How crouch gait can dynamically induce stiff-knee gait.

Abstract:

:Children with cerebral palsy frequently experience foot dragging and tripping during walking due to a lack of adequate knee flexion in swing (stiff-knee gait). Stiff-knee gait is often accompanied by an overly flexed knee during stance (crouch gait). Studies on stiff-knee gait have mostly focused on excessive knee muscle activity during (pre)swing, but the passive dynamics of the limbs may also have an important effect. To examine the effects of a crouched posture on swing knee flexion, we developed a forward-dynamic model of human walking with a passive swing knee, capable of stable cyclic walking for a range of stance knee crouch angles. As crouch angle during stance was increased, the knee naturally flexed much less during swing, resulting in a 'stiff-knee' gait pattern and reduced foot clearance. Reduced swing knee flexion was primarily due to altered gravitational moments around the joints during initial swing. We also considered the effects of increased push-off strength and swing hip flexion torque, which both increased swing knee flexion, but the effect of crouch angle was dominant. These findings demonstrate that decreased knee flexion during swing can occur purely as the dynamical result of crouch, rather than from altered muscle function or pathoneurological control alone.

journal_name

Ann Biomed Eng

authors

van der Krogt MM,Bregman DJ,Wisse M,Doorenbosch CA,Harlaar J,Collins SH

doi

10.1007/s10439-010-9952-2

subject

Has Abstract

pub_date

2010-04-01 00:00:00

pages

1593-606

issue

4

eissn

0090-6964

issn

1573-9686

journal_volume

38

pub_type

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