Research Information System
2024 Medical Technologies Congress, TIPTEKNO 2024, Muğla, Turkey, 10 - 12 October 2024, (Full Text)
Cerebral Palsy (CP) is a permanent movement disorder seen in early childhood causing crouch gait. Such crouch gait is often ascribed to excessive knee flexion due to shortness or slowness of knee flexors (i.e., hamstrings). While hamstring lengthening surgery is a well-established intervention for CP patients with impaired knee flexion, a subset of patients exhibits an improved knee movement post-operatively despite pre-operatively having normal muscle length and velocity. In this study, we examined the post-operative gait improvements of patients with such normal hamstrings and calculated changes of muscle length and velocity using musculoskeletal modeling. Our results indicate that the improvement is not related to surgery induced changes in muscle length or velocity. This remarkable finding can be explained based on our previous studies in CP patients, which showed that epimuscular myofascial force transmission can change hamstring muscles' mechanics to become more representative of the pathological condition in the knee: the intervention may have relaxed the pre-operatively overly tight epimuscular connective structures and led to an isometric position shift of hamstrings to distal positions.