabilitation in patients exhibiting both toe-walking and stiff-legged gait patterns.
- Toe-walking itself can be a significant factor contributing to reduced knee flexion, independent of other potential causes like spasticity.