Effect of a rigid ankle-foot orthosis on hamstring length in children with hemiplegia

Effect of a rigid ankle-foot orthosis on hamstring length in children with hemiplegia
Issue online:
13 Feb 2007
Accepted for publication 29th August 2001.
To cite this article: N S Thompson MD FRCS (Tr&Orth), T C Taylor FRCS, K R McCarthy BSc MCSP, A P Cosgrove MD FRCS(Tr&Orth), R J Baker PhD (2002)
Effect of a rigid ankle-foot orthosis on hamstring length in children with hemiplegia
Developmental Medicine & Child Neurology 44 (1), 51Ò57.
doi:10.1111/j.1469-8749.2002.tb00259.x
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N S Thompson MD FRCS (Tr&Orth)11Orthopaedic Specialist Registrar, Department of Orthopaedic Research, Musgrave Park Hospital, Belfast, Northern Ireland.*Correspondence to first author at Department of Orthopaedic Research, Musgrave Park Hospital, Stockmans Lane, Belfast BT9 7JB, Northern Ireland., T C Taylor FRCS22Consultant Orthopaedic Surgeon, Department of Orthopaedic Research, Musgrave Park Hospital, Belfast, Northern Ireland., K R McCarthy BSc MCSP33Senior Physiotherapist, Department of Orthopaedic Research, Musgrave Park Hospital, Belfast, Northern Ireland., A P Cosgrove MD FRCS(Tr&Orth)44Consultant Orthopaedic Surgeon, Department of Orthopaedic Research, Musgrave Park Hospital, Belfast, Northern Ireland., R J Baker PhD55Gait Analysis Services Manager, Department of Orthopaedic Research, Musgrave Park Hospital, Belfast, Northern Ireland.,

Correspondence to first author at Department of Orthopaedic Research, Musgrave Park Hospital, Stockmans Lane, Belfast BT9 7JB, Northern Ireland.

Abstract
Eighteen children with hemiplegia, mean age 8 years 5 months, underwent gait analysis and musculoskeletal modelling using specially designed software. The maximum lengths of the hamstrings were determined for each child walking in and out of an ankle-foot orthosis (AFO). The muscles were deemed to be short if shorter than the normal average -1SD. In bare feet 8 participants had short medial hamstrings with a higher proportion of these in the less involved individuals. All participants showed an increase in maximum hamstring length when wearing an AFO. In all but one child this was sufficient to restore hamstring length to within normal limits. These finding suggest that hamstring pathology in hemiplegic gait is usually secondary to more distal lower limb pathology.

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