Crouch gait or flexed-knee gait in cerebral palsy: Is there a difference? A systematic review

O’Sullivan, Rory; Marron, A.; Brady, Karen

doi:10.1016/j.gaitpost.2020.09.001

Cited by 17 publications

(8 citation statements)

References 85 publications

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“…Several walking patterns have been identified in children with CP. In many studies, crouch gait and jump gait are pooled under the denomination “flexed knee gait” because of the excessive knee flexion appearing during early stance in both of these gait patterns 32 . Although an increased knee maximum flexion between the first and sixth minutes of the 6mwe was also found in crouch gait in a previous study, 8 differences were highlighted by the present study in children who walk with jump gait.…”

Section: Discussionmentioning

confidence: 39%

“…In many studies, crouch gait and jump gait are pooled under the denomination "flexed knee gait" because of the excessive knee flexion appearing during early stance in both of these gait patterns. 32 Although an increased knee maximum flexion between the first and sixth minutes of the 6mwe was also found in crouch gait in a previous study, 8 differences were highlighted by the present study in children who walk with jump gait. First, increased knee flexion was observed only in early midstance in jump gait, whereas it was increased throughout the stance phase in crouch gait.…”

Section: Specificities Of Gait Deterioration According To Walking Pat...mentioning

confidence: 97%

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Short Walking Exercise Leads to Gait Changes and Muscle Fatigue in Children With Cerebral Palsy Who Walk With Jump Gait

Parent

Maso

Pouliot-Laforte

et al. 2021

Am J Phys Med Rehabil

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Section: Discussionmentioning

confidence: 39%

Section: Specificities Of Gait Deterioration According To Walking Pat...mentioning

confidence: 97%

Short Walking Exercise Leads to Gait Changes and Muscle Fatigue in Children With Cerebral Palsy Who Walk With Jump Gait

Parent

Maso

Pouliot-Laforte

et al. 2021

Am J Phys Med Rehabil

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show abstract

“…Especially those individuals with relatively good GMFCS levels, but decreased knee flexion range of motion, and delayed peak knee flexion within the gait cycle showed a high risk of being classified as “non-responsive in their gait characteristics” when undergoing standard treatment. While problems with knee-flexion and the timing of peak knee flexion among children with cerebral palsy are well known [ 25 ], the current study highlights that these problems might in fact predispose individuals to further worsening of gait. In-depth future evaluations would be required to better understand why the GPS of these individuals did not respond positively or even worsened after the treatment, and what could be done to avoid this outcome.…”

Section: Discussionmentioning

confidence: 84%

Identifying treatment non-responders based on pre-treatment gait characteristics - A machine learning approach

Visscher,

Murer,

Fahimi

et al. 2023

Heliyon

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“…The crouching gait is specifically manifested that the knee flexion angle is too large, and the patient cannot walk upright. Long-term crouching posture could lead to knee cartilage degradation and joint pain (O'Sullivan et al, 2020). The outcomes of this study demonstrated that the knee flexion deformity of the patient had improved after surgery.…”

Section: Discussionmentioning

confidence: 67%

Evaluation of Multilevel Surgeries in Children With Spastic Cerebral Palsy Based on Surface Electromyography

Luo

Zhang

et al. 2021

Front. Neurosci.

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The root mean square (RMS) of the surface electromyography (sEMG) signal can respond to neuromuscular function, which displays a positive correlation with muscle force and muscle tension under positive and passive conditions, respectively. The purpose of this study was to investigate the changes in muscle force and tension after multilevel surgical treatments, functional selective posterior rhizotomy (FSPR) and tibial anterior muscle transfer surgery, and evaluate their clinical effect in children with spastic cerebral palsy (SCP) during walking. Children with diplegia (n = 13) and hemiplegia (n = 3) with ages from 4 to 18 years participated in this study. They were requested to walk barefoot at a self-selected speed on a 15-m-long lane. The patient's joints' range of motion (ROM) and sEMG signal of six major muscles were assessed before and after the multilevel surgeries. The gait cycle was divided into seven phases, and muscle activation state can be divided into positive and passive conditions during gait cycle. For each phase, the RMS of the sEMG signal amplitude was calculated and also normalized by a linear envelope (10-ms running RMS window). The muscle tension of the gastrocnemius decreased significantly during the loading response, initial swing, and terminal swing (p < 0.05), which helped the knee joint to get the maximum extension when the heel is on the ground and made the heel land smoothly. The muscle force of the gastrocnemius increased significantly (p < 0.05) during the mid-stance, terminal stance, and pre-swing, which could generate the driving force for the human body to move forward. The muscle tension of the biceps femoris and semitendinosus decreased significantly (p < 0.05) during the terminal stance, pre-swing, and initial swing. The decreased muscle tension could relieve the burden of the knee flexion when the knee joint was passively flexed. At the terminal swing, the muscle force of the tibial anterior increased significantly (p < 0.05), which could improve the ankle dorsiflexion ability and prevent foot drop and push forward. Thus, the neuromuscular function of cerebral palsy during walking can be evaluated by the muscle activation state and the RMS of the sEMG signal, which showed that multilevel surgical treatments are feasible and effective to treat SCP.

show abstract

Crouch gait or flexed-knee gait in cerebral palsy: Is there a difference? A systematic review

Cited by 17 publications

References 85 publications

Short Walking Exercise Leads to Gait Changes and Muscle Fatigue in Children With Cerebral Palsy Who Walk With Jump Gait

Short Walking Exercise Leads to Gait Changes and Muscle Fatigue in Children With Cerebral Palsy Who Walk With Jump Gait

Identifying treatment non-responders based on pre-treatment gait characteristics - A machine learning approach

Evaluation of Multilevel Surgeries in Children With Spastic Cerebral Palsy Based on Surface Electromyography

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