Common abnormal kinetic patterns of the knee in gait in spastic diplegia of cerebral palsy

We studied the kinetic characteristics of the knee in patients with spastic diplegia. Twenty three children with spastic diplegia were recruited and h ad their 46 limbs categorised into the following four groups: jump (n = 7), crouch (n = 8), recurvatum (n = 14) and wild (n = 17). In the crouch patte rn, the patients usually had a larger and longer lasting internal knee exte nsor moments in stance suggesting that rectus femoris had a relatively high activation. In the recurvatum pattern, the internal knee flexor moment was large and long lasting in stance. The biceps femoris showed less activity on EMG although the knee flexor moment was large and we concluded that the soft tissue behind the knee joint provided this flexor moment. In the jump knee pattern there was abnormal power generation at the knee and ankle join ts in initial stance, which did not contribute to normal progression but ai ded upward body motion. In the mild group the kinetic data was similar to t hat seen in normal children. Knowledge of kinetic patterns in these patient s may help in their subsequent management. (C) 2000 Elsevier Science B.V. A ll rights reserved.