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Gait electromyography in normal and spastic children, with special reference to quadriceps femoris and hamstring
Insights
Children with spastic cerebral palsy exhibit altered gait patterns, including shorter stance phases and prolonged muscle activity. Careful management of hamstring and quadriceps spasticity is crucial to prevent hyperextended knee gait.
Area of Science:
- Biomedical Engineering
- Neuroscience
- Pediatric Orthopedics
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder affecting motor control.
- Gait abnormalities are a hallmark of spastic CP, impacting mobility and quality of life.
- Understanding muscle function during gait is essential for effective therapeutic interventions.
Purpose of the Study:
- To investigate gait patterns in children with spastic cerebral palsy using telemetered electromyography.
- To analyze the phasic behavior of quadriceps femoris and medial hamstring muscles during gait.
- To identify potential correlations between muscle spasticity and specific gait deviations.
Main Methods:
- Telemetered gait electromyography was employed.
- Gait parameters were assessed in 26 normal children and 32 children with spastic cerebral palsy.
- Phasic activity of quadriceps femoris and medial hamstring muscles was analyzed.
Main Results:
- Children with spastic CP had a shorter stance phase compared to normal children.
- Muscle activity in spastic muscles showed prolonged or dysphasic patterns.
- A high incidence of spastic quadriceps was observed in patients with spastic hamstrings.
Conclusions:
- Altered gait patterns and muscle phasic behavior are characteristic of spastic cerebral palsy.
- Over-weakening spastic hamstrings may lead to genu recurvatum (hyperextended knee gait).
- Balancing hamstring and quadriceps spasticity is critical, with slight knee flexion being a preferred outcome over hyperextension.
Abstract:
Telemetered gait electromyography was used to investigate gait patterns and the phasic behavior of the quadriceps femoris and medial hamstring muscles in 26 normal children and 32 children with spastic cerebral palsy. The average child with spastic cerebral palsy was found to have a shorter stance phase than the normal, but the cadence, while more variable, was nearly the same as normal. The spastic muscles typically exhibited prolonged phasic activity or a dysphasic pattern. Most of the patients with spastic hamstrings also had spastic quadriceps, suggesting that over-weakening the hamstrings may produce an unwanted genu recurvatum or hyperextended knee gait. Care must be taken to balance hamstring spasticity with quadriceps spasticity. A final result with slight knee flexion is preferable to hyperextension.