Identification of secondary and tertiary impairments in neurologically induced gait deviations, such as
crouch gait, is not always straightforward, but essential in order to decide upon the most efficient
medical treatment in patients with cerebral palsy (CP). Until now, exact intersegmental dependency of
the development of foot deformities has not been investigated. Therefore, the aim of this study was to
explore if an artificially induced bilateral knee flexion contracture causes compensatory mechanisms in
foot motion during gait in healthy children.
Three-dimensional kinematic and kinetic data from 30 healthy children (mean age 10.6 years) were
derived from the Oxford Foot model (OFM). Participants walked first in an artificially induced crouch gait
(limitation of knee extension to 408) and then normally. Walking speed was kept the same in both
conditions.
Analysis revealed small but significant (p < 0.05) differences between the two conditions in hindfoot
and forefoot kinematics in all three planes during the stance phase as well as for all peak internal
moments within the foot. In general the foot tended to compensate for an artificial knee flexion
contracture with an increase in maximal dorsiflexion, eversion and external rotation of the hindfoot,
which also allowed increased foot motion in other foot segments.
The results of this study showed that an isolated proximal joint contracture had an influence on foot
position during stance in healthy children. Further interpretation of the data in relation to CP children
will be possible as soon as comparable OFM data of pathological crouch gait is available.