Treatment of genu recurvatum in hemiparetic adult patients: A systematic literature review

Abstract

Even though all the various treatments produced encouraging results, most of the reviewed studies presented methodological limitations. Moreover, none of the selected articles suggested a treatment strategy which takes account of the various aetiologies in genu recurvatum. On the basis of some of the reviewed articles and our own clinical experience, we propose an aetiology-specific treatment strategy for genu recurvatum patients. In a broad patient population, this categorization could form the basis for testing the specificity of each treatment method as a function of the cause of genu recurvatum. This approach could help confirm the clinical indications and identify the most appropriate treatment for each patient.

Reduction of genu recurvatum through adjustment of plantarflexion resistance of an articulated ankle-foot orthosis in individuals post-stroke

“…A potential cause of genu recurvatum includes but not limited to weakness / spasticity of the knee extensors, weakness of the knee flexors and/or contracture / spasticity of ankle plantarflexors (Bleyenheuft et al, 2010). To address these potential causes of genu recurvatum, orthoses such as knee-ankle-foot orthoses (KAFOs) (Boudarham et al, 2013), knee orthoses (Portnoy et al, 2015) and ankle-foot orthoses (AFOs) (Jagadamma et al, 2010) have been utilized.…”

Control of Stroke-Related Genu Recurvatum With Prolonged Timing of Dorsiflexor Functional Electrical Stimulation: A Case Study

“…1,2 From a biomechanical point of view, it is characterized by a ground reaction force vector anterior to the knee joint center. 1,3,4 Different causal mechanisms that may lead to genu recurvatum have been proposed in the literature, including (i) weakness of quadriceps, hamstrings, or buttock muscles; (ii) spasticity of quadriceps; (iii) limited ankle dorsiflexion during the stance phase; and (iv) proprioceptive disorders. 1 Depending on the identified or suspected cause, different types of treatment have been proposed such as medical therapy (eg, intramuscular injection of botulinum A toxin into triceps surae 5 ), orthotic devices (eg, ankle-foot orthoses [AFOs], 6 knee-ankle-foot orthoses 4 ), rehabilitation techniques (eg, feedback electrogoniometric devices or multichannel electrical stimulation 1 ) or surgical procedures (eg, aponeurotic calf muscle lengthening 1 ).…”

Um modelo diferente de brace para a reeducação da marcha hemiparética com genu recurvatum: efeitos sobre a distribuição das pressões plantares

“…In patients with quadriceps weakness, this phenomenon raises a knee extensor moment, avoiding the fall in flexion during the midstance, as a strategy for greater stability in the lower limb. Besides being a walking aesthetic problem, it can cause pain and therefore limit the autonomy of the patient in daily life activities 3 . It can be caused due to various phenomena, such as weakness or spasticity of the quadriceps muscle, spasticity and/ or contracture of the plantarflexors, and proprioceptive deficits 2 .…”