PURPOSE Synergistic neuro-excitability in the lower extremities may be related to gait disorders. This study aimed to report spontaneous changes after correcting knee flexion gait and discuss the underlying mechanisms. METHODS A prospective study of 23 children with cerebral palsy was conducted to assess postoperative changes in gross motor function, joint range of motion (ROM), and spasticity. Characteristics of children/limbs with spontaneous decrease in gastrocnemius spasticity were assessed. RESULTS In 10 patients (19 limbs) without gastrocnemius release, the Modified Ashworth scores in the gastrocnemius decreased in 6 limbs after 3 months and in 10 limbs after 6 months. Those limbs with spontaneous changes had worse preoperative knee flexion contracture than the limbs without spasticity changes (knee ROM limitation score 5.4 vs. 3.7, p = 0.026). CONCLUSIONS Patients with knee flexion contracture recruited greater plantar flexion-knee extension couple to balance knee flexion gait, and synergistic neuro-excitability of the gastrocnemius was enhanced. Our early results suggest preservation of the gastrocnemius in treating knee flexion gait, especially for patients with knee flexion contracture.

中文翻译：

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矫正脑性瘫痪患儿膝关节屈曲步态后腓肠肌痉挛自发性降低。

目的下肢的协同神经兴奋性可能与步态障碍有关。这项研究旨在报告纠正膝盖屈曲步态后的自发性变化并讨论其潜在机制。方法对23名脑瘫患儿进行了一项前瞻性研究，以评估术后其总体运动功能，关节活动范围（ROM）和痉挛状态的变化。评估腓肠肌痉挛自发性降低的儿童/四肢的特征。结果10例（19肢）无腓肠肌释放的患者，腓肠肌的改良Ashworth评分在3个月后的6肢和6个月后的10肢中降低。那些自发改变的肢体比没有痉挛改变的肢体术前膝盖屈曲挛缩的能力更差（膝ROM限制得分5.4 vs. 3.7，p = 0。026）。结论膝关节屈曲挛缩的患者招募了更多的plant屈屈膝延伸夫妇来平衡膝关节屈曲步态，并增强了腓肠肌的协同神经兴奋性。我们的早期结果表明，保留腓肠肌可以治疗膝关节屈曲步态，尤其是对于膝关节屈曲挛缩的患者。