Estimation of hamstring length at initial contact based on kinematic gait data

This study proposes a simple estimate of hamstring length at initial contact (LEST) for use when musculoskeletal modelling is not available. The estimate is calculated by using the kinematic curves to measure the excessive flexion (above normal) at the hip and knee at initial contact. The excessive hip flexion is then multiplied by a scaling factor (k) and the excessive knee flexion subtracted from the result. Validation of this estimate was carried out using kinematic gait data from 25 children with cerebral palsy (50 limbs) by comparing the results of the estimate with an equivalent measure derived from musculoskeletal modelling (LTRUE). Very high agreement was found when LTRUE and LEST were compared for the three biarticular hamstring muscles, demonstrated by correlation coefficients of over 0.9. Different k values were tested with a value of 3 giving the best results overall. The estimate is acceptable as a simple ‘rule of thumb’ for use in clinical practice. It can provide useful additional information to complement the clinical examination and gait assessment results.