Article

Two of the most common gait patterns in children with spastic diplegic cerebral
palsy (CP) are termed 'crouch gait' and 'jump gait'.
While outcomes of surgical
interventions designed to improve functional mobility are generally positive,
many children displaying these gait patterns show minimal or no improvement
post-surgery. A poor response to treatment may be partially attributable to
incorrect interpretations of muscle function. Computational techniques that
assess muscle function may help address this issue, but before studying specific
surgeries, the gait patterns themselves must be better understood. The aim of
this study was to identify differences in lower-limb muscle function when
comparing crouch, jump and able-bodied gait patterns by quantifying the potential
of lower-limb muscles to accelerate the body's center of mass. A muscle's
potential acceleration was defined as the acceleration induced by a unit of
muscle force. Dynamic simulations of walking using musculoskeletal models were
developed for eight children with crouch gait, ten with jump gait, and ten
controls. There were significant differences (p<0.05) in muscle potential
accelerations between crouch and able-bodied gait patterns, and between jump and
able-bodied gait patterns, for most of the major muscles of the hip, knee, and
ankle. One important outcome was the identification of the significantly reduced
potential of gluteus medius to extend the hip in both crouch gait and jump gait.
Potential acceleration analyses appear to be suitable for evaluating differences
between common gait patterns and may also be applied to study the effects of
surgical treatments. The results of such studies may lead to improved treatment
outcomes for individuals with impaired mobility.
CI - Copyright (c) 2012 Elsevier B.V. All rights reserved.

Langue : ANGLAIS