Abstract
In 50 consecutive ambulating purely spastic diplegic children (100 limbs), with a mean age of 6.4 y having bilateral hamstring tightness with a popliteal angle ≥ 50° the Thomas test was done and the popliteal, modified popliteal angle and the hamstring shift were determined. Radiologically, the sacrofemoral angle (SFA) and the lumbar lordosis angel were measured. The correlations between the SFA and hamstring shift, lumbar lordosis angle and hamstring shift and between the SFA and the lumbar lordosis angle were analyzed and the effect of muscle imbalance on these angles was assessed.
Highlights
IntroductionIt has long been believed that children with crouch gait have hamstring spasticity and this has been the focus of several recent studies
Hamstring spasticity is one of the main problems in cerebral palsy
We intentionally focused in this study on the static assessment of the relationship between pelvic tilt by measuring the sacrofemoral angle and hamstring length on assessing the static hamstring tightness using the bilateral popliteal test, we are fully aware of the pivotal importance of the dynamic examination and gait studies in reaching a conclusive assessment in walking children with crouch gait in spastic dipegia
Summary
It has long been believed that children with crouch gait have hamstring spasticity and this has been the focus of several recent studies. They revealed that hamstring muscles are usually normal in length in most of these children. Even though the length of the hamstring is normal, it appears contracted when anterior pelvic tilt increases. Hamstring release in this condition may further increase the pelvic tilt. Hip flexion contracture along with weakness of the triceps surae are contributing factors in anterior pelvic tilt and crouch gait, respectively [2]. The principle that all diplegic CP patients need hamstring release is controversial as this may further aggravate gait with apparent hamstring tightness
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