Prediction of outcome after rectus femoris surgery in cerebral palsy: the role of cocontraction of the rectus femoris and vastus lateralis.
Rectus femoris surgery was performed on 70 patients with cerebral palsy and stiff-knee gait. Fifty-three patients underwent distal rectus transfer, and 17 patients had distal rectus release with complete muscle mobilization. Gait analysis was performed preoperatively and postoperatively at a minimum of 1 year. Swing-phase peak knee flexion (PKF) was improved in the transfer group, allowing improved foot clearance and more efficient gait (p = 0.04). PKF in swing deteriorated slightly in the release group (p = 0.04). The presence of abnormal swing-phase electromyogram (EMG) activity in the rectus alone or abnormal combined rectus and vastus lateralis activity did not influence the PKF results in either surgery (p < 0.05). The Ely test had no predictive value in identifying patients with abnormal EMG activity (p > 0.05). Preoperative knee range of motion was not a significant variable in determining relative success of rectus surgery. No deleterious effects were observed in stance phase in either group (p > 0.05).
Chambers
H
H
Motion Analysis Laboratory, Children's Hospital, San Diego, CA 92123, USA.
Lauer
A
A
Kaufman
K
K
Cardelia
J M
JM
Sutherland
D
D
D000293:Adolescent; D000328:Adult; D002547:Cerebral Palsy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D005684:Gait; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome