The functional effect of a distal rectus femoris tenotomy in adults with cerebral palsy

Drefus, Lisa C.; Buckland, Melanie A.; Backus, Sherry I.; Root, Leon

doi:10.1016/j.gaitpost.2014.03.017

Cited by 7 publications

(12 citation statements)

References 18 publications

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“…Despite a number of studies demonstrated that the confined knee flexion in post-stroke gait was due to the over-activation of RF [ 7 , 8 ], different opinion about the role of RF in post-stroke stiff knee exists [ 9 , 23 ]. In our study, we did not find any effects of stroke on the RMS of RF though the knee had shown significantly reduced knee flexion ( Fig 5A ).…”

Section: Discussionmentioning

confidence: 99%

“…Abnormal excessive activation of RF has been extensively observed in the post-stroke hemiparesis patients and is considered as a primary cause of stiff knee [ 6 ]. Some other studies showed that a transfer surgery or a botulinum toxin injection could lower the over-activity of RF, accompanied by the knee flexion improvement during swing [ 7 , 8 ]. However, Knuppe et al reported that the RF activity during swing phase was not associated with stiff knee after nerve injury [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Associations between lower-limb muscle activation and knee flexion in post-stroke individuals: A study on the stance-to-swing phases of gait

Wang

Yue

et al. 2017

PLoS ONE

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Reduced knee flexion is a leading feature of post-stroke gait, but the causes have not been well understood. The purpose of this study was to investigate the relationship between the knee flexion and the lower-limb muscle activation within the stance-to-swing phases of gait cycle in the post-stroke hemiplegic patients. Ten stroke patients and 10 age- and gender-matched healthy subjects participated in the experiment. The lower-limb kinematic signals and the surface electromyography (sEMG) signals of the left and right rectus femoris (RF), biceps femoris (BF) and lateral gastrocnemius (GS) were recorded during walking. The angle range (AR) of knee flexion, the root mean square (RMS) and the mean frequency (MNF) of sEMG signals were calculated from the terminal stance (TSt) to the initial swing (ISw) phases of gait cycle. Stroke patients showed lower bilateral AR of knee flexion and lower RMS of GS on the paretic side, but higher MNF of RF on the non-paretic side compared with the controls. Within the stroke patients, significant differences were found between their paretic and non-paretic limbs in the AR of knee flexion, as well as in the RMS and MNF of GS (p < 0.05). Regression analysis showed that the RMS of BF, MNF of BF and MNF of GS explained 82.1% of variations in AR of knee flexion on paretic side (r2 = 0.821). But the RMS and MNF of all the muscles (including the RF, GS and BF) could explain 65.6% of AR of knee flexion variations on the non-paretic side (r2 = 0.656), and 45.2% of variations for the healthy subjects (r2 = 0.452). The reduced knee flexion during gait was associated with altered magnitude and frequency of muscle contractions and with simplified muscle synergy in the post-stroke hemiplegic patients. Identifying the muscles that are responsible for knee stiffness may facilitate improvement of rehabilitation strategy for post-stroke gait.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations between lower-limb muscle activation and knee flexion in post-stroke individuals: A study on the stance-to-swing phases of gait

Wang

Yue

et al. 2017

PLoS ONE

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“…In cases with dystonia, intrathecal baclofen application was shown to be beneficial [ 52 ]. Depending on the underlying problem, surgical procedures normally consist of derotational osteotomies [ 53 , 54 ], open reduction of hip dislocations with or without concomitant bony procedures [ 55 , 56 , 57 ], tenotomies [ 58 , 59 , 60 , 61 , 62 ] or guided growth with temporal (hemi) epiphysiodesis [ 63 , 64 , 65 , 66 ]. Care has to be taken with tenotomies for gaining more range of motion (ROM) of the affected joints which is generally accompanied by a further weakening of the muscle in our clinical experience.…”

Section: Preterm-related Orthopedic Disordersmentioning

confidence: 99%

The Effects of Preterm Birth on Musculoskeletal Health-Related Disorders

Schachinger

Farr

2021

JCM

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Preterm birth is associated with various diseases and conditions which demand multidisciplinary medical care. Approximately 10% of all neonates are born prematurely with an increasing survival rate in almost all Western countries. This ongoing, yet desirable trend is creating new challenges for sufficient medical treatment regimens, which should be upheld throughout the patients’ lives. Orthopedic surgeons are focused on musculoskeletal disorders and the improvement of patients’ ability to cope with the challenges of everyday life. The most common conditions associated with preterm birth are cerebral palsy and a dysregulation of the calcium/phosphorus metabolism, which may lead to fractures. These diseases may vary greatly in their organic manifestation and clinical presentation. This demands multidisciplinary cooperation and parental support. Clinical management is aimed on the early enhancement of a patient’s physical, as well as neurological condition, and to prevent the development of secondary musculoskeletal disorders. In this article, we give an overview of the current literature on the most common musculoskeletal disorders associated with preterm birth and critically discuss state of the art diagnostic standards and treatment algorithms.

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“…[2][3][4][5][6][7][8][9][10][11][12][13] In some studies, the lack of a control group was associated with small sample sizes. 14,15 Other studies had control groups that were poorly matched. 16 Studies with sizeable, reasonably well-matched control groups showed effect sizes like those in the original report.…”

mentioning

confidence: 99%

“…In contrast, many subsequent studies did not have a control group 2–13 . In some studies, the lack of a control group was associated with small sample sizes 14,15 . Other studies had control groups that were poorly matched 16 .…”

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confidence: 99%

Rectus femoris transfer in children with cerebral palsy: comparing a propensity score‐matched observational study to a randomized controlled trial

Schwartz

Ries

2020

Develop Med Child Neuro

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RCT Randomized controlled trial RFT Rectus femoris transfer ROM Range of motion SEMLS Single-event multilevel surgery AIM To test whether an observational study employing propensity score matching could accurately estimate the causal treatment effects of rectus femoris transfer (RFT) as part of single-event multilevel surgery (SEMLS) in ambulatory children with cerebral palsy. METHOD We used a large clinical database to derive a propensity score for treatment assignment (SEMLSAERFT) and used this score to generate a matched patient cohort. We compared the causal treatment effects estimated from this matched cohort with a previously published randomized controlled trial (RCT). RESULTS The treated arms of the observational study and RCT were well matched. There were 129 limbs (81 males) with a mean age of 10 years 7 months (4y 7mo) in the treated arm of the observational study, and 129 limbs (68 males) with a mean age of 10 years 2 months (3y 9mo) in the control arm of the observational study. Differences between the observational study and RCT cohorts were clinically meaningless for knee flexion kinematics (1-4°), timing of knee angle extrema (<3% gait cycle), and speed (<5mm/s). Postoperative changes in the observational study matched those from the RCT. All but one of the observational study confidence intervals were completely contained within the corresponding RCT confidence interval; there were no meaningful differences in magnitude or sign of key outcomes related to stiff knee gait. INTERPRETATION Propensity score matching is an accurate method for estimating the causal treatment effects of RFT as part of an SEMLS. It seems reasonable to extend this approach to other common components of SEMLS treatment in this population.

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The functional effect of a distal rectus femoris tenotomy in adults with cerebral palsy

Cited by 7 publications

References 18 publications

Associations between lower-limb muscle activation and knee flexion in post-stroke individuals: A study on the stance-to-swing phases of gait

Associations between lower-limb muscle activation and knee flexion in post-stroke individuals: A study on the stance-to-swing phases of gait

The Effects of Preterm Birth on Musculoskeletal Health-Related Disorders

Rectus femoris transfer in children with cerebral palsy: comparing a propensity score‐matched observational study to a randomized controlled trial

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