Article

The purpose of this study was to determine the effect of a distal rectus femoris
tenotomy on function and gait in adults with cerebral palsy who had diminished
knee flexion during swing. A stiff knee gait pattern is commonly seen in
individuals with cerebral palsy and frequently leads to tripping and falling.
Five subjects, 25-51 years, (34.6+/-10.3 years) participated in the study; each
individual had the surgery after the age of 18. Four of the five subjects
underwent bilateral distal rectus femoris tenotomies for a total of nine limbs
being studied. Four of the five subjects had a single procedure of a distal
rectus femoris tenotomy and one subject also had bilateral adductor tenotomies.
All individuals underwent a pre-operative and post-operative, (3.28+/-1.6 years)
three-dimensional gait analysis. Pre-operative gait revealed diminished peak knee
flexion and out of phase rectus femoris activity with a quiet vastus lateralis
during swing in all subjects. Significant findings after a distal rectus femoris
tenotomy included: improved peak swing knee flexion, improved peak stance hip
extension, and increased total knee excursion without loss in knee extension
strength. During swing, knee flexion angle improved on average 11 degrees which
correlated with subjective report of less shoe wear, tripping, and falling due to
improved clearance. In conclusion, a distal rectus femoris tenotomy should be
considered a surgical option for adults with cerebral palsy and a stiff knee gait
pattern to improve mobility, function, and quality of life.
CI - Copyright (c) 2014 Elsevier B.V. All rights reserved.

Langue : ANGLAIS