Abstract
Skeletal structures act as lever arms during walking. Muscle activity and the ground reaction against gravity exert forces on the skeleton, which generate torque (moments) around joints. These lead to the sequence of movements which form normal human gait. Skeletal deformities in cerebral palsy (CP) affect the function of bones as lever arms and compromise gait. Lever arm dysfunction should be carefully considered when contemplating treatment to improve gait in children with CP.
Highlights
Normal gait relies on the integrity of the musculo-skeletal system and its neurological control
Skeletal structures act as lever arms during walking
Muscle activity and the ground reaction against gravity exert forces on the skeleton, which generate torque around joints. These lead to the sequence of movements which form normal human gait
Summary
Normal gait relies on the integrity of the musculo-skeletal system and its neurological control. The reaction force from the ground, are used in an optimal way to stabilise joints and minimise energy expenditure During this sequence of events, the bones act as rigid lever arms, facilitating the application of torque on the joints. Foot deformities are commonly caused by muscle imbalance and abnormal loading These secondary musculo-skeletal deformities add significantly to the motor impairment of children with CP. When considering gait management options in children with CP, it is important to distinguish between problems arising from the primary neurological compromise and those caused by the secondary musculo-skeletal deformities. When considering the management of musculo-skeletal deformity, optimal treatment of the lever arm dysfunction can lead to significant improvements in gait. Adequate understanding of lever arm dysfunction in CP gait is of paramount importance when considering management options
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