Stiff knee gait

NewsBot · Mar 29, 2016

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Plantar flexor muscle weakness may cause stiff-knee gait
Adnan Apti et al
Gait and Postue; Article in Press

Aim
The iterative simulation studies proclaim that plantar flexor (PF) muscle weakness is one of the contributors of stiff knee gait (SKG), although, whether isolated PF weakness generates SKG has not been validated in able-bodied people or individuals with neuromuscular disorders. The aim of the study was to investigate the effects of isolated PF muscle weakness on knee flexion velocity and SKG in healthy individuals.

Method
Twenty able-bodied young adults (23 ? 3 years) participated in this study. Passive stretch (PS) protocol was applied until the PF muscle strength dropped 33.1% according to the hand-held dynamometric measurement. Seven additional age-matched able-bodies were compared with participants? to discriminate the influence of slow-walking. All participants underwent 3D gait analysis before and after the PS. Peak knee flexion angle, range of knee flexion between toe-off and peak knee flexion, total range of knee-flexion, and time of peak knee flexion in swing were selected to describe SKG pattern.

Results
After PS, the reduction of plantar flexor muscle strength (33.14%) caused knee flexion velocity drop at toe-off (p= 0.008) and developed SKG pattern by decreasing peak knee flexion (p = 0.0001), range of knee flexion in early swing (p = 0.006), and total knee flexion range (p = 0.002). These parameters were significantly correlated with decreased PF velocity at toe-off (p = 0.015, p = 0.0001, p = 0.005 respectively). The time of peak knee flexion was not significantly different between before and after stretch conditions (p = 0.130).

Conclusions
These findings verified that plantar flexor weakness cause SKG pattern by completing three of SKG parameters. Any treatment protocol that weakens the plantar flexor muscle might impact the SKG pattern.
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NewsBot · Mar 29, 2016

Weakening iliopsoas muscle in healthy adults may induce stiff knee pattern
Nazif Ekin Akalan, Adnan Apti, Shavkat Kuchimov, Yener Temelli, Merve Oren, Anand Nene
Acta Orthop Traumatol Turc

Objective: To investigate the relation between iliopsoas muscles weakness and related hip-joint velocity reduction and stiff knee gait (SKG) during walking in healthy individuals.
Design: Design: In 15 neurologically intact able-bodied participants (average age: 22.4 ? 0.81 years), a load 5% of each individual's body weight was placed on the non-dominant thigh. For 33 min (135sec x 13 repetitions x 5sec rest), a passive stretch (PS) was applied with the load until the hip-flexor muscle strength dropped from 5/5 to 3+/5 according to the manual muscle test. All the participants underwent gait analysis before and after the PS to compare sagittal plane hip knee and ankle kinematics and kinetics and temporo-spatial parameters. The Paired-T test was used to compare pre and post stretching findings and the Pearson correlation coefficient (r) was calculated to determine the strength of the correlation between SKG parameters and interested gait parameters (p<0.05).
Results: Reduced hip-flexion velocity (mean, 21.5%, p = 0.005) was one of the contributors of SKG that acted by decreasing the peak knee flexion (PKF) (-20%, p = 0.0008), total knee range (-18.9%, p = 0.003), and the range of knee flexion between toe-off and PKF (-26.7%, p = 0.001), and by shortening the duration between toe-off to PKF (-16.3%, p = 0.0005).
Conclusions: Conclusions: These findings verify that any treatment protocol that slows hip-flexion during gait by weakening the ilio-psoas muscle may have a great potential to produce an SKG pattern combined with reducing gait velocity.
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