Article

Identification of secondary and tertiary impairments in neurologically induced
gait deviations, such as crouch gait, is not always straightforward, but
essential in order to decide upon the most efficient medical treatment in
patients with cerebral palsy (CP). Until now, exact intersegmental dependency of
the development of foot deformities has not been investigated. Therefore, the aim
of this study was to explore if an artificially induced bilateral knee flexion
contracture causes compensatory mechanisms in foot motion during gait in healthy
children. Three-dimensional kinematic and kinetic data from 30 healthy children
(mean age 10.6 years) were derived from the Oxford Foot model (OFM). Participants
walked first in an artificially induced crouch gait (limitation of knee extension
to 40 degrees ) and then normally. Walking speed was kept the same in both
conditions. Analysis revealed small but significant (p<0.05) differences between
the two conditions in hindfoot and forefoot kinematics in all three planes during
the stance phase as well as for all peak internal moments within the foot. In
general the foot tended to compensate for an artificial knee flexion contracture
with an increase in maximal dorsiflexion, eversion and external rotation of the
hindfoot, which also allowed increased foot motion in other foot segments. The
results of this study showed that an isolated proximal joint contracture had an
influence on foot position during stance in healthy children. Further
interpretation of the data in relation to CP children will be possible as soon as
comparable OFM data of pathological crouch gait is available.
CI - Copyright (c) 2013 Elsevier B.V. All rights reserved.

Langue : ANGLAIS