Assessment of the Hip and Knee Flexion Contractures in Cerebral Palsy Patients with Crouch Gait

Abstract

The knee is the most affected joint in children with cerebral palsy. Flexion contracture of the knee is the cause of the crouch gait pattern, instability in stance phase of gait, and difficulties during standing and sitting, and other daily living activities. Hip flexion contracture in crouch gait is mostly compensation of the knee flexion contracture and ankle equines. The psoas muscle is the primary reason for the hip flexion contracture and is known to be associated with increased anterior pelvic tilt, crouching gait, hip instability and lumbar lordosis. Children with cerebral palsy may even give up walking due to the high energy demand in the adult period. The purpose of this article is to review the causes of the knee and hip flexion contractures, clinical evaluations, and treatment principles in children with cerebral palsy. The biomechanical reasons of knee and hip flexion deformity are discussed in detail in the light of previous studies and gait analysis data. (JAREM 2012; 2: 33-7)