Back to Search
Start Over
Evidence of knee extensor dysfunction during sit-to-stand following distal femoral extension osteotomy and patellar tendon advancement in young adults with cerebral palsy: A pilot study
- Source :
- Gait & Posture. 58:527-532
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- A distal femoral extension osteotomy with patellar tendon advancement (DFEO+PTA) is a common treatment for individuals with cerebral palsy (CP) who walk in crouch. Musculoskeletal modeling suggests that the typical patella baja position post-DFEO+PTA may limit one's abilities to perform sit-to-stand (STS) tasks; however, STS function has not been assessed. Our purpose was to compare how well individuals who received a DFEO+PTA can perform a 5-times STS test (FTSST) eight or more years after surgery compared to their peers who did not receive a DFEO+PTA (non-DFEO+PTA group). Twenty-one participants completed the task (12 DFEO+PTA, 9 non-DFEO+PTA). Three-dimensional kinematics and kinetics were captured. Kinetics were non-dimensionalized to facilitate group comparisons. Non-DFEO+PTA participants performed the FTSST moderately faster than the DFEO+PTA group (median(IQR), 14.6(9.3) seconds vs. 20.3(10.1) seconds, non-parametric effect size ɣ=0.97, p=0.241). Peak negative knee power was larger for the non-DFEO+PTA group (Mean±SD, -0.063±0.025 vs. -0.048± 0.020, Cohen's d=0.66, p=0.165). A similar but weaker trend was observed for negative hip power (median(IQR) -0.120(0.066) vs. -0.105(0.044), ɣ=0.43, p=0.671). Both groups used their hips approximately twice as much as their knees to perform the task. The functional deficit among DFEO+PTA participants may be due to patella baja decreasing the knee extensor moment arm, which concurs with the modeling prediction. The group differences may also be due to the non-DFEO+PTA group being slightly higher functioning. Future research is warranted to determine if optimizing patella position during a DFEO+PTA may improve unaided STS function without compromising gait improvements.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Knee Joint
medicine.medical_treatment
Tendon Transfer
0206 medical engineering
Biophysics
Pilot Projects
02 engineering and technology
Osteotomy
Cerebral palsy
Young Adult
03 medical and health sciences
0302 clinical medicine
Patellar Ligament
otorhinolaryngologic diseases
medicine
Humans
Orthopedics and Sports Medicine
Young adult
Gait
Retrospective Studies
Knee extensors
Sit to stand
business.industry
Cerebral Palsy
Rehabilitation
Patella
medicine.disease
020601 biomedical engineering
Patellar tendon
Biomechanical Phenomena
Surgery
Physical therapy
Female
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 09666362
- Volume :
- 58
- Database :
- OpenAIRE
- Journal :
- Gait & Posture
- Accession number :
- edsair.doi.dedup.....81bfb76fc00bd17afffe053b12dfcbd8