Article

The main aim of this study was to define the threshold angle of equinus beyond
which significant changes in 3D lower limb kinematics and kinetics occur in
typically developing children and to describe these changes.A customized orthosis
was fitted on the right ankle of 10 typically developing children and was
adjusted to +10 degrees ankle dorsiflexion, 0 degrees , -10 degrees , -20 degrees
plantarflexion and maximum plantarflexion. Gait was analyzed using an
optoelectronic system. A gait velocity of 1m/s was imposed.Most of the kinematic
and kinetic changes were significantly altered from the -10 degrees condition. In
the sagittal plane, the results showed increased knee flexion at initial contact,
increased knee flexion or hyperextension in stance, increased hip flexion at
initial contact and increased anterior pelvic tilt. Other changes included
increased knee varus, reduced hip adduction and more internal foot progression.
The ankle plantarflexion moment was bi-phasic during stance, peak ankle power
generation was reduced, peak knee extension moment was decreased and hip
extension moments increased. On the contralateral side, there was a significant
increase in ankle plantarflexion at initial contact and a significant decrease in
knee flexion during swing phaseat maximum plantarflexion.Although slight
modifications occurred for smaller degrees of equinus, the results suggest that
significant kinematic and kinetic changes occurred during gait in both limbs from
10 degrees of plantarflexion. The results of this study also provide some
indications regarding the primary causes of gait deviations and secondary
compensatory strategiesin children with a clinical dorsiflexion limitation.
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