Stiff knee gait in adults with spastic paresis: A systematic review of the effects of chemodenervation of the rectus femoris muscle

Marc J. Nederhand*, Martin J.B. Tenniglo, Anand V. Nene, Hans J. Rietman, Jaap H. Buurke

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterAcademicpeer-review

Abstract

This systematic review is performed to determine the effects of chemodenervation (Motor Branch Block (MBB) or Neuro Muscular Block(NMB)) of the Rectus femoris muscle on stiff knee gait. Studies selected from 4 electronic data bases included adults suffering from a central neurological disorder with range of knee motion during gait as outcome. Secondary outcomes were walking speed and energy cost. Data from stroke patients were pooled where possible. Peak knee flexion during swing improved in all 8 included studies. Data pooling of stroke patients showed a significant improvement of 7,40 (P=0,002) in the NMB studies and 11,30 (P=0,0009) in the MBB studies. Pooling of walking speed showed no significant difference. A decrease in net energy cost varying from 0.5-0.9 J. kg-1.m-1 (9-15 %) was noted. The only moderate increase in knee flexion does not affect walking speed. The improvement in energy cost might result from decreased knee extensor moment and/or decreased (energy-inefficient) compensations.

Original languageEnglish
Title of host publicationBiosystems and Biorobotics
PublisherSpringer International Publishing AG
Pages759-763
Number of pages5
DOIs
Publication statusPublished - 1 Jan 2013
Externally publishedYes

Publication series

NameBiosystems and Biorobotics
Volume1
ISSN (Print)2195-3562
ISSN (Electronic)2195-3570

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