Peripheral and central mechanisms of hindfoot equinus in childhood hemiplegia.
A detailed clinical examination of 24 hemiplegic children at a mean age of 9.9 years showed that nine had an obligate toe-strike when walking at a self-selected speed and this was maintained throughout stance. None of the 24 children had a fixed equinus. No association could be found between this pattern of gait equinus and lower-limb atrophy, reduced ankle-joint range, muscle extensibilite, power of dorsiflexors and plantarflexors or actual muscle imbalance at the ankle joint. Gait equinus was independent of reduced compliance of the calf muscles, of a clinical diagnosis of tonic spasticity, of fine-motor dexterity of the toes, and of the side of the hemiplegia. Gait equinus cannot be explained merely in terms of a central paralytic foot-drop. A developmental model of equinus is advanced.
Lin
J P
JP
Edinburgh University Faculty of Medicine, Royal Hospital for Sick Children.
Brown
J K
JK
D000843:Ankle Joint / Q000294:innervation; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000503:physiopathology*; D002547:Cerebral Palsy / Q000175:diagnosis / Q000503:physiopathology*; D002648:Child; D004863:Equinus Deformity / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005684:Gait / Q000502:physiology*; D006429:Hemiplegia / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007870:Leg Length Inequality / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D009046:Motor Neurons / Q000502:physiology*; D009119:Muscle Contraction / Q000502:physiology; D009132:Muscles / Q000294:innervation*; D009460:Neurologic Examination; D011712:Pyramidal Tracts / Q000503:physiopathology*; D012026:Reflex, Stretch / Q000502:physiology