title: The effect of isolated gastrocnemius contracture and gastrocnemius recession on lower extremity kinematics and kinetics during stance.
abstract: BACKGROUND
  Isolated gastrocnemius contracture limits ankle dorsiflexion with full knee extension and is potentially problematic during mid-stance of gait when 10° of dorsiflexion and full knee extension are needed. It is during this time that patients with isolated gastrocnemius contracture may demonstrate altered kinematics and/or kinetics. When conservative management fails to resolve painful foot pathologies associated with non-spastic isolated gastrocnemius contracture, gastrocnemius recession surgery has been suggested to resolve contracture and improve function and strength. However, there are no published reports on lower extremity kinematics/kinetics in the non-spastic isolated gastrocnemius contracture population. Assessment of alterations in gait mechanics is necessary to examine the effects of this potential surgical intervention.
  
  
  METHODS
  Lower extremity kinematics and kinetics were assessed in 6 patients clinically diagnosed with isolated gastrocnemius contracture pre- and post-surgical recession compared with 33 healthy control participants.
  
  
  RESULTS
  Pre-operatively, patients with isolated gastrocnemius contracture demonstrated significantly increased peak knee flexion angles and knee flexion moments during mid-stance. There were no differences in peak ankle dorsiflexion angle or peak plantar flexion moment. Gastrocnemius recession did not alter gait kinematics/kinetics following surgery. Joint kinematic strategies utilized to compensate for isolated gastrocnemius contracture varied minimally between participants with IGC; most employed a flexed knee strategy, while one participant utilized a reduced ankle dorsiflexion strategy.
  
  
  CONCLUSIONS
  Select post-surgical gait mechanics were unaltered; however, gait mechanics were not similar between non-spastic isolated gastrocnemius contracture patients and healthy control participants. Surgical intervention for patients with isolated gastrocnemius contracture does not appear to create any negative gait adaptations; however, patients may benefit from gait retraining post-recession as maladaptive gait patterns persist post operatively.
authors: Department of Athletic Training, Daemen College, Amherst, NY, USA. nchimera@daemen.edu
authors: Nicole J
authors: NJ
authors: Chimera
authors: Michael
authors: M
authors: Castro
authors: Irene
authors: I
authors: Davis
authors: Kurt
authors: K
authors: Manal
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology*; D003286:Contracture / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000503:physiopathology*; D004856:Postural Balance; D011187:Posture; D016059:Range of Motion, Articular