Combined three-dimensional gait and plantar pressure analyses detecting significant functional deficits in children with juvenile idiopathic arthritis
| Autor: | J. Merker, Johannes-Peter Haas, Ansgar Schwirtz, M. Hartmann |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty Adolescent Knee Joint Biophysics Arthritis 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Spatio-Temporal Analysis Pressure Medicine Humans Orthopedics and Sports Medicine Ground reaction force Range of Motion Articular Pedobarography Child Gait Retrospective Studies 030203 arthritis & rheumatology business.industry Foot Rehabilitation medicine.disease Arthritis Juvenile Biomechanical Phenomena Walking Speed Preferred walking speed medicine.anatomical_structure Gait analysis Case-Control Studies Female Ankle Range of motion business Gait Analysis 030217 neurology & neurosurgery Ankle Joint |
| Zdroj: | Gaitposture. 66 |
| ISSN: | 1879-2219 |
| Popis: | Background Children suffering from juvenile idiopathic arthritis (JIA), a heterogeneous group of chronic inflammatory joint diseases, adapt to individual gait patterns to avoid loading of inflamed, swollen and painful joints. As the interpretability of previous studies is limited, this study aims to assess the functional capacity, loads and plantar pressure distribution in the gait of a homogeneous JIA group. Research question Does a symmetrical lower limb joint involvement influence the gait dynamics in JIA patients, and how are the results of three-dimensional gait analysis (3DGA) and pedobarography related? Methods Fifty JIA patients with symmetrical hip, knee and ankle joint arthritis and 27 healthy controls performed 3DGA and pedobarography at self-selected walking speeds. Kinematics and kinetics of lower limb joints were retrospectively compared in range of motion and in time-normalized waveforms. Plantar load was evaluated by measuring peak pressure, pressure-time integral and maximum force of the whole foot and ten selected foot regions. 1D-SPM analysis, parametric and non-parametric statistical significance tests and correlation coefficients were used for statistical analysis. Results JIA patients had a significantly slower walking speed with an anteriorly tilted pelvis and a reduced extension motion of all joints of the lower limb. The horizontal ground reaction forces and generated hip and ankle power during propulsion phase were small. Patients experienced reduced loading at toe regions, which correlated with limited ankle plantarflexion motion in the push-off phase. The total peak pressure was significantly increased and loads at lateral midfoot and metatarsal regions were higher in patients. Significance Symmetrical lower limb arthritis is linked to crouch-like gait and restricted gait dynamics with increased total peak pressure. The results confirm earlier results of 3DGA and provide new insights regarding waveform analysis and plantar loading in JIA patients. The used methods help to design individualized functional treatment of JIA patients. |
| Databáze: | OpenAIRE |
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