Abstract
Background: Previous study showed the triceps surae exhibits spring-like behavior about the ankle during walking in children with cerebral palsy. Thus, the work generated by the triceps surae is diminished relative to typically developing children. This study investigated whether the quadriceps offset the lack of triceps surae work production in children with cerebral palsy who walk in crouch. Methods: Seven children with cerebral palsy (8-16 yrs) and 14 typically developing controls (8-17 yrs) walked overground at their preferred speed in a motion analysis laboratory. Shear wave tensiometers were used to track patellar and Achilles tendon loading throughout the gait cycle. Tendon force measures were coupled with muscle-tendon kinematic estimates to characterize the net work generated by the quadriceps and triceps surae about the knee and ankle, respectively. Findings: Children with cerebral palsy generated significantly less triceps surae work when compared to controls (P < 0.001). The reverse was true at the knee. Children with cerebral palsy generated positive net work from the quadriceps about the knee, which exceeded the net quadriceps work generated by controls (P = 0.028). Interpretation: There was a marked difference in functional behavior of the triceps surae and quadriceps in children with cerebral palsy who walk in crouch. In particular, the triceps surae of children with cerebral palsy exhibited spring-like behavior about the ankle while the quadriceps exhibited more motor-like behavior about the knee. This redistribution in work could partly be associated with the elevated energetic cost of walking in children with cerebral palsy and is relevant to consider when planning treatments to correct crouch gait.
| Original language | English (US) |
|---|---|
| Article number | 105871 |
| Journal | Clinical Biomechanics |
| Volume | 102 |
| DOIs | |
| State | Published - Feb 2023 |
Bibliographical note
Funding Information:Funding provided by NIH R01HD092697. We would like to thank Stacy Ngwesse, Elizabeth Duffy, Andy Ries, and the Gillette Children's Center for Gait and Motion Analysis team for recruitment, data collection, and data processing used in this study. J.A.M. and D.G.T. are co-inventors on a patent for tensiometer technology (U.S. Patent No. 10631775). The other authors have no declarations of interest.
Funding Information:
Funding provided by NIH R01 HD092697 . We would like to thank Stacy Ngwesse, Elizabeth Duffy, Andy Ries, and the Gillette Children's Center for Gait and Motion Analysis team for recruitment, data collection, and data processing used in this study. J.A.M. and D.G.T. are co-inventors on a patent for tensiometer technology (U.S. Patent No. 10631775). The other authors have no declarations of interest.
Publisher Copyright:
© 2023 Elsevier Ltd
Keywords
- Achilles tendon
- Muscle-tendon work loops
- Patellar tendon
- Shear wave tensiometer