Article

Knee recurvatum (KR) during gait is common in hemiplegic patients. Quadriceps
spasticity has been postulated as a cause of KR in this population. The aim of
this study was to assess the role of rectus femoris spasticity in KR by using
selective motor nerve blocks of the rectus femoris nerve in hemiparetic stroke
patients. The data from six adult, post-stroke hemiplegic patients who underwent
a rectus femoris nerve block for a stiff-knee gait were retrospectively analyzed.
An extensive clinical and functional evaluation was performed and gait was
assessed by motion analysis (kinematic, kinetic and electromyographic parameters)
before and during the block realized using 2% lidocaine injected under a
neurostimulation and ultrasonographic targeting procedure. The main outcome
measures were the peak knee extension in stance and peak knee extensor moment
obtained during gait analysis. No serious adverse effect of the nerve block was
observed. The block allowed a reduction of rectus femoris overactivity in all
patients. Peak knee extension and extensor moment in stance did not improve in
any patient, but peak knee flexion during the swing phase was significantly
higher after block (mean: 31.2 degrees post, 26.4 pre, p < 0.05). Our results
provide arguments against the hypothesis that the spasticity of the rectus
femoris contributes to KR.
CI - Copyright (c) 2013 Elsevier B.V. All rights reserved.

Langue : ANGLAIS