CLINICAL PEARLS: Genu Recurvate In Stroke Patients - HARPREET SINGH, MRS. SURANGIKA WADUGODAPITIYA

SURANGIKA WADUGODAPITIYA

To be able to walk independently is one of the primary goals of a rehabilitation programme for people who have suffered a stroke. On regaining the ability to walk, patients often do so with abnormal walking patterns that are a result of the underlying neurological impairments and the compensatory strategies that they develop as they attempt to walk. Abnormal walking patterns are undesirable as they reduce the ability to balance; increase energy expenditure and can lead to deformity and muscle wasting. The challenge for physiotherapists is to determine the causes of an individual patient's abnormal walking pattern to provide the most appropriate and effective treatment.

Genu recurvatum or knee hyperextension is a commonly acquired deformity found in many rehabilitation populations with both musculoskeletal and upper motor neuron pathologies. A majority of patients after stroke are affected by this biomechanical phenomenon – “genu recurvatum”. Knee hyperextension is defined as extension of the affected knee beyond the neutral anatomical position during the stance phase of gait, instead of the normal flexion of the knee joint that is important for shock absorption. One of the greatest impediments to energy-efficient ambulation is the development of a genu recurvatum deformity. When this deviation occurs, the thigh and lower limb segments move posteriorly in direct opposition to the anterior advancement of the proximal body mass over the fixed distal base of support.

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