L1—L3 Segment
Hip flexors and hip adductors are innervated at the L1-L2 levels. With L2 sparing, knee extensors have partial innervation but are not at full strength. Distal lower extremity muscle strength is absent.
The distribution of muscle imbalance—hip flexion and hip adduction with absent hip extension and hip abduction—leads to the development of contractures and early paralytic hip dislocation. Pelvic obliquity seen in asymmetric hip pathology enhances scoliosis. Gravity-related foot equinus deformity may develop.Ambulation during young childhood is typical with the use of bracing and assistive devices. Longterm ambulation through adulthood is less likely as priorities change and there are further increases in the already high-energy demands of walking (25). The extent of bracing necessary to achieve ambulation is usually related to the amount of active knee extension.
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