Interrelationships of Strength and Gait Before and After Hamstrings Lengthening

Damiano, Diane L.; Abel, Mark F.; Pannunzio, Michael E.; Romano, John-Paul

doi:10.1097/01241398-199905000-00013

Cited by 25 publications

(16 citation statements)

References 12 publications

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“…Similar concerns have been reported in other studies. 9,15 A lack of stability in positioning of the limbs may also explain the increased variability with repeated testing. For example, the assistant held the lower leg for the measures of knee extensors at 20˚ flexion; however, it was difficult to maintain a consistent position during testing.…”

Section: Discussionmentioning

confidence: 99%

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Hand‐held dynamometry for muscle strength measurement in children with cerebral palsy

Crompton

Galea

Phillips

2007

Develop Med Child Neuro

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The aim of this study was to investigate the reliability of hand‐held dynamometry for measuring isometric lower‐limb muscle strength in children with cerebral palsy (CP). Twentythree children (14 males, nine females) with CP (spastic diplegia; Gross Motor Function Classification System Levels I‐III) aged 5 years 7 months to 14 years 5 months (mean 9y 6mo [SD 2y 8mo]) attended two test sessions 1 week apart. A ‘make’ test, using a gradual build‐up of force to a maximum isometric contraction, was employed and peak values were normalized to body weight for analyses. Within‐session reliability was high with an intraclass correlation coefficient (ICC) of 1,1>0.79 for all muscle groups, and there was acceptable between‐session reliability ICC>0.70 and measurement errors for hip flexors and extensors (measured in supine), knee flexors and extensors, and ankle dorsiflexors (with stabilization). Within‐ and between‐session reliability was poor (ICC<0.70) for hip extensors (in prone), knee extensors (20° flexion), ankle dorsiflexors (without stabilization), and ankle plantarflexors. Measurement error differed in each test and across limbs, with stabilization producing inconsistent reliability outcomes. Changes in strength measurements in children with CP should take into account measurement error for particular muscle groups. Changes should be determined for separate muscle groups and limbs, and reported relative to body weight. Different testing positions may be required for greater reliability.

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Section: Discussionmentioning

confidence: 99%

“…This force value was normalized with respect to body weight (Newtons/ kilogram [N/kg]; body mass) 15 to control for differences in strength due to different body and muscle sizes.…”

Section: Discussionmentioning

confidence: 99%

Hand‐held dynamometry for muscle strength measurement in children with cerebral palsy

Crompton

Galea

Phillips

2007

Develop Med Child Neuro

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“…Previous research has shown loss of strength after hamstring lengthening in children with CP [25], but we are not aware of any published data quantifying strength changes following SSML orthopaedic surgery. We found that at 6 months after surgery, there was a significant reduction in muscle strength in all groups measured.…”

Section: Discussionmentioning

confidence: 82%

Recovery of muscle strength following multi-level orthopaedic surgery in diplegic cerebral palsy

Seniorou¹,

Thompson²,

Harrington³

et al. 2007

Gait & Posture

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“…Fixed hamstring shortness is thought to contribute to poor walking and sitting function [1,2]. Surgical lengthening can improve mobility [3][4][5][6] and sitting posture [7,8], but inappropriate lengthening may negatively affect the functioning [9]. Variation in the clinical assessment of muscle length [4,10,11], and the wide range of values recorded for the normally developing population [4] may influence treatment decisions and, consequently, this may explain some of the variation in response to intervention in children with SCP [14,15].…”

Section: Introductionmentioning

confidence: 99%

The effect of anaesthesia on the assessment of hamstring length in spastic cerebral palsy

McNee

Gough

Shortland

2007

Journal of Pediatric Orthopaedics B

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The decision to surgically lengthen the hamstring muscle group in a child with spastic cerebral palsy is based, in part, on the range of motion measurements made in the clinic, particularly, the popliteal angle. This measurement is often repeated when the child is under anaesthesia, before surgery. We were interested to know whether a systematic difference exists between the popliteal angles measured under these conditions, and to understand under which condition the measurement is more reliable. The effect of anaesthesia on the measurement of range of motion has not been reported previously. We repeated the measurement of popliteal angle in 15 children with spastic cerebral palsy (30 limbs, mean age: 8 years 3 months), on the evening before surgery when they were conscious, and again when they were under anaesthesia. The means of measurements made under the two conditions were not significantly different (p=0.17, paired t-test). Repeated measurements of popliteal angle when the patient was conscious were, however, less reliable than those made under anaesthesia (standard error of 15 and 5 degrees, respectively). This resulted in poor agreement between measurements made on the same patient under the two conditions (95% limits of agreement were -19 and 25 degrees). Our study supports the common practice of surgeons of reassessing hamstring length under anaesthesia before single level and multilevel surgeries and incorporation of these measurements into their decision-making.

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Interrelationships of Strength and Gait Before and After Hamstrings Lengthening

Cited by 25 publications

References 12 publications

Hand‐held dynamometry for muscle strength measurement in children with cerebral palsy

Hand‐held dynamometry for muscle strength measurement in children with cerebral palsy

Recovery of muscle strength following multi-level orthopaedic surgery in diplegic cerebral palsy

The effect of anaesthesia on the assessment of hamstring length in spastic cerebral palsy

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