Long ‐term muscle changes after hamstring lengthening in children with bilateral cerebral palsy

AimTo evaluate short ‐term (1y postoperatively; E1) and long‐term (at least 4y postoperatively; E2) changes in hamstring muscle‐tendon length (MTL) and lengthening velocity after hamstring lengthening in children with bilateral cerebral palsy (CP).MethodThree ‐dimensional gait analysis was performed in 19 children (16 males, 3 females; 36 limbs; mean age at surgery 9y [SD 3y]; range 6–10y) with flexed knee gait, preoperative ankle dorsiflexion lower than 20 degrees, and CP before bilateral hamstring lengthening (E0), at E1 and E2. Hamstring MTL (norm alized by leg length) and velocity were assessed via OpenSim software.ResultsMTL increased from E0 to E1 (p=0.004) and decreased from E1 to E2 (p<0.020). Hamstring lengthening velocity did not change. In the subgroup with short, not slow hamstrings, the increase in MTL was maintained at E2.InterpretationHamstring lengthening is an efficient procedure to lengthen short and/or slow hamstrings short ‐term. The desired outcome with maintenance of the postoperative changes in hamstring MTL is only achieved for preoperatively short, not slow hamstrings.What this paper adds Surgical hamstring lengthening can be confirmed via musculoskeletal modelling in OpenSim software. Surgical hamstring lengthening in cerebral palsy does not change hamstring lengthening velocity. Short, not slow hamstrings present a long ‐lasting muscle‐tendon length (MTL) increase after hamstring lengthening. Changes in MTL after hamstring l...
Source: Developmental Medicine and Child Neurology - Category: Child Development Authors: Tags: Original Article Source Type: research