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Related Experiment Videos

Novel biomechanics demonstrate gait dysfunction due to hamstring tightness.

Kevin M Cooney1, James O Sanders, M Cecilia Concha

  • 1Motion Analysis Laboratory, Shriners Hospitals for Children, Erie PA 16505, USA. kcooney@shrinenet.org

Clinical Biomechanics (Bristol, Avon)
|October 11, 2005
PubMed
Summary

Children with cerebral palsy have limited knee extension due to hamstring tightness. A new measure, Available Knee Extension, links clinical findings to dynamic gait limitations, aiding in assessment.

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Area of Science:

  • Biomechanics
  • Pediatric Orthopedics
  • Neuromuscular Disorders

Background:

  • Children with cerebral palsy often exhibit hamstring tightness, leading to reduced knee extension during the terminal swing phase of gait.
  • The traditional popliteal angle measurement inadequately reflects dynamic hamstring tightness and its impact on gait.
  • This study investigates a novel method to quantify dynamic hamstring tightness in children with cerebral palsy.

Purpose of the Study:

  • To develop and validate a new clinical measure, Available Knee Extension, for assessing dynamic hamstring tightness in children with cerebral palsy.
  • To determine the relationship between this novel measure and limitations in terminal swing knee extension during gait.
  • To compare gait parameters and hamstring muscle activity between children with cerebral palsy and typically developing children.

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Main Methods:

  • Six children with cerebral palsy and six typically developing children underwent physical examination and instrumented gait analysis.
  • A modified popliteal angle measurement, assessing resistance at first stretch (R(1)), was used to calculate Available Knee Extension.
  • Passive R(1) measurements were correlated with gait analysis data, including knee extension and hamstring electromyography (EMG).

Main Results:

  • Available Knee Extension showed a significant correlation with reduced terminal swing knee extension (r = -0.7251, P < 0.0001).
  • Children with cerebral palsy exhibited significantly slower walking velocity, reduced terminal swing knee extension, and decreased power absorption compared to controls.
  • Eleven of twelve affected knees demonstrated negative Available Knee Extension, indicating marked limitation.

Conclusions:

  • The novel measure of Available Knee Extension effectively links clinical hamstring tightness assessments to dynamic gait limitations in children with cerebral palsy.
  • This measure provides a valuable biomechanical insight into the functional impact of hamstring tightness.
  • Available Knee Extension may improve the clinical evaluation and management of gait abnormalities in this population.