Cerebral Palsy maybe/maybe not

walking in hemiplegia. If you cast or AFO the ankle into dorsiflexion leaving a flexible metatarsal (ball of foot) roll over (flexible or absent toe plate), then the ground reaction ought to disappear and swing phase knee flexion resume.

If that is what happens then attention to the ankle mechanics will tremendously improve walking.

Some of the stiff knee walkers are stiff in the knee because the quadriceps group of (4) muscles fires just at or before swing phase. In other words, the quadriceps muscle thinks it is one of the hip flexors and is firing along with the hip flexion group. Remember it is the hip flexors which initiate swing phase.

OK the knee is actually stiff of it’s own muscular choice, not ground reaction. Still a way out. Is this 2C?

But in order 2C we need to look closely at one of the four parts of the quadriceps, that one that does not attach to the femur (thigh) bone but rather extends up to the pelvis. [= rectus femoris] That is the part that can be recruited as a supplemental hip flexor. We recruit when we need additional hip flexion power. However, if that circuitry runs amok or is passed on by reflex of RF spindles, then the entire quadriceps muscle fires with the hip flexors in walking (ought not) and may recruit by reflex the rest of the muscle group. If the rectus femoris is simply reacting to stretch when the thigh is extended, then releasing the upper end of the RF from the pelvis will solve the problem. Hoo hah!