title: Association between isometric muscle strength and gait joint kinetics in adolescents and young adults with cerebral palsy.
abstract: The purpose of this study was to determine the association between isometric muscle strength of the lower limbs and gait joint kinetics in adolescents and young adults with cerebral palsy (CP). Twenty-five participants (11 males) with bilateral spastic CP, aged 14-22 years (mean: 18.9, sd: 2.0 yr) and Gross Motor Function Classification System (GMFCS) level II (n=19) and III (n=6) were tested. Hand held dynamometry was used to measure isometric strength (expressed in Nm/kg) of the hip, knee, and ankle muscles using standardized testing positions and procedures. 3D gait analysis was performed with a VICON system to calculate joint kinetics in the hip, knee and ankle during gait. Ankle peak moments exceeded by far the levels of isometric strength of the plantar flexors, while the knee and hip peak moments were just at or below maximal isometric strength of knee and hip muscles. Isometric muscle strength showed weak to moderate correlations with peak ankle and hip extension moment and power during walking. Despite considerable muscle weakness, joint moment curves were similar to norm values. Results suggest that passive stretch of the muscle-tendon complex of the triceps surae contributes to the ankle moment during walking and that muscle strength assessment may provide additional information to gait kinetics.
authors.affiliation: Dpt of Rehabilitation Medicine, Research Institute MOVE, VU University Medical Centre Amsterdam, PO Box 7057, 1007 MB Amsterdam, The Netherlands. a.dallmeijer@vumc.nl
authors.forename: A J
authors.initials: AJ
authors.lastname: Dallmeijer
authors.forename: R
authors.initials: R
authors.lastname: Baker
authors.forename: K J
authors.initials: KJ
authors.lastname: Dodd
authors.forename: N F
authors.initials: NF
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D001696:Biomechanical Phenomena / Q000502:physiology; D002547:Cerebral Palsy / Q000175:diagnosis / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D007537:Isometric Contraction; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D053581:Muscle Strength Dynamometer; D016059:Range of Motion, Articular / Q000502:physiology*; D012016:Reference Values; D055070:Resistance Training / Q000379:methods*; D018570:Risk Assessment; D012720:Severity of Illness Index; D055815:Young Adult