WHAT IF THE CAUSE WAS NOT WHERE WE ALWAYS THOUGHT?
Stiff knee gait is a common condition in post-stroke patients, characterised by reduced or delayed flexion of the joint during the swing phase of the gait cycle. The standard treatment for this deficit is botulinum toxin injection to the rectus femoris, which is considered responsible for braking movements because of its spasticity. However, the average increase in flexion following surgery is lower than 10°.
What if this is not the main cause then? Try shifting your focus below the knee!
Together with the Movement Analysis Laboratory of Correggio (Azienda USL – IRCCS di Reggio Emilia, Italy), we created a model to analyse this mechanism thanks to instrumental Gait Analysis: despite being assessed as a spastic muscle by the clinical evaluation, the rectus femoris appears to be responsible for only 19% of stiff knees. On the other hand, 74% of patients do not have a correct ankle push-off, which would automatically determine the flexion of the joint above: this is the real core issue of these patients!
Can you imagine how many inappropriate surgeries could be avoided if we always combined clinical and instrumental evaluation?
We conducted a study to estimate how many more appropriate treatments a correct assessment can ensure, thus avoiding unnecessary healthcare costs.
The outstanding results sparked a lot of interest and pave the way for new approaches to this condition:
https://pubmed.ncbi.nlm.nih.gov/23755883/
https://pubmed.ncbi.nlm.nih.gov/31228856/
Photo created by kjpargeter – www.freepik.com
