Biomechanical and Clinical Correlates of Stance-Phase Knee Flexion in XXXX With @entity306 .

@entity1 @entity2653 @entity1746 @entity1613 @entity306
OBJECTIVE: To identify biomechanical and clinical parameters that influence knee flexion (KF) angle at initial contact (IC) and during single limb stance phase of gait in @entity1 with @entity306 ( @entity306 ) who walk with flexed-knee gait. DESIGN: Retrospective analysis of gait kinematics and clinical data collected from 2010-2013. SETTING: Motion _ Gait Analysis Laboratory at Lucile Packard @entity1 's Hospital, Stanford, CA. @entity1 : Gait analysis data from @entity1 with @entity306 (Gross Motor Function Classification System [GMFCS] I-III) who had no prior surgery were analyzed. @entity1 exhibiting KF >= 20   at IC were included; the more-involved limb was analyzed. METHODS: Outcome measures were analyzed with respect to clinical findings, including passive range of motion, @entity1746 ( @entity2653 ), gait kinematics, and musculoskeletal models of muscle-tendon lengths during gait. MAIN OUTCOME MEASURES: @entity1613 ( @entity1613 ) and minimum KF during single-limb support (KFSLS) were investigated. RESULTS: Thirty-four @entity1 met the inclusion criteria, and their data were analyzed (20 males and 14 females, mean age 10.1 years, range 5-20 years). Mean @entity1613 was 34.4    8.4 degrees and correlated with lower @entity2653 score (   = -0.530, P = .004), later peak KF during swing (   = 0.614, P < .001), and shorter maximal muscle length of the semimembranosus (   = -0.359, P = .037). Mean KFSLS was 18.7    14.9 and correlated to KF contracture (   = 0.605, P < .001) and shorter maximal muscle length of the semimembranosus (   = -0.572, P < .001) and medial gastrocnemius (   = -0.386, P = .024). GMFCS correlated more strongly to @entity1613 (   = 0.502, P = .002) than to KFSLS (   = 0.371, P = .031). Linear regression found that both the @entity2653 score (P = .001) and delayed timing of peak KF during swing (P = .001) independently predicted @entity1613 . KF contracture (P = .026) and maximal length of the semimembranosus (P = .043) independently predicted KFSLS. CONCLUSION: Correlates of @entity1613 differed from those for KFSLS and suggest that impaired selective motor control and later timing of swing-phase KF influence knee position at IC, whereas KF contracture and muscle lengths influence minimal KF in single-limb support, findings with important treatment implications.
