DYNAMIC IMPLICATIONS OF HIP FLEXION CONTRACTURES

Hip flexion contractures are a common complication in disabled patient s. However, no previous study has examined reduced hip motion during g ait. This retrospective analysis evaluates the relationship between th e degree of hip flexion contracture found on static testing and the de gree found during gait and also assesses the strength of the associati on between hip flexion contractures and compensatory mechanisms such a s anterior pelvic tilting, increased knee flexion, and decreased contr alateral step length. Clinical and quantitative gait laboratory data w ere obtained from 41 consecutive patients with mostly neurologically b ased impairments who presented with bilateral hip flexion contractures on Thomas testing (82 limbs). Correlation studies demonstrated a rela tively weak association between the degree of peak hip extension durin g gait and hip flexion contracture by Thomas testing (r = 0.41, P < 0. 0001). Limited hip extension was most closely associated with anterior pelvic tilting (r = 0.60, P < 0.0001), whereas Thomas test measuremen ts yielded a correlation with anterior pelvic tilt of only r = 0.36 (P < 0.001) and were insignificant predictor variables of anterior pelvi c tilting in regression analysis. Thus, peak hip extension and anterio r pelvic tilting assessed during gait were poorly associated with the static Thomas test measurements, and anterior pelvic tilt was most str ongly correlated with reduced hip extension during gait compared with the other compensatory mechanisms.