Article

Many patients respond positively to treatments for crouch gait, yet surgical
outcomes are inconsistent and unpredictable. In this study, we developed a
multivariable regression model to determine if biomechanical variables and other
subject characteristics measured during a physical exam and gait analysis can
predict which subjects with crouch gait will demonstrate improved knee kinematics
on a follow-up gait analysis. We formulated the model and tested its performance
by retrospectively analyzing 353 limbs of subjects who walked with crouch gait.
The regression model was able to predict which subjects would demonstrate
'Improved' and 'Unimproved' knee kinematics with over 70% accuracy, and was able
to explain approximately 49% of the variance in subjects' change in knee flexion
between gait analyses. We found that improvement in stance phase knee flexion was
positively associated with three variables that were drawn from knowledge about
the biomechanical contributors to crouch gait: (i) adequate hamstrings lengths
and velocities, possibly achieved via hamstrings lengthening surgery, (ii) normal
tibial torsion, possibly achieved via tibial derotation osteotomy, and (iii)
sufficient muscle strength
Copyright (c) 2011 Elsevier B.V. All rights reserved.
- Paralysie cérébrale

Langue : ANGLAIS