The influence of rectus femoris transfer on knee range of motion of cerebral palsy patients
DOI:
https://doi.org/10.11606/issn.2317-0190.v12i2a102528Keywords:
Cerebral Palsy, Gait Analysis, Knee Joint, Range of Motion, Rectus Femoris TransferAbstract
Stiff knee gait is a common walking pattern in cerebral palsy and rectus femoris spasticity is the etiology in many cases. Rectus femoris transfer has been used in the treatment of this condition, but surgery outcomes are variable. In order to evaluate the effectiveness of this procedure, twenty-eight patients with diparetic spastic cerebral palsy, that had undergone rectus femoris transfer, were reviewed in retrospective study. In the subgroup A (n=16), patients did not use orthosis or walking aids, but in the subgroup B(n=12) they did. A complete tridimensional gait analysis before and after surgery was considered an inclusion criterion. The objective was to evaluate the effect of treatment at knee range of motion (kinematic) and patient quality of life (questionnaire). Results show increase of knee range of motion in both subgroups (p = 0,006 in the subgroup A and p = 0,045 in the subgroup B). The subjective evaluation (questionnaire) demonstrated high level of satisfaction despite the fact that there was no change in the activities of dairy life after surgery. The results suggest that further investigation is necessary to identify which factors could influence rectus transfer results and a more objective instrument, like Gross Motor Function Measure, is a better option to evaluate function level.
Downloads
References
Ferrareto I, Souza AMC. Paralisia cerebral: aspectos práticos. São Paulo: Editora Memnon; 1998.
Chambers HG. Advances in cerebral palsy. Curr Opin Orthop. 2002;13(6):424-431.
Grande AB, Luque AF, Alfaro CG, Chacon MB, Gonzalez MT, Roldan JMD. Parálisis cerebral infantil: estudio de 250 casos. Rev Neurol. 2002;35(9):812-817.
Chambers HG, Sutherland DH. A practical guide to gait analysis. J Am Acad Orthop Surg. 2002;10(3):222-31.
Gage JR, Deluca PA, Renshaw TS. Gait analysis: principles and applications. The Journal Of Bone and Joint Sugery. 1995;77A(10):1607-1623.
Lee EH, Goh JCH, Bose K. Value Of gait analysisiIn the assessment of surgery in cerebral palsy. Arch Phys Med Rehabil. 1992;73(7):642-646.
Perry J, Gage JR, Hicks RR, Koop S, Werntz JR. Rectus femoris tranfer to improve knee function of children with cerebral palsy. Devel Med And Child Neurol. 1987;29:159-166.
Davis RB, Ounpuu S, Tyburski DJ, Gage JR. A gait analysis data collection and reduction technique. Hum motion analysis: current applications and future directions. Piscataway: IEEE Press; 1996. p.17-42.
Kabada MP, Ramakrishnan HK, Wootten ME. Measurement of lower extremity kinematics during level walking. J Orthop Res. 1990;8:383-392.
Siegel S, Castellan NJ. Nonparametric Statistics. 2nd ed. New York: Editora McGraw-Hill Int; 1988.
Smith PA, Saw A, Chen S, Sirirungruangsarn Y, Hassani S, Harris G,et al. Rectus femoris transfer for children with cerebral palsy: long term outcome. J Pediatr Orthop. 2003;23(5):672-678.
Sutherland DH, Davids JR. Common gait abnormalities of the knee in cerebral palsy. Clinical Orthopaedics And Related Research. 1993;228:139-147.
Ounpuu S, Muik E, Davis RB, Gage JR, Deluca PA. Rectus femoris surgery in children with cerebral palsy - Part II: a comparision between the effect of transfer and release of the distal rectus femoris on knee motion. J Pediatr Orthop. 1993;13(3):331-335.
Perry J. Distal rectus femoris transfer. Devel Med And Child Neurol. 1987;29:153-158.
Van der linden ML, Aitchison AM, Hazlewood ME, Hillmam SJ, Robb JE. Effects of surgical lengthening of the hamstrings without a concomitant distal rectus femoris transfer in ambulant patients with cerebral palsy. J Pediatr Orthop. 2003;23(3):308-313.
Ounpuu S, Muik E, Davis RB, Gage JR, Deluca PA. Rectus femoris surgery in children with cerebral palsy - Part I: the effect of rectus femoris transfer location on knee motion. J Pediatr Orthop. 1993;13(3):325-335.
Morris C, Galuppi BE, Rosenbaum PL. Reliability of family report for the gross motor function classification system. Dev Med Child Neurol. 2004;46:455-460.
Wren T, Pirpiris M, Dorey F, Otsuka NY. Outcome assessment by gait analysis versus functional testing and quality of life questionnaires. Washington: Annual Meeting of the American Academy of Orthopaedic Surgeons; 2005.
Damiano DL, Abel MF. Relation of gait analysis to gross motor function in cerebral palsy. Devel Med And Child Neurol. 1996;38:389-396.
Rosenbaum PL, Walter DJ, Hanna SE, Palisano RJ, Russel DJ, Raina P, et al. Prognosis for gross motor function in cerebral palsy. Jama. 2002;288(11):1357-1363.
Downloads
Published
Issue
Section
License
Copyright (c) 2005 Acta Fisiátrica
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
