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Abstract

The purpose of this study is to determine if children more severely involved with cerebral palsy respond as well to rectus transfer and hamstring surgery as those with less severe involvement. Ninety-nine children were classified as independent community ambulators, crutch/walker-dependent community ambulators, or household/exercise ambulators. Maximum knee extension in stance and total range of knee motion in gait increased following surgery in all groups. Peak knee flexion in swing was maintained in the independent group only, but timing of knee flexion in swing improved in all groups. All groups showed increases in stride length, and the household/exercise group also showed an increase in walking speed. Four of 39 crutch/walker-dependent community ambulators and 13 of 21 household/exercise ambulators progressed to the next higher functional ambulation group.

Importance of preswing rectus femoris activity in stiff-knee gait

“…Several studies have reported that rectus femoris transfer typically improves knee flexion (Gage et al ., 1987; Õunpuu et al ., 1993a; Õunpuu et al ., 1993b; Rethlefsen et al ., 1999; Sutherland et al ., 1990). However, less positive outcomes related to swing phase peak knee flexion have more recently been reported in some patients (Yngve et al ., 2002). …”

Gait improvement surgery in ambulatory children with diplegic cerebral palsy

“…The advantage is that the patients need only one hospital admission and one period of rehabilitation. Favorable short-term outcome of multi-level surgery has been reported ( Saraph et al 2002 , Yngve et al 2002 , Lofterød and Terjesen 2008 ). When the present study was planned, only a few studies had followed the children more than 1 year postoperatively ( Saraph et al 2005 , Rodda et al 2006 ).…”