Article

Psoas contracture is known to cause abnormal hip motion in patients
with cerebral palsy. The authors investigated the clinical relevance of hip
kinematic and kinetic parameters, and 3D modeled psoas length in terms of
discriminant validity, convergent validity, and responsiveness. METHODS:
Twenty-four patients with cerebral palsy (mean age 6.9 years) and 28 normal
children (mean age 7.6 years) were included. Kinematic and kinetic data were
obtained by three dimensional gait analysis, and psoas lengths were determined
using a musculoskeletal modeling technique. Validity of the hip parameters were
evaluated. RESULTS: In discriminant validity, maximum psoas length (effect size r
= 0.740), maximum pelvic tilt (0.710), maximum hip flexion in late swing (0.728),
maximum hip extension in stance (0.743), and hip flexor index (0.792) showed
favorable discriminant ability between the normal controls and the patients. In
convergent validity, maximum psoas length was not significantly correlated with
maximum hip extension in stance in control group whereas it was correlated with
maximum hip extension in stance (r = -0.933, p < 0.001) in the patients group. In
responsiveness, maximum pelvic tilt (p = 0.008), maximum hip extension in stance
(p = 0.001), maximum psoas length (p < 0.001), and hip flexor index (p < 0.001)
showed significant improvement post-operatively.
CONCLUSIONS: Maximum pelvic
tilt, maximum psoas length, hip flexor index, and maximum hip extension in stance
were found to be clinically relevant parameters in evaluating hip flexor
contracture.

Langue : ANGLAIS