title: DOES RECTUS FEMORIS TRANSFER INCREASE KNEE FLEXION DURING STANCE PHASE IN CEREBRAL PALSY?
abstract: OBJECTIVE
  To evaluate whether distal rectus femoris transfer (DRFT) is related to postoperative increase of knee flexion during the stance phase in cerebral palsy (CP).
  
  
  METHODS
  The inclusion criteria were Gross Motor Function Classification System (GMFCS) levels I-III, kinematic criteria for stiff-knee gait at baseline, and individuals who underwent orthopaedic surgery and had gait analyses performed before and after intervention. The patients included were divided into the following two groups: NO-DRFT (133 patients), which included patients who underwent orthopaedic surgery without DRFT, and DRFT (83 patients), which included patients who underwent orthopaedic surgery that included DRFT. The primary outcome was to evaluate in each group if minimum knee flexion in stance phase (FMJFA) changed after treatment.
  
  
  RESULTS
  The mean FMJFA increased from 13.19° to 16.74° (p=0.003) and from 10.60° to 14.80° (p=0.001) in Groups NO-DRFT and DRFT, respectively. The post-operative FMJFA was similar between groups NO-DRFT and DRFT (p=0.534). The increase of FMJFA during the second exam (from 13.01° to 22.51°) was higher among the GMFCS III patients in the DRFT group (p<0.001).
  
  
  CONCLUSIONS
  In this study, DRFT did not generate additional increase of knee flexion during stance phase when compared to the control group. Level of Evidence III, Retrospective Comparative Study.
authors.affiliation: . Associação de Assistência à Criança Deficiente (AACD), Gait Laboratory, São Paulo, SP, Brazil.; . Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Medicina de Reabilitação (IMREA/HC/FMUSP), São Paulo, SP, Brazil.; . Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Ortopedia e Traumatologia, Paralysis Group, São Paulo, SP, Brazil.
authors.forename: Mauro César
authors.initials: MC
authors.lastname: de Morais
authors.affiliation: . Associação de Assistência à Criança Deficiente (AACD), Gait Laboratory, São Paulo, SP, Brazil.
authors.forename: Francesco Camara
authors.initials: FC
authors.lastname: Blumetti
authors.affiliation: . Associação de Assistência à Criança Deficiente (AACD), Gait Laboratory, São Paulo, SP, Brazil.
authors.forename: Cátia Miyuki
authors.initials: CM
authors.lastname: Kawamura
authors.affiliation: . Associação de Assistência à Criança Deficiente (AACD), Gait Laboratory, São Paulo, SP, Brazil.; . Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Medicina de Reabilitação (IMREA/HC/FMUSP), São Paulo, SP, Brazil.
authors.forename: José Augusto Fernandes
authors.initials: JA
authors.lastname: Lopes
authors.affiliation: . Associação de Assistência à Criança Deficiente (AACD), Gait Laboratory, São Paulo, SP, Brazil.; . Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Medicina de Reabilitação (IMREA/HC/FMUSP), São Paulo, SP, Brazil.
authors.forename: Daniella Lins
authors.initials: DL
authors.lastname: Neves
authors.affiliation: . Associação de Assistência à Criança Deficiente (AACD), Gait Laboratory, São Paulo, SP, Brazil.
authors.forename: Michelle de Oliveira
authors.initials: Mde O
authors.lastname: Cardoso
keywords: Cerebral palsy; Gait; Knee joint; Range of motion, articular