An examination of the knee function during gait in children with myelomeningocele

In this retrospective study, 37 patients with myelomeningocele who had unde rgone gait analysis were examined. Patients were divided into groups based on the level of involvement (29 sides: L4; 26 sides: L5, 19 sides: S1-2). R esults showed increased knee flexion and associated knee extensor moments w ith increasing level of neurologic involvement. The mean coronal plane knee position in stance was normal in all groups and not related to coronal pla ne knee moment. However, there was an increased incidence of a net knee add uctor moment in stance with increasing involvement (mean, 0.02 +/- 0.18 N.m /kg for the L4 group). The presence of a visual valgus thrust based on vide o records was not reliable in predicting an abnormal knee coronal plane mom ent. An abnormal knee adductor moment in stance was most highly related to coronal plane trunk motion (r = -0.62) and not tibial torsion (r = -0.340). Increased transverse plane range of motion of the knee was most highly rel ated to transverse plane trunk motion (r = 0.67).