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. 2013 May;38(1):86-91.
doi: 10.1016/j.gaitpost.2012.10.019. Epub 2012 Nov 27.

Muscle contributions to vertical and fore-aft accelerations are altered in subjects with crouch gait

Katherine M Steele  1 , Ajay Seth, Jennifer L Hicks, Michael H Schwartz, Scott L Delp
Affiliations

Muscle contributions to vertical and fore-aft accelerations are altered in subjects with crouch gait

Katherine M Steele et al. Gait Posture. 2013 May.

Abstract

The goals of this study were to determine if the muscle contributions to vertical and fore-aft acceleration of the mass center differ between crouch gait and unimpaired gait and if these muscle contributions change with crouch severity. Examining muscle contributions to mass center acceleration provides insight into the roles of individual muscles during gait and can provide guidance for treatment planning. We calculated vertical and fore-aft accelerations using musculoskeletal simulations of typically developing children and children with cerebral palsy and crouch gait. Analysis of these simulations revealed that during unimpaired gait the quadriceps produce large upward and backward accelerations during early stance, whereas the ankle plantarflexors produce large upward and forward accelerations later in stance. In contrast, during crouch gait, the quadriceps and ankle plantarflexors produce large, opposing fore-aft accelerations throughout stance. The quadriceps force required to accelerate the mass center upward was significantly larger in crouch gait than in unimpaired gait and increased with crouch severity. The gluteus medius accelerated the mass center upward during midstance in unimpaired gait; however, during crouch gait the upward acceleration produced by the gluteus medius was significantly reduced. During unimpaired gait the quadriceps and ankle plantarflexors accelerate the mass center at different times, efficiently modulating fore-aft accelerations. However, during crouch gait, the quadriceps and ankle plantarflexors produce fore-aft accelerations at the same time and the opposing fore-aft accelerations generated by these muscles contribute to the inefficiency of crouch gait.

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Conflict of interest statement

Conflict of Interest Statement

None of the authors had financial or personal conflict of interest with regard to this study. Original Article

Figures

Figure 1
Figure 1
Musculoskeletal model of an individual with cerebral palsy and crouch gait. Vertical and fore-aft accelerations of the mass center were calculated by analyzing muscle-driven simulations.
Figure 2
Figure 2
Average hip, knee, and ankle flexion angles and moments during unimpaired gait and mild, moderate, and severe crouch gait. The joint moments are normalized by body mass (kg).
Figure 3
Figure 3
The average (A) fore-aft and (B) vertical accelerations of the mass center during stance produced by each muscle and (C) the average muscle force during stance normalized by body weight (BW). Error bars are ± 1 standard error. A ‘*’ indicates a significant difference (p < 0.05) in the student’s t-test comparing unimpaired gait and crouch gait. An arrow indicates a significant change with crouch severity (p < 0.05) from a one-way ANOVA comparing mild, moderate, and severe crouch gait. In (B), ‘Gravity’ indicates the acceleration of the mass center when only gravity is applied to the mass center. The vertical acceleration provided by skeletal alignment is equal to 9.81 m/s2 minus ‘Gravity.’
Figure 4
Figure 4
The fore-aft accelerations of the mass center produced by the vasti (gray line) and gastrocnemius (black line) during stance. The gray area shows the experimentally measured acceleration of the mass center (fore-aft ground reaction force normalized by body mass).
See this image and copyright information in PMC

References

    1. Wren TA, Rethlefsen S, Kay RM. Prevalence of specific gait abnormalities in children with cerebral palsy: influence of cerebral palsy subtype, age, and previous surgery. J Pediatr Orthop. 2005;25:79–83. - PubMed
    1. Jahnsen R, Villien L, Aamodt G, Stanghelle JK, Holm I. Musculoskeletal pain in adults with cerebral palsy compared with the general population. J Rehabil Med. 2004;36:78–84. - PubMed
    1. Graham H, Selber P. Musculoskeletal aspects of cerebral palsy. J Bone Joint Surg Br. 2003;85:157–66. - PubMed
    1. Rose J, Gamble JG, Medeiros J, Burgos A, Haskell WL. Energy cost of walking in normal children and in those with cerebral palsy: comparison of heart rate and oxygen uptake. J Pediatr Orthop. 1989;9:276–9. - PubMed
    1. Waters RL, Mulroy S. The energy expenditure of normal and pathologic gait. Gait Posture. 1999;9:207–31. - PubMed

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