Rectus femoris surgery for the correction of stiff knee gait in cerebral palsy: A systematic review and meta-analysis

Josse, Antoine; Pons, Christelle; Printemps, Camille; Chan-Waï-Nam, Julie; Affes, Hassene; Brochard, Sylvain; Thepaut, Matthias

doi:10.1016/j.otsr.2021.103022

Cited by 7 publications

(2 citation statements)

References 50 publications

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“…The transfer or lengthening of the rectus femoris muscle is the most common orthopedic procedure to increase knee flexion during the swing phase of walking [ 38 , 39 , 40 ]. Theoretically, it was assumed that the transfer of RF and changing its function from knee extensor to flexion should increase the knee flexion ROM [ 39 ]; however, the mechanism and benefits of the surgery were recently seriously questioned [ 18 , 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

Contribution of Different Impairments to Restricted Knee Flexion during Gait in Individuals with Cerebral Palsy

Manikowska

Brazevič

Jóźwiak

et al. 2022

JPM

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The coexistence of overlapping impairments modulates the knee pattern in the swing phase of walking in children with cerebral palsy (CP). The impact and contribution of each impairment to the reduction of knee range-of-motion is unknown. The aim of the study was to establish the gradation of the impact of individual coexisting impairments on the knee flexion range-of-motion. Passive range-of-motion, selective motor control, strength, and spasticity from 132 patients (Male = 76, Female = 56, age:11 ± 4 years) with spastic CP were tested with clinical tools. Knee flexion range-of-motion at terminal stance, pre-swing, and initial swing phases were assessed by gait analysis. Hypertonia (β = −5.75) and weakness (β = 2.76) of knee extensors were associated with lower range of knee flexion (R2 = 0.0801, F = 11.0963, p < 0.0001). The predictive factors (R2 = 0.0744, F = 7.2135, p < 0.0001) were strength (β = 4.04) and spasticity (β = −2.74) of knee extensors and strength of hip flexors (β = −2.01); in swing those were knee extensors hypertonia (β = −2.55) and passive range of flexion (β = 0.16) (R2 = 0.0398, F = 3.4010, p = 0.01). Hypertonia of knee extensors has the strongest impact on knee flexion range-of-motion; secondary is the strength of knee extensors. The knee extensors strength with knee extensors hypertonia and strength of hip flexors contributes in stance. Knee extensors hypertonia with passive knee flexion range-of-motion contributes in swing.

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Section: Discussionmentioning

confidence: 99%

Contribution of Different Impairments to Restricted Knee Flexion during Gait in Individuals with Cerebral Palsy

Manikowska

Brazevič

Jóźwiak

et al. 2022

JPM

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“…Additionally, they stated that EMG signals can describe the clinical condition of patients before and after surgery [6]. Particularly, several studies also reported a strong association between the EMG of RF and gait impairments in these patients [7–9].…”

Section: Introductionmentioning

confidence: 99%

Rectus Femoris Electromyography Signal Clustering: Data-Driven Management of Crouch Gait in Patients with Cerebral Palsy

Davoudi,

Salami,

Reisig

et al. 2024

Preprint

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This study aimed to investigate how electromyography (EMG) cluster analysis of the rectus femoris (RF) could help to better interpret gait analysis in patients with cerebral palsy (CP). The retrospective gait data of CP patients were categorized into two groups: initial examination (E1, 881 patients) and subsequent examination (E2, 377 patients). Envelope-formatted EMG data of RF were collected. Using PCA and a combined PSO-K-means algorithm, main clusters were identified. Patients were further classified into crouch, jump, recurvatum, stiff and mild gait for detailed analysis. The clusters (labels) were characterized by a significant peak EMG activity during mid-swing (L1), prolonged EMG activity during stance (L2), and a peak EMG activity during loading response (L3). Notably, L2 contained 76% and 92% of all crouch patients at E1 and E2, respectively. Comparing patients with a crouch gait pattern in L2-E1 and L2-E2, two subgroups emerged: patients with persistent crouch (G1) and patients showing improvement at E2 (G2). The minimum activity of RF during 20-45% of the gait was significantly higher (p= 0.025) in G1 than in G2. A greater chance of improvement from crouch gait might be associated with lower RF activity during the stance phase. Using our findings, we could potentially establish an approach to improve clinical decision-making regarding treatment of patients with CP.

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Congenital hypoplasia and aplasia of the quadriceps: Diagnosis and treatment

Ripoll

Solla

Oborocianu

et al. 2023

Orthopaedics & Traumatology: Surgery & Research

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Rectus femoris surgery for the correction of stiff knee gait in cerebral palsy: A systematic review and meta-analysis

Cited by 7 publications

References 50 publications

Contribution of Different Impairments to Restricted Knee Flexion during Gait in Individuals with Cerebral Palsy

Contribution of Different Impairments to Restricted Knee Flexion during Gait in Individuals with Cerebral Palsy

Rectus Femoris Electromyography Signal Clustering: Data-Driven Management of Crouch Gait in Patients with Cerebral Palsy

Congenital hypoplasia and aplasia of the quadriceps: Diagnosis and treatment

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