Article

Prolonged swing phase rectus femoris (RF) activity has been implicated as a cause
of stiff-knee gait (SKG) in children with cerebral palsy (CP) and continues to be
cited as an indicator for RF intervention. The purpose of this study was to
determine what, if any, association exists between abnormal RF activity during
preswing, initial swing and/or midswing and SKG in children with CP. This
retrospective analysis involved three examiners independently reviewing sagittal
plane knee kinematic and RF surface electromyographic (EMG) data from 407
affected limbs of 234 pediatric patients with CP. Five kinematic parameters were
rated by each examiner as normal or pathologic: peak knee flexion, knee range of
motion during initial swing, total knee range of motion, peak knee flexion
timing, and rate of knee flexion. These ratings were used to classify each limb
into one of three groups: SKG, Borderline SKG, or Non-SKG. From a representative
EMG tracing, RF activity was examined during: the first half of preswing, the
latter 2/3 of initial swing, and midswing. Chi-squared tests were used to
determine if significant associations existed between SKG and RF activation
during these three subphases. There was no association between SKG and prolonged
RF activity during the latter 2/3 of initial swing or during midswing. However, a
significant relationship between SKG and RF activity during the first half of
preswing was found (p<0.001). Neither prolonged RF activity during initial swing,
nor the presence of RF activity during midswing, were associated with SKG, thus
refuting these commonly held associations.
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Langue : ANGLAIS