Rectus femoris transfer improves stiff knee gait in hemiplegic adults following stroke or traumatic brain injury


rectus femoris transfer; stiff knee gait; stroke; traumatic brain injury; adults.

Published online: Apr 24 2019

Alex Vermeiren, Lynn Bar-On, Anja Van Campenhout


The aim of this study was to provide quantitative evidence of the effect of rectus femoris (RF) transfer surgery on improving gait in adults suffering from stiff knee gait (SKG) following stroke or traumatic brain injury (TBI).

Retrospective cohort study

University hospital, department of orthopaedic surgery

Hemiplegic patients with decreased peak knee flexion in swing, reduced total knee range of motion and spasticity of the RF demonstrated by a positive Duncan Ely test and a pathologic dynamic electromyography of the RF.

Ten right hemiplegic patients had a distal RF transfer. Pre- and postoperative kinematic, kinetic, and spatiotemporal parameters derived from 3D gait analysis and parameters from clinical examinations were retrospectively compared.

All patients (average age 40 ± 29 years) had an improvement of their gait. Statistically significant improvements were observed in walking velocity and peak knee flexion in swing (19.93° ±11.80°), knee flexion velocity at toe-off (110.26° ± 65.74°) and total knee range of motion (20.78° ± 0.66°).

RF transfer improves knee flexion in swing in adult patients suffering from SKG following stroke or TBI and is thus a reliable treatment option.