Purpose: Children with spastic diplegic and hemiplegic cerebral palsy frequently ambulate with flexed knee gait. There has been concern that hamstring lengthening used to treat this problem may weaken hip extension. This study evaluates the primary outcome of hamstring transfer plus lengthening in comparison with traditional hamstring lengthening in treating flexed knee gait in ambulatory patients with cerebral palsy.
Methods: A total of 47 children (67 lower limbs) ranging in age from 5 to 17 years old were included in this study. All subjects underwent a variety of additional surgeries at the time of the hamstring surgery as part of a multilevel treatment plan. All patients who met the inclusion criteria were divided into two groups, the hamstring lengthening alone group (HSL) and the hamstring transfer plus lengthening group (HST). Full gait analysis studies were done for all subjects pre-operatively and 1 year post-operatively.
Results: There were 25 patients (35 limbs) in the HSL group and 22 patients (32 limbs) in the HST group. There was no significant difference in age, gender, or the time from surgery to post-operative gait analysis between groups. On physical examination, both HSL and HST groups showed improvement in passive knee extension, popliteal angle, and straight leg raise. Maximum knee extension in stance phase was improved in both groups. The maximum hip extension in late stance phase was significantly improved only in the HST group. The peak hip extension power in stance phase showed significant improvement only in the HST group and a significant decrease for the HSL group.
Conclusions: The findings of this study demonstrated that both the HSL and HST procedures resulted in similar amounts of improvement in passive range of motion of the knee, as well in knee extension in stance during gait at 1 year post-operatively. However, with the HST procedure, there was better preservation of hip extension power and improved hip extension in stance. The HST procedure should be considered when hamstring surgery is performed.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3400004 | PMC |
| http://dx.doi.org/10.1007/s11832-012-0405-3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Correlations among flexibility, stiffness, strength and muscle ultrasound parameters in older males afflicted with hamstrings tightness.
J Bodyw Mov Ther
October 2024
Department of Physical Therapy, Allied Health Sciences Faculty, Burapha University, Chonburi, Thailand. Electronic address:
Introduction: Age-induced inflexibility may lead to significant mobility impairments and declines in well-being. However, the relationship between the structural and mechanical properties of soft tissue and joint extensibility remains unclear. This study aimed to investigate the correlation between flexibility, muscle tendon unit (MTU) stiffness, muscle ultrasound characteristics, muscle strength, and hamstring flexibility prediction in older males with hamstring inflexibility.
View Article and Find Full Text PDFComparison of Percutaneous Versus Open Hamstring Lengthening in Patients of Spastic Diplegic Cerebral Palsy - A Randomized Controlled Trial.
J Orthop Case Rep
November 2024
Department of Physical Medical and Rehabilitation, King George Medical University, Lucknow, Uttar Pradesh, India.
Article Synopsis
- - Cerebral palsy (CP) can cause crouch gait due to tight hamstrings, leading to the need for surgical procedures like hamstring lengthening, with new methods like percutaneous techniques emerging as options.
- - A study compared two types of hamstring lengthening surgeries (percutaneous vs. open) in children with spastic diplegic CP, focusing on their impact on gait and knee function.
- - Results showed that both methods significantly improved patient outcomes, with no major differences between them, indicating that percutaneous hamstring lengthening is a safe and effective alternative to traditional surgery.
Multiscale hamstring muscle adaptations following 9 weeks of eccentric training.
J Sport Health Sci
October 2024
Department of Bioengineering, Stanford University, Stanford, CA, 94305, USA; Department of Mechanical Engineering, Stanford University, Stanford, CA, 94305, USA. Electronic address:
Article Synopsis
- Eccentric training via Nordic hamstring exercises (NHE) is effective in preventing hamstring strains by promoting changes in muscle structure, specifically increasing muscle fascicle length and adding sarcomeres in series within the muscle fibers.
- In a study with 12 participants, after 9 weeks of NHE training, the biceps femoris long-head (BFlh) showed significant improvements, including a 19% and 33% increase in fascicle length in the central and distal regions, respectively, along with a 40% increase in knee flexion strength.
- Following a 3-week period of no training (detraining), muscle adaptations such as fascicle length
Hamstrings are Stretched More and Faster during Accelerative Running Compared to Speed-Matched Constant-Speed Running.
Med Sci Sports Exerc
October 2024
Department of Bioengineering, Stanford University, Stanford, CA.
Article Synopsis
- Hamstring injuries are frequent in field sports, especially during accelerative running, yet previous studies mainly examined constant-speed running mechanics.
- Researchers analyzed hamstring lengths and velocities in 10 participants across both accelerative and constant-speed running trials, revealing that accelerative running leads to longer hamstring lengths and higher lengthening velocities, particularly at speeds below 75% of maximum.
- The findings suggest that coaches and sports medicine professionals should focus on the specific demands of accelerative running, as it creates conditions that could increase the risk of hamstring injuries.
Fascicle Behavior and Muscle Activity of The Biceps Femoris Long Head during Running at Increasing Speeds.
J Sports Sci Med
September 2024
College of Physical Education and Health, Wenzhou University, Wenzhou, China.
Article Synopsis
- Hamstring strain injuries (HSIs) are common in high-speed running sports, particularly affecting the biceps femoris long head (BFlh) muscle, but the exact causes during running are not well understood.
- This study aimed to measure the behavior of the BFlh muscle-tendon unit (MTU) and its fascicles in college sprinters while running at varying speeds on a treadmill.
- Results showed that during the late swing phase of running, BFlh fascicles had minimal length change (about 1 cm) and were most active during both late swing and early stance phases, indicating a disconnect between muscle fascicle lengthening and MTU changes.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!