SynthesisGait & posture2017
Effectiveness of surgical and non-surgical management of crouch gait in cerebral palsy: A systematic review.
Synthesis in Gait & posture, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 77 citations in OpenAlex.
- State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy.Current neurology and neuroscience reports · 2020Pooled it
- Toward a hybrid exoskeleton for crouch gait in children with cerebral palsy: neuromuscular electrical stimulation for improved knee extension.Journal of neuroengineering and rehabilitation · 2020Trial
- Effect of a Combined Stretching and Strength Training Program on Gait Function in Children with Cerebral Palsy, GMFCS Level I & II: A Randomized Controlled Trial.Medicina (Kaunas, Lithuania) · 2019Trial
- A lower-extremity exoskeleton improves knee extension in children with crouch gait from cerebral palsy.Science translational medicine · 2017Trial
- Increasing error at targeted phase of gait facilitates motor adaptation for improving crouch gait in children with cerebral palsy.Journal of neurophysiology · 2026Article
- Robot-Assisted Gait Training Combined with Conventional Physiotherapy in Postoperative Patients with Diplegic Cerebral Palsy: A Pilot Single Cohort Observational Study.Sensors (Basel, Switzerland) · 2026Observational
- Evaluating the rehabilitative and assistive impact of the Agilik exoskeleton: a pre-post single-group study in children with cerebral palsy.Frontiers in medicine · 2026Article
- Gait Event Detection From Thigh Segment Kinematics in Children With Crouch Gait.IEEE journal of translational engineering in health and medicine · 2026Article
- Combined hamstrings lengthening and patellar tendon retensioning for neurogenic knee flexion in spastic diplegia.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Influence of crouch angle on lower-extremity kinetic gait profile and walk distance in children with cerebral palsy: a cross-sectional study.BMC biomedical engineering · 2025Article
- Changes in Motor Function in a Child with Cerebral Palsy Following Multiple Botulinum Toxin Injections: A Case Report.Children (Basel, Switzerland) · 2025Article
- Does patella lowering as part of multilevel surgery improve knee kinematics in children with cerebral palsy and crouch gait? A meta-analysis of comparative studies.Journal of children's orthopaedics · 2024Review
- Article
- Knee Flexion While Walking Exceeds Knee Flexion Contracture in Children with Spastic Cerebral Palsy.Children (Basel, Switzerland) · 2023Article
- The Rehabilitation Interventions and Adaptive Technologies Used for Treating Patients With Cerebral Palsy.Cureus · 2023Review
- American Society of Biomechanics Clinical Biomechanics Award 2021: Redistribution of muscle-tendon work in children with cerebral palsy who walk in crouch.Clinical biomechanics (Bristol, Avon) · 2023Article
- Long-term outcome of hamstring lengthening versus transfer and the role of biceps femoris lengthening in patients with spastic diplegia and dynamic knee flexion in gait.Journal of children's orthopaedics · 2022Article
- Short-Term Outcome of Rehabilitation Program with Hybrid Assistive Limb after Tendon Lengthening in Patients with Cerebral Palsy.Pediatric reports · 2022Article
- Defining usual physiotherapy care in ambulant children with cerebral palsy in the United Kingdom: A mixed methods consensus study.Child: care, health and development · 2022Review
- Interleaved Assistance and Resistance for Exoskeleton Mediated Gait Training: Validation, Feasibility and Effects.Proceedings of the ... IEEE/RAS-EMBS International Conference on Biomedical Robotics and Biomechatronics. IEEE/RAS-EMBS International Conference on Biomedical Robotics and Biomechatronics · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCerebral palsy (CP) is a prevalent group of neuromotor disorders caused by early injury to brain regions or pathways that control movement. Patients with CP exhibit a range of functional motor disabilities and pathologic gait patterns. Crouch gait, characterized by increased knee flexion throughout stance, is a common gait pattern in CP that increases energy costs of walking and contributes to ambulatory decline. Our aim was to perform the first systematic literature review on the effectiveness of interventions utilized to ameliorate crouch gait in CP.
methodsComprehensive searches of five medical databases yielded 38 papers with 30 focused on orthopaedic management.
resultsEvidence supports the use of initial hamstring lengthenings and rectus femoris transfers, where indicated, for improving objective gait measures with limited data on improving gait speed or gross motor function. In contrast, evidence argues against hamstring transfers and revision hamstring lengthening, with recent interest in more technically demanding corrective procedures. Only eight studies evaluated alternatives to surgery, specifically strength training, botulinum toxin or orthoses, with inconsistent and/or short-lived results.
conclusionsAlthough crouch in CP is recognized clinically as a complex multi-joint, multi-planar gait disorder, this review largely failed to identify interventions beyond those which directly address sagittal plane knee motion, indicating a major knowledge gap. Quality of existing data was notably weak, with few studies properly controlled or adequately sized. Outcomes from specific procedures are confounded by multilevel surgeries. Successful longer term strategies to prevent worsening of crouch and subsequent functional decline are needed. LEVEL OF EVIDENCE: Systematic review.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.