Article

OBJECTIVES: To detect outcome measures that could help differentiate between
dynamic and fixed equinus (FEQ) deformities in children with cerebral palsy, and
secondary, to describe the function of the gastrocnemius and soleus (SOL) muscles
when either dynamic triceps surae tightness or FEQ contracture is present.
A group-comparison study. SETTING: Gait analysis laboratory.
Children (N=23; 31 limbs) with cerebral palsy; 12 limbs showed a
fixed contracture (FEQ group) and 19 limbs showed dynamic tightness of the
triceps muscle (dynamic equinus group). Healthy children (N=12) without a
neurologic or orthopedic disorder served as the control group. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Time-distance, kinematic and kinetic gait
variables, muscle-tendon length, and velocity parameters.
RESULTS: Maximal ankle
dorsiflexion angles were decreased in both equinus groups compared with the
control group. Ankle range of motion, maximal power generation of the plantar
flexors, and its timing during the gait cycle were different among groups. The
ankle slope parameter showed substantial differences among groups. Muscle-tendon
length parameters for the SOL and the medial (MGAC) and lateral gastrocnemius
muscles were abnormal in both equinus groups compared with the control group.
Maximal muscle lengths of the MGAC and SOL were longer in the dynamic equinus
than FEQ group. Peak lengthening velocity of the triceps surae muscle was
significantly slower for all triceps surae muscles in the FEQ group than in the
dynamic equinus group and occurred in the early swing phase. CONCLUSIONS: The
presented results indicate that peak lengthening velocity of the triceps surae
muscle might be one of the discriminating factors between FEQ and dynamic equinus
deformity in children with cerebral palsy. This could help clinical decision
making for treatment of an equinus gait pattern.
CI - Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS