Abstract
Soft-tissue contracture is usually defined as a permanent shortening of the musculotendinous complex limiting the mobility of a joint. Contracture is mainly due to the consequences of joint immobilization and is one of the main causes of gait disorders. Different approaches have been used to evaluate the influence of contractures on gait, such as observational, experimental, simulation, and animal studies. The main effects of contracture can be summarized muscle by muscle: soleus contracture causes an ankle plantarflexion; gastrocnemius contracture causes a knee flexion and an ankle plantarflexion; hamstring contracture causes a knee flexion and an increased posterior pelvic tilt; psoas contracture causes a hip flexion and a specific knee flexion pattern. Identifying and understanding specific gait patterns associated with contractures support clinical gait analysis and therefore the management of patients with gait deviations. However, contractures are rarely isolated and are often combined with other clinical impairments, such as spasticity and weakness, making their interpretation complex. New approaches, such as advanced neuromusculoskeletal simulations and machine learning, are needed to improve knowledge on the relationships between impairments (including contractures) and gait deviations.
This is a preview of subscription content, log in via an institution to check access.
References
Abdulmassih S, Phisitkul P, Femino JE, Amendola A (2013) Triceps surae contracture: implications for foot and ankle surgery. J Am Acad Orthop Surg 21(7):398–407. https://doi.org/10.5435/JAAOS-21-07-398
Alvarez C, De Vera M, Beauchamp R, Ward V, Black A (2007) Classification of idiopathic toe walking based on gait analysis: development and application of the ITW severity classification. Gait Posture 26(3):428–435. https://doi.org/10.1016/j.gaitpost.2006.10.011
Armand S, Moissenet F, De Coulon G, Bonnefoy-Mazure A (2017) Identifying and understanding gait deviations: critical review and perspectives. Mov Sport Sci 98:77–88. https://doi.org/10.1051/sm/2017016
Arnold AS, Liu MQ, Schwartz MH, Ounpuu S, Delp SL (2006a) The role of estimating muscle-tendon lengths and velocities of the hamstrings in the evaluation and treatment of crouch gait. Gait Posture 23(3):273–281. https://doi.org/10.1016/j.gaitpost.2005.03.003
Arnold AS, Liu MQ, Schwartz MH, Ounpuu S, Dias LS, Delp SL (2006b) Do the hamstrings operate at increased muscle-tendon lengths and velocities after surgical lengthening? J Biomech 39(8):1498–1506. https://doi.org/10.1016/j.jbiomech.2005.03.026
Arnold EM, Ward SR, Lieber RL, Delp SL (2010) A model of the lower limb for analysis of human movement. Ann Biomed Eng 38(2):269–279. https://doi.org/10.1007/s10439-009-9852-5
Assal M, Shofer JB, Rohr E, Price R, Czerniecki J, Sangeorzan BJ (2003) Assessment of an electronic goniometer designed to measure equinus contracture. J Rehabil Res Dev 40(3):235–239
Attias M (2017) Study of the effect of muscle contractions on human walking. PhD thesis in French. Université Claude Bernard Lyon 1
Attias M, Bonnefoy-Mazure A, De Coulon G, Cheze L, Armand S (2016a) Feasibility and reliability of using an exoskeleton to emulate muscle contractures during walking. Gait Posture 50:239–245. https://doi.org/10.1016/j.gaitpost.2016.09.016
Attias M, Chevalley O, Bonnefoy-Mazure A, De Coulon G, Cheze L, Armand S (2016b) Effects of contracture on gait kinematics: a systematic review. Clin Biomech (Bristol, Avon) 33:103–110. https://doi.org/10.1016/j.clinbiomech.2016.02.017
Attias M, Bonnefoy-Mazure A, De Coulon G, Cheze L, Armand S (2017) Influence of different degrees of bilateral emulated contractures at the triceps surae on gait kinematics: the difference between gastrocnemius and soleus. Gait Posture 58:176–182. https://doi.org/10.1016/j.gaitpost.2017.07.118
Balzer J, Schelldorfer S, Bauer C, van der Linden ML (2013) Effects of simulated crouch gait on foot kinematics and kinetics in healthy children. Gait Posture 38(4):619–624. https://doi.org/10.1016/j.gaitpost.2013.02.009
Barber L, Barrett R, Lichtwark G (2011) Validity and reliability of a simple ultrasound approach to measure medial gastrocnemius muscle length. J Anat 218(6):637–642. https://doi.org/10.1111/j.1469-7580.2011.01365.x
Barfod KW, Riecke AF, Boesen A, Hansen P, Maier JF, Doessing S, Troelsen A (2018) Validity and reliability of an ultrasound measurement of the free length of the Achilles tendon. Dan Med J 65(3):1–5
Boone DC, Azen SP, Lin CM, Spence C, Baron C, Lee L (1978) Reliability of goniometric measurements. Phys Ther 58(11):1355–1360
Born CT, Gil JA, Goodman AD (2017) Joint contractures resulting from prolonged immobilization: etiology, prevention, and management. J Am Acad Orthop Surg 25(2):110–116. https://doi.org/10.5435/JAAOS-D-15-00697
Borton DC, Walker K, Pirpiris M, Nattrass GR, Graham HK (2001) Isolated calf lengthening in cerebral palsy. Outcome analysis of risk factors. J Bone Joint Surg Br 83(3):364–370. https://doi.org/10.1302/0301-620x.83b3.0830364
Broom L et al. (2017) A translational approach to capture gait signatures of neurological disorders in mice and humans. Sci Rep 7(1):3225 https://doi.org/10.1038/s41598-017-03336-1
Campanini I, Merlo A, Damiano B (2013) A method to differentiate the causes of stiff-knee gait in stroke patients. Gait Posture 38(2):165–169. https://doi.org/10.1016/j.gaitpost.2013.05.003
Carney BT, Oeffinger D, Gove NK (2006a) Sagittal knee kinematics after rectus femoris transfer without hamstring lengthening. J Pediatr Orthop 26(2):265–267. https://doi.org/10.1097/01.bpo.0000218535.89727.47
Carney BT, Oeffinger D, Meo AM (2006b) Sagittal knee kinematics after hamstring lengthening. J Pediatr Orthop B 15(5):348–350. https://doi.org/10.1097/01202412-200609000-00008
Cerny K, Perry J, Walker JM (1994) Adaptations during the stance phase of gait for simulated flexion contractures at the knee. Orthopedics 17(6):501–513
Cloodt E, Rosenblad A, Rodby-Bousquet E (2018) Demographic and modifiable factors associated with knee contracture in children with cerebral palsy. Dev Med Child Neurol. https://doi.org/10.1111/dmcn.13659
Conn PM (2013) Animal Models for the Study of Human Disease. https://doi.org/10.1016/C2011-0-05225-0
Davids JR, Foti T, Dabelstein J, Bagley A (1999) Voluntary (normal) versus obligatory (cerebral palsy) toe-walking in children: a kinematic, kinetic, and electromyographic analysis. J Pediatr Orthop 19(4):461–469. https://doi.org/10.1097/00004694-199907000-00008
Dayanidhi S, Dykstra PB, Lyubasyuk V, McKay BR, Chambers HG, Lieber RL (2015) Reduced satellite cell number in situ in muscular contractures from children with cerebral palsy. J Orthop Res 33(7):1039–1045. https://doi.org/10.1002/jor.22860
de Morais Filho MC, Kawamura CM, Kanaji PR, Juliano Y (2010) The relation of triceps surae surgical lengthening and crouch gait in patients with cerebral palsy. J Pediatr Orthop B 19(3):226–230. https://doi.org/10.1097/BPB.0b013e3283387cdb
Delp SL, Arnold AS, Speers RA, Moore CA (1996) Hamstrings and psoas lengths during normal and crouch gait: implications for muscle-tendon surgery. J Orthop Res 14(1):144–151. https://doi.org/10.1002/jor.1100140123
Delp SL et al (2007) OpenSim: open-source software to create and analyze dynamic simulations of movement. IEEE Trans Biomed Eng 54(11):1940–1950. https://doi.org/10.1109/TBME.2007.901024
DeLuca PA, Ounpuu S, Davis RB, Walsh JH (1998) Effect of hamstring and psoas lengthening on pelvic tilt in patients with spastic diplegic cerebral palsy. J Pediatr Orthop 18(6):712–718. https://doi.org/10.1097/01241398-199811000-00004
Desloovere K, Molenaers G, Feys H, Huenaerts C, Callewaert B, Van de Walle P (2006) Do dynamic and static clinical measurements correlate with gait analysis parameters in children with cerebral palsy? Gait Posture 24(3):302–313. https://doi.org/10.1016/j.gaitpost.2005.10.008
Diong J, Harvey LA, Kwah LK, Eyles J, Ling MJ, Ben M, Herbert RD (2012) Incidence and predictors of contracture after spinal cord injury—a prospective cohort study. Spinal Cord 50(8):579–584. https://doi.org/10.1038/sc.2012.25
Domagalska M, Szopa A, Syczewska M, Pietraszek S, Kidon Z, Onik G (2013) The relationship between clinical measurements and gait analysis data in children with cerebral palsy. Gait Posture 38(4):1038–1043. https://doi.org/10.1016/j.gaitpost.2013.05.031
Ellington MD, Scott AC, Linton J, Sullivan E, Barnes D (2018) Rectus femoris transfer versus rectus intramuscular lengthening for the treatment of stiff knee gait in children with cerebral palsy. J Pediatr Orthop 38(4):e213–e218. https://doi.org/10.1097/BPO.0000000000001138
English C, Fisher L, Thoirs K (2012) Reliability of real-time ultrasound for measuring skeletal muscle size in human limbs in vivo: a systematic review. Clin Rehabil 26(10):934–944. https://doi.org/10.1177/0269215511434994
Figueiredo J, Santos CP, Moreno JC (2018) Automatic recognition of gait patterns in human motor disorders using machine learning: a review. Med Eng Phys 53:1–12. https://doi.org/10.1016/j.medengphy.2017.12.006
Fox AS, Carty CP, Modenese L, Barber LA, Lichtwark GA (2018) Simulating the effect of muscle weakness and contracture on neuromuscular control of normal gait in children. Gait Posture 61:169–175. https://doi.org/10.1016/j.gaitpost.2018.01.010
Gajdosik RL (2001) Passive extensibility of skeletal muscle: review of the literature with clinical implications Clin Biomech (Bristol, Avon) 16(2):87–101 https://doi.org/10.1016/S0268-0033(00)00061-9
Galey SA, Lerner ZF, Bulea TC, Zimbler S, Damiano DL (2017) Effectiveness of surgical and non-surgical management of crouch gait in cerebral palsy: a systematic review. Gait Posture 54:93–105. https://doi.org/10.1016/j.gaitpost.2017.02.024
Galli M, Cimolin V, Crivellini M, Albertini G (2005) Gait analysis before and after gastrocnemius fascia lengthening in children with cerebral palsy. J Appl Biomater Biomech 3(2):98–105
Galli M, Cimolin V, Crivellini M, Albertini G (2009) Long-term evaluation of isolated gastrocnemius fascia lengthening in children with cerebral palsy using gait analysis. J Pediatr Orthop B 18(5):228–233. https://doi.org/10.1097/BPB.0b013e32832bf65c
Garlich MW, Baltgalvis KA, Call JA, Dorsey LL, Lowe DA (2010) Plantarflexion contracture in the mdx mouse. Am J Phys Med Rehabil 89(12):976–985. https://doi.org/10.1097/PHM.0b013e3181fc7c9e
Gaudreault N, Gravel D, Nadeau S, Desjardins P, Briere A (2007) A method to evaluate contractures effects during the gait of children with Duchenne dystrophy. Clin Orthop Relat Res 456:51–57. https://doi.org/10.1097/BLO.0b013e3180312bd7
Gaudreault N, Gravel D, Nadeau S (2009) Evaluation of plantar flexion contracture contribution during the gait of children with Duchenne muscular dystrophy. J Electromyogr Kinesiol 19(3):e180–e186. https://doi.org/10.1016/j.jelekin.2007.09.004
Geyer H, Herr H (2010) A muscle-reflex model that encodes principles of legged mechanics produces human walking dynamics and muscle activities. IEEE Trans Neural Syst Rehabil Eng 18(3):263–273. https://doi.org/10.1109/TNSRE.2010.2047592
Goodman MJ, Menown JL, West JM Jr, Barr KM, Vander Linden DW, McMulkin ML (2004) Secondary gait compensations in individuals without neuromuscular involvement following a unilateral imposed equinus constraint. Gait Posture 20(3):238–244. https://doi.org/10.1016/j.gaitpost.2003.09.005
Gracies JM (2005) Pathophysiology of spastic paresis. I: paresis and soft tissue changes. Muscle Nerve 31(5):535–551. https://doi.org/10.1002/mus.20284
Graham HK et al (2016) Cerebral palsy. Nat Rev Dis Primers 2:15082. https://doi.org/10.1038/nrdp.2015.82
Harato K, Nagura T, Matsumoto H, Otani T, Toyama Y, Suda Y (2008) A gait analysis of simulated knee flexion contracture to elucidate knee-spine syndrome. Gait Posture 28(4):687–692. https://doi.org/10.1016/j.gaitpost.2008.05.008
Hemo Y, Macdessi SJ, Pierce RA, Aiona MD, Sussman MD (2006) Outcome of patients after Achilles tendon lengthening for treatment of idiopathic toe walking. J Pediatr Orthop 26(3):336–340. https://doi.org/10.1097/01.bpo.0000217743.44609.44
Hoang PD, Gandevia SC, Herbert RD (2014) Prevalence of joint contractures and muscle weakness in people with multiple sclerosis. Disabil Rehabil 36(19):1588–1593. https://doi.org/10.3109/09638288.2013.854841
Houx L, Brochard S, Lempereur M, Remy-Neris O (2012) Simulation of unilateral equinus using an adjustable orthosis in children: design, feasibility and biomechanical effects. Prosthetics Orthot Int 36(1):131–136. https://doi.org/10.1177/0309364611427764
Houx L, Lempereur M, Remy-Neris O, Brochard S (2013) Threshold of equinus which alters biomechanical gait parameters in children. Gait Posture 38(4):582–589. https://doi.org/10.1016/j.gaitpost.2013.01.026
Houx L, Lempereur M, Remy-Neris O, Gross R, Brochard S (2014) Changes in muscle activity in typically developing children walking with unilaterally induced equinus. Clin Biomech (Bristol, Avon) 29(10):1116–1124. https://doi.org/10.1016/j.clinbiomech.2014.09.015
Iwasawa H, Nomura M, Sakitani N, Watanabe K, Watanabe D, Moriyama H (2016) Stretching after heat but not after cold decreases contractures after spinal cord injury in rats. Clin Orthop Relat Res 474(12):2692–2701. https://doi.org/10.1007/s11999-016-5030-x
Kang MH, Oh JS (2017) Relationship between weightbearing ankle dorsiflexion passive range of motion and ankle kinematics during gait. J Am Podiatr Med Assoc 107(1):39–45. https://doi.org/10.7547/14-112
Kedem P, Scher DM (2016) Evaluation and management of crouch gait. Curr Opin Pediatr 28(1):55–59. https://doi.org/10.1097/MOP.0000000000000316
Kerrigan DC, Riley PO, Rogan S, Burke DT (2000) Compensatory advantages of toe walking. Arch Phys Med Rehabil 81(1):38–44. https://doi.org/10.1053/apmr.2000.0810038
Khodadadeh S, McClelland MR, Patrick JH, Edwards RH, Evans GA (1986) Knee moments in Duchenne muscular dystrophy. Lancet 328(8506):544–545. https://doi.org/10.1016/S0140-6736(86)90114-5
Lee KM, Chung CY, Kwon DG, Han HS, Choi IH, Park MS (2011) Reliability of physical examination in the measurement of hip flexion contracture and correlation with gait parameters in cerebral palsy. J Bone Joint Surg Am 93(2):150–158. https://doi.org/10.2106/JBJS.J.00252
Lund ME, de Zee M, Andersen MS, Rasmussen J (2012) On validation of multibody musculoskeletal models. Proc Inst Mech Eng H 226(2):82–94. https://doi.org/10.1177/0954411911431516
Mallet C, Simon AL, Ilharreborde B, Presedo A, Mazda K, Pennecot GF (2016) Intramuscular psoas lengthening during single-event multi-level surgery fails to improve hip dynamics in children with spastic diplegia. Clinical and kinematic outcomes in the short- and medium-terms. Orthop Traumatol Surg Res 102(4):501–506. https://doi.org/10.1016/j.otsr.2016.01.022
Manzur AY, Hyde SA, Rodillo E, Heckmatt JZ, Bentley G, Dubowitz V (1992) A randomized controlled trial of early surgery in Duchenne muscular dystrophy. Neuromuscul Disord 2(5–6):379–387. https://doi.org/10.1016/s0960-8966(06)80009-x
Mathewson MA, Lieber RL (2015) Pathophysiology of muscle contractures in cerebral palsy. Phys Med Rehabil Clin N Am 26(1):57–67. https://doi.org/10.1016/j.pmr.2014.09.005
Mathewson MA, Chambers HG, Girard PJ, Tenenhaus M, Schwartz AK, Lieber RL (2014) Stiff muscle fibers in calf muscles of patients with cerebral palsy lead to high passive muscle stiffness. J Orthop Res 32(12):1667–1674. https://doi.org/10.1002/jor.22719
Matjacic Z, Olensek A (2007) Biomechanical characterization and clinical implications of artificially induced crouch walking: differences between pure iliopsoas, pure hamstrings and combination of iliopsoas and hamstrings contractures. J Biomech 40(3):491–501. https://doi.org/10.1016/j.jbiomech.2006.02.018
Matjacic Z, Olensek A, Bajd T (2006) Biomechanical characterization and clinical implications of artificially induced toe-walking: differences between pure soleus, pure gastrocnemius and combination of soleus and gastrocnemius contractures. J Biomech 39(2):255–266. https://doi.org/10.1016/j.jbiomech.2004.11.024
McMulkin ML, Gordon AB, Tompkins BJ, Caskey PM, Baird GO (2016) Long term gait outcomes of surgically treated idiopathic toe walkers. Gait Posture 44:216–220. https://doi.org/10.1016/j.gaitpost.2015.12.013
Michlitsch MG, Rethlefsen SA, Kay RM (2006) The contributions of anterior and posterior tibialis dysfunction to varus foot deformity in patients with cerebral palsy. J Bone Joint Surg Am 88(8):1764–1768. https://doi.org/10.2106/JBJS.E.00964
Morais Filho MC, de Godoy W, Santos CA (2006) Effects of intramuscular psoas lengthening on pelvic and hip motion in patients with spastic diparetic cerebral palsy. J Pediatr Orthop 26(2):260–264. https://doi.org/10.1097/01.bpo.0000194700.06398.a2
Mutlu A, Livanelioglu A, Gunel MK (2007) Reliability of goniometric measurements in children with spastic cerebral palsy. Med Sci Monit 13(7):CR323–CR329
Novacheck TF, Trost JP, Schwartz MH (2002) Intramuscular psoas lengthening improves dynamic hip function in children with cerebral palsy. J Pediatr Orthop 22(2):158–164. https://doi.org/10.1097/01241398-200203000-00004
O'Byrne JM, Kennedy A, Jenkinson A, O'Brien TM (1997) Split tibialis posterior tendon transfer in the treatment of spastic equinovarus foot. J Pediatr Orthop 17(4):481–485. https://doi.org/10.1097/01241398-199707000-00014
Pomarino D, Ramirez Llamas J, Martin S, Pomarino A (2017) Literature review of idiopathic toe walking: etiology, prevalence, classification, and treatment. Foot Ankle Spec 10(4):337–342. https://doi.org/10.1177/1938640016687370
Pothrat C, Authier G, Viehweger E, Berton E, Rao G (2015) One- and multi-segment foot models lead to opposite results on ankle joint kinematics during gait: implications for clinical assessment. Clin Biomech (Bristol, Avon) 30(5):493–499. https://doi.org/10.1016/j.clinbiomech.2015.03.004
Powden CJ, Hoch JM, Hoch MC (2015) Reliability and minimal detectable change of the weight-bearing lunge test: a systematic review. Man Ther 20(4):524–532. https://doi.org/10.1016/j.math.2015.01.004
Prabhu RK, Swaminathan N, Harvey LA (2013) Passive movements for the treatment and prevention of contractures. Cochrane Database Syst Rev (12):CD009331. https://doi.org/10.1002/14651858.CD009331.pub2
Rezgui T, Megrot F, Fradet L, Marin F (2013) On the imitation of CP gait patterns by healthy subjects. Gait Posture 38(4):576–581. https://doi.org/10.1016/j.gaitpost.2013.01.022
Rhie TY, Sung KH, Park MS, Lee KM, Chung CY (2013) Hamstring and psoas length of crouch gait in cerebral palsy: a comparison with induced crouch gait in age- and sex-matched controls. J Neuroeng Rehabil 10(10). https://doi.org/10.1186/1743-0003-10-10
Romkes J, Brunner R (2007) An electromyographic analysis of obligatory (hemiplegic cerebral palsy) and voluntary (normal) unilateral toe-walking. Gait Posture 26(4):577–586. https://doi.org/10.1016/j.gaitpost.2006.12.010
Rutz E, Gaston MS, Tirosh O, Brunner R (2012) Hip flexion deformity improves without psoas-lengthening after surgical correction of fixed knee flexion deformity in spastic diplegia. Hip Int 22(4):379–386. https://doi.org/10.5301/HIP.2012.9453
Sackley C, Brittle N, Patel S, Ellins J, Scott M, Wright C, Dewey ME (2008) The prevalence of joint contractures, pressure sores, painful shoulder, other pain, falls, and depression in the year after a severely disabling stroke. Stroke 39(12):3329–3334. https://doi.org/10.1161/STROKEAHA.108.518563
Schwartz MH, Rozumalski A, Truong W, Novacheck TF (2013) Predicting the outcome of intramuscular psoas lengthening in children with cerebral palsy using preoperative gait data and the random forest algorithm. Gait Posture 37(4):473–479. https://doi.org/10.1016/j.gaitpost.2012.08.016
Smith LR, Lee KS, Ward SR, Chambers HG, Lieber RL (2011) Hamstring contractures in children with spastic cerebral palsy result from a stiffer extracellular matrix and increased in vivo sarcomere length. J Physiol 589(Pt 10):2625–2639. https://doi.org/10.1113/jphysiol.2010.203364
Smith LR, Chambers HG, Lieber RL (2013) Reduced satellite cell population may lead to contractures in children with cerebral palsy. Dev Med Child Neurol 55(3):264–270. https://doi.org/10.1111/dmcn.12027
Sutherland DH, Santi M, Abel MF (1990) Treatment of stiff-knee gait in cerebral palsy: a comparison by gait analysis of distal rectus femoris transfer versus proximal rectus release. J Pediatr Orthop 10(4):433–441. https://doi.org/10.1097/01241398-199007000-00001
Sutherland DH, Zilberfarb JL, Kaufman KR, Wyatt MP, Chambers HG (1997) Psoas release at the pelvic brim in ambulatory patients with cerebral palsy: operative technique and functional outcome. J Pediatr Orthop 17(5):563–570. https://doi.org/10.1097/00004694-199709000-00002
Ten Berge SR, Halbertsma JP, Maathuis PG, Verheij NP, Dijkstra PU, Maathuis KG (2007) Reliability of popliteal angle measurement: a study in cerebral palsy patients and healthy controls. J Pediatr Orthop 27(6):648–652. https://doi.org/10.1097/BPO.0b013e3180dca15d
Trudel G, Laneuville O, Coletta E, Goudreau L, Uhthoff HK (2014) Quantitative and temporal differential recovery of articular and muscular limitations of knee joint contractures; results in a rat model. J Appl Physiol (1985) 117(7):730–737 https://doi.org/10.1152/japplphysiol.00409.2014
Truong WH, Rozumalski A, Novacheck TF, Beattie C, Schwartz MH (2011) Evaluation of conventional selection criteria for psoas lengthening for individuals with cerebral palsy: a retrospective, case-controlled study. J Pediatr Orthop 31(5):534–540. https://doi.org/10.1097/BPO.0b013e31821f8ee3
van der Krogt MM, Doorenbosch CA, Harlaar J (2007) Muscle length and lengthening velocity in voluntary crouch gait. Gait Posture 26(4):532–538. https://doi.org/10.1016/j.gaitpost.2006.11.208
van der Krogt MM, Bar-On L, Kindt T, Desloovere K, Harlaar J (2016) Neuro-musculoskeletal simulation of instrumented contracture and spasticity assessment in children with cerebral palsy. J Neuroeng Rehabil 13(1):64. https://doi.org/10.1186/s12984-016-0170-5
van Trijffel E, van de Pol RJ, Oostendorp RA, Lucas C (2010) Inter-rater reliability for measurement of passive physiological movements in lower extremity joints is generally low: a systematic review. J Physiother 56(4):223–235
Vanmechelen IM, Shortland AP, Noble JJ (2018) Lower limb muscle volume estimation from maximum cross-sectional area and muscle length in cerebral palsy and typically developing individuals. Clin Biomech (Bristol, Avon) 51:40–44. https://doi.org/10.1016/j.clinbiomech.2017.11.004
Vuillermin C, Rodda J, Rutz E, Shore BJ, Smith K, Graham HK (2011) Severe crouch gait in spastic diplegia can be prevented: a population-based study. J Bone Joint Surg Br 93(12):1670–1675. https://doi.org/10.1302/0301-620X.93B12.27332
Westberry DE, Davids JR, Davis RB, de Morais Filho MC (2008) Idiopathic toe walking: a kinematic and kinetic profile. J Pediatr Orthop 28(3):352–358. https://doi.org/10.1097/BPO.0b013e318168d996
Whitehead CL, Hillman SJ, Richardson AM, Hazlewood ME, Robb JE (2007) The effect of simulated hamstring shortening on gait in normal subjects. Gait Posture 26(1):90–96. https://doi.org/10.1016/j.gaitpost.2006.07.011
Wong K, Trudel G, Laneuville O (2015) Noninflammatory joint contractures arising from immobility: animal models to future treatments. Biomed Res Int 2015:848290. https://doi.org/10.1155/2015/848290
Zollner AM, Pok JM, McWalter EJ, Gold GE, Kuhl E (2015) On high heels and short muscles: a multiscale model for sarcomere loss in the gastrocnemius muscle. J Theor Biol 365:301–310. https://doi.org/10.1016/j.jtbi.2014.10.036
Zwick EB, Saraph V, Zwick G, Steinwender C, Linhart WE, Steinwender G (2002) Medial hamstring lengthening in the presence of hip flexor tightness in spastic diplegia. Gait Posture 16(3):288–296. https://doi.org/10.1016/s0966-6362(02)00022-x
Author information
Authors and Affiliations
Corresponding author
Section Editor information
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this entry
Cite this entry
Armand, S., Attias, M. (2019). Contracture and Gait Deviations. In: Handbook of Human Motion. Springer, Cham. https://doi.org/10.1007/978-3-319-30808-1_200-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-30808-1_200-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-30808-1
Online ISBN: 978-3-319-30808-1
eBook Packages: Springer Reference EngineeringReference Module Computer Science and Engineering