Gait characteristics in children with Duchenne Muscular Dystrophy during the last 2 years of free ambulation (Preprint)

2021 ◽  
Author(s):  
Juliette Ropars ◽  
Laetitia Houx ◽  
Sylvain Brochard ◽  
François Rousseau ◽  
Carole Vuillerot ◽  
...  
Keyword(s):  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Gait Analysis ◽  
Plantar Flexion ◽  
Reaction Force ◽  
Statistical Parametric Mapping ◽  
Initial Contact ◽  
Gait Patterns ◽  
Gait Characteristics ◽  
Abnormal Gait

BACKGROUND Duchenne Muscular Dystrophy (DMD), the most common neuromuscular disease in children, is a severe, progressive disease that affects skeletal muscle. Abnormal gait patterns in children with DMD result from compensatory adaptations of their locomotor system to maintain free ambulation in response to the slow, progressive muscle weakness, contractures and osteoarticular changes caused by the disease. Identification of gait abnormalities can be challenging because current understanding of how gait patterns changes progressively in children with DMD is limited. 3D gait analysis could thus increase understanding about the effects of the disease on gait, guide treatments and help to predict key milestones, such as ambulation loss. This latter event is important because it is an endpoint for clinical trials and studies of DMD disease progression. OBJECTIVE The primary aim of this study was to analyze the gait characteristics of children with Duchenne Muscular Dystrophy (DMD) during their last 2 years of free ambulation. The secondary aim was to explore the capacity of gait variables to predict the time of loss of ambulation. METHODS The gait of eighteen children with DMD and fourteen age-matched control children was recorded using a 3D optoelectronic system. Statistical parametric mapping was used to compare kinematic and kinetic variables between groups. Multivariate regression was used to identify predictors of the time of ambulation loss among spatiotemporal, kinematic and kinetic variables. RESULTS Compared with the controls, anterior pelvic tilt was increased during the whole gait cycle, hip flexion was increased during the second part of stance phase and of the entire swing, knee flexion was increased during swing, dorsiflexion was reduced during stance, and plantar flexion occurred in swing in the DMD group. Maximal ground reaction force, ankle dorsiflexion moment at initial contact, knee power absorption and generation during loading response, and maximal power generation of the hip at the end of stance were all reduced. A combination of gait variables, mostly kinetic, predicted the duration before ambulation loss to be less than three months. CONCLUSIONS The gait of children with DMD who are close to losing ambulation is characterized by specific deviations. The time of ambulation loss was accurately predicted by 3D gait variables, particularly kinetic. Combined with data from the clinical examination, 3D gait analysis provides valuable information to guide physical therapy, including targeted muscle strengthening and stretching, to help patients maintain free ambulation as long as possible.

Biomechanical Analysis on the Foot under Normal and Abnormal Gait for Orthotics Design

2007 ◽  
Vol 353-358 ◽  
pp. 2179-2182 ◽  
Author(s):  
Jae Ok Lee ◽  
Young Shin Lee ◽  
Se Hoon Lee ◽  
Young Jin Choi ◽  
Soung Ha Park
Keyword(s):  
Gait Analysis ◽  
Human Body ◽  
Center Of Pressure ◽  
Reaction Force ◽  
The Body ◽  
Biomechanical Analysis ◽  
Gait Characteristics ◽  
Abnormal Gait ◽  
Experimental Apparatus ◽  
Analysis System

The foot plays an important role in supporting the body and keeping body balance. An abnormal walking habit breaks the balance of the human body as well as the function of the foot. The foot orthotics which is designed to consider biomechanics effectively distributes the load of the human body on the sole of the foot. In this paper, gait analysis is performed for subjects wearing the orthotics. In this study, three male subjects were selected. The experimental apparatus consists of a plantar pressure analysis system and digital EMG system. The gait characteristics are simulated by ADAMS/LifeMOD. The COP (Center of Pressure), EMG and ground reaction force were investigated. As a result of gait analysis, the path of COP was improved and muscle activities were decreased with orthotics on the abnormal walking subjects.

scholarly journals Classification of the Gait Patterns of Boys With Duchenne Muscular Dystrophy and Their Relationship to Function

2010 ◽  
Vol 25 (9) ◽  
pp. 1103-1109 ◽  
Author(s):  
Susan Sienko Thomas ◽  
Cathleen E. Buckon ◽  
Alina Nicorici ◽  
Anita Bagley ◽  
Craig M. McDonald ◽  
...  
Keyword(s):  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Gait Patterns

P119: Case study: Can we explain the increased tip-toe gait in a 10-year old boy with Duchenne Muscular Dystrophy by the combination of gait analysis, strength measurements and muscle imaging data?

2017 ◽  
Vol 57 ◽  
pp. 370-371
Author(s):  
Marije Goudriaan ◽  
Catherine Huenaerts ◽  
Nathalie Goemans ◽  
Marleen van den Hauwe ◽  
Simon-Henri Schless ◽  
...  
Keyword(s):  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Gait Analysis ◽  
Imaging Data

scholarly journals Short-term results of gait analysis with the Heidelberg foot measurement method and functional outcome after operative treatment of ankle fractures

2022 ◽  
Vol 15 (1) ◽  
Author(s):  
Jessica C. Böpple ◽  
Michael Tanner ◽  
Sarah Campos ◽  
Christian Fischer ◽  
Sebastian Müller ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Ground Reaction Force ◽  
Measurement Method ◽  
Reaction Force ◽  
Statistical Parametric Mapping ◽  
Ankle Fractures ◽  
Parametric Mapping ◽  
Healthy Participants ◽  
Over Time ◽  
Dorsal Flexion

Abstract Background Ankle fractures are common fractures in trauma surgery. Several studies have compared gait patterns between affected patients and control groups. However, no one used the Heidelberg Foot Measurement Method in combination with statistical parametric mapping of the entire gait cycle in this patient cohort. We sought to identify possible mobility deficits in the tibio-talar joint and medial arch in patients after ankle fractures as a sign of stiffness and pain that could result in a pathological gait pattern. We focused on the tibio-talar flexion as it is the main movement in the tibio-talar joint. Moreover, we examined the healing progress over time. Methods Fourteen patients with isolated ankle fractures were included prospectively. A gait analysis using the Heidelberg Foot Measurement Method was performed 9 and 26 weeks after surgery to analyse the tibio-talar dorsal flexion, the foot tibia dorsal flexion, the subtalar inversion and the medial arch as well as the cadence, the walking speed and the ground reaction force. The American Orthopedic Foot & Ankle Society ankle hindfoot score was used to obtain clinical data. Results were compared to those from 20 healthy participants. Furthermore, correlations between the American Orthopedic Foot & Ankle Society hindfoot score and the results of the gait analysis were evaluated. Results Statistical parametric mapping showed significant differences for the Foot Tibia Dorsal Flexion for patients after 9 weeks (53–75%: p = 0.001) and patients after 26 weeks (58–70%: p = 0.011) compared to healthy participants, respectively. Furthermore, significant differences regarding the tibio-talar dorsal flexion for patients 9 weeks after surgery (15–40%: p < 0.001; 56,5–70%: p = 0.007; 82–88%: p = 0.033; 97–98,5%: p = 0.048) as well as patients after 26 weeks (62,5–65%: p = 0.049) compared to healthy participants, respectively. There were no significant differences looking at the medial arch and the subtalar inversion. Moreover, significant differences regarding the ground reaction force were found for patients after 9 weeks (0–17%: p < 0.001; 21–37%: p < 0.001; 41–54%: p < 0.001; 60–64%: p = 0.013) as well as patients after 26 weeks (0–1,5%: p = 0.046; 5–15%: p < 0.001; 27–33%: p = 0.001; 45–49%: p = 0.005; 57–59%: p = 0.049) compared to healthy participants, respectively. In total, the range of motion in the tibio-talar joint and the medial arch was reduced in affected patients compared to healthy participants. Patients showed significant increase of the range of motion between 9 and 26 weeks. Conclusions This study shows, that patients affected by ankle fractures show limited mobility in the tibio-talar joint and the medial arch when compared to healthy participants. Even though the limitation of motion remains at least over a period of 26 weeks, a significant increase can be recognized over time. Furthermore, if we look at the absolute values, the patients’ values tend to get closer to those of the control group. Trial registration This study is registered at the German Clinical Trials Register (DRKS00023379).

scholarly journals BIOMECHANICAL SYMMETRY DURING DROP JUMP AND SINGLE-LEG HOP LANDING IN UNINJURED ADOLESCENT ATHLETES

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0002
Author(s):  
Nicole Mueske ◽  
Mia J. Katzel ◽  
Kyle P. Chadwick ◽  
Curtis VandenBerg ◽  
J. Lee Pace ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Reaction Force ◽  
Statistical Parametric Mapping ◽  
Return To Sport ◽  
Series Data ◽  
Initial Contact ◽  
Drop Jump ◽  
Adolescent Athletes ◽  
Peak Knee ◽  
Dominant Side

BACKGROUND Symmetry of strength, thigh girth and hop distance is often used as a benchmark in return to sport testing. Using symmetry as a gold standard has been translated into biomechanical testing; however, kinematic and kinetic symmetry during dynamic tasks in adolescents without lower extremity injury is not well understood. The purpose of this study was to assess symmetry in uninjured adolescent athletes during double and single-leg landing tasks. METHODS 36 uninjured athletes (ages 7-15 years, mean 12.4, SD 2.4; 47% female) completed vertical drop jump (DJ) and single-leg hop (SLH) for distance tasks; lower extremity kinematics and kinetics were collected through 3-D motion analysis using a 6 degree-of-freedom model; 2-3 trials per participant per side were analyzed. Differences between dominant and non-dominant limbs from initial contact to peak knee flexion were examined using statistical parametric mapping (SPM), a methodology for performing statistics on time series data. The SPM method allows differences between dominant and non-dominant limbs to be evaluated for statistical significance at all time points throughout the landing movement. RESULTS During both DJ (Figure 1) and SLH (Figure 2), the dominant limb tended to be more internally rotated at the hip throughout landing, but the asymmetry was significant only for short periods early in landing during the DJ (p<0.05) and at mid-landing in the SLH (p=0.01). Additionally, the dominant hip tended to have less abducted positioning throughout both tasks, but differed significantly only shortly after initial contact in the SLH landing (p=0.04). The dominant limb ankle was less inverted (p<0.001) with a lower external inversion moment (p<0.001) during early to mid-landing in the DJ, and less everted (p=0.04) with higher external inversion moment (p=0.05) early in SLH landing. The only asymmetry observed in either task in the sagittal plane was slightly higher external ankle flexion moments (p=0.05) just after initial contact in the DJ. No asymmetries were detected in peak vertical ground reaction force or knee kinematics/kinetics for either task. CONCLUSION/SIGNIFICANCE Uninjured adolescent athletes exhibited only slight asymmetries during double and single-leg landing, primarily at the hip and ankle in the frontal and transverse planes. The hip may perform larger adjustments to accommodate center of mass location, while the ankle fine-tunes the landing as the closest segment to the ground. This study supports that normal biomechanics are symmetric during double and single-leg landing. Biomechanical symmetry is therefore a reasonable target in return to sport assessment. While only small regions of statistically significant asymmetry were identified, it is possible that greater asymmetries are present within individuals. In the grouped analysis, asymmetry towards the dominant side for one individual could offset asymmetry towards the non-dominant side of another individual. In future analysis, we will examine the magnitude and significance of within-subject asymmetry.

Jumping Mechanography is a Suitable Complementary Method to Assess Motor Function in Ambulatory Boys with Duchenne Muscular Dystrophy

2021 ◽  
Author(s):  
Astrid Blaschek ◽  
Martin Rodrigues ◽  
Rainer Rawer ◽  
Christine Müller ◽  
Lena Ille ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Reaction Force ◽  
Drug Efficacy ◽  
Measuring Method ◽  
Physical Parameters ◽  
First Choice ◽  
Standing Up ◽  
Jumping Mechanography

Abstract Objective The number of clinical trials for Duchenne muscular dystrophy (DMD) has increased substantially lately, therefore appropriate clinical instruments are needed to measure disease progression and drug efficacy. Jumping mechanography is a medical diagnostic method for motion analysis, which allows to quantify physical parameters. In this study, we compared mechanography with timed function tests (TFTs). Methods 41 ambulatory DMD patients performed a total of 95 chair rising tests (CRT) and a total of 76 single two-legged jumps (S2LJ) on a mechanography ground reaction force platform. The results were correlated with a 6-minute walk test (6MWT) and the time required to run 10 meters, stand up from a supine position, and climb four stairs, all performed in the same setting. Results Our measurements show a high correlation between mechanography and the TFTs: S2LJ/10-m run, r = 0.62; CRT/10-m run, r = 0.61; S2LJ/standing up from supine, r = 0.48; CRT/standing up from supine, r = 0.58; S2LJ/climb four stairs, r = 0.55; CRT/climb four stairs, r = 0.51. The correlation between mechanography and the 6MWT was only moderate with r = 0.38 for S2LJ/6MWT and r = 0.39 for CRT/6MWT. Interpretation Jumping mechanography is a reliable additional method, which can be used for physical endpoint measurements in clinical trials. We confirmed our assumption, that the method provides additional information concerning performance at movement with higher power output. We suggest using the S2LJ as a first-choice tandem tool combined with the 6MWT. In patients with higher disability, the CRT is an alternative measuring method, because with the progression of the disease this is longer feasible.

scholarly journals The Biomechanical Effect of the Sensomotor Insole on a Pediatric Intoeing Gait

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Akiyoshi Mabuchi ◽  
Hiroshi Kitoh ◽  
Masato Inoue ◽  
Mitsuhiko Hayashi ◽  
Naoki Ishiguro ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Internal Rotation ◽  
Stance Phase ◽  
Three Dimensional ◽  
Step Length ◽  
Femoral Anteversion ◽  
Swing Phase ◽  
Gait Patterns ◽  
Abnormal Gait ◽  
Biomechanical Effect

Background. The sensomotor insole (SMI) has clinically been shown to be successful in treating an intoeing gait. We investigated the biomechanical effect of SMI on a pediatric intoeing gait by using three-dimensional gait analysis. Methods. Six patients with congenital clubfeet and four patients with idiopathic intoeing gait were included. There were five boys and five girls with the average age at testing of 5.6 years. The torsional profile of the lower limb was assessed clinically. Three-dimensional gait analysis was performed in the same shoes with and without SMI. Results. All clubfeet patients exhibited metatarsal adductus, while excessive femoral anteversion and/or internal tibial torsion was found in patients with idiopathic intoeing gait. SMI showed significant decreased internal rotation of the proximal femur in terminal swing phase and loading response phase. The internal rotation of the tibia was significantly smaller in mid stance phase and terminal stance phase by SMI. In addition, SMI significantly increased the walking speed and the step length. Conclusions. SMI improved abnormal gait patterns of pediatric intoeing gait by decreasing femoral internal rotation through the end of the swing phase and the beginning of the stance phase and by decreasing tibial internal rotation during the stance phase.

The Differences in Gait Pattern Between Dancers and Non-Dancers

2008 ◽  
Vol 24 (4) ◽  
pp. 451-457 ◽  
Author(s):  
C. -W. Lung ◽  
J. -S. Chern ◽  
L. -F. Hsieh ◽  
S. -W. Yang
Keyword(s):  
Ankle Sprain ◽  
Healthy Subjects ◽  
Center Of Pressure ◽  
Reaction Force ◽  
High Stress ◽  
Gait Pattern ◽  
Swing Phase ◽  
Gait Patterns ◽  
Gait Characteristics ◽  
Walking Pattern

AbstractStudents in dancing department routinely perform hours of dancing every day. Extreme ankle posture can subject the ankle of the dancers to high stress and can significantly increase the mobility of the ankle. This causes ankle sprain which occurs frequently during daily walking. Measurements of the ground reaction force (GRF) and the center of pressure (CoP) provide useful variables to analyze the walking patterns of dancers, which might help understand the causes of ankle sprain. The aims of this work were (1) to investigate the differences in gait patterns between dancers and non-dancers and (2) to explore the gait characteristics in dancers. Thirteen students in dancing department and twenty age-matched normal healthy subjects were recruited. All subjects were requested to walk along a 10-meter walkway. Results showed that the dancers have greater medial shear force of the GRF, and decreased the CoP velocity during the pre-swing phase, delayed peak-CoP velocity occurrence during the mid-stance, and straighter CoP trajectory through the forefoot at push off. The intense and demanding dancing activities change the walking pattern of dancers, which may lead to higher chance of getting ankle sprain.

Sign in / Sign up

Export Citation Format

Share Document