Early signs of gait deviation in Duchenne muscular dystrophy

L. Doglio, E. Pavan, I. Pernigotti, P. Petralia, C. Frigo, C. Minetti

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background. Most analytical studies found in literature only focus on specific aspects of Duchenne muscular dystrophy (DMD) gait and posture (joint range of motion, standing balance, variations of gait spatial-temporal parameters). Some of them analyze single cases and do not provide a comprehensive evaluation of locomotion. There are few studies about DMD gait patterns, most of them concerning small groups of patients, sometimes not homogeneous, in which the clinical manifestations of the next stages of DMD were present. Aim. The goal of our study was to analyze the characteristics of gait patterns in early stage patients, when clinical and functional evaluation do not allow to quantify initial walking worsening or to identify the changes adopted to compensate for muscle weakness. Setting. Gait Analysis Laboratory by using a sixcamera motion capture system (Vicon, Oxford Metrics, UK), set at a sampling rate of 60 Hz. Subjects were asked to walk barefoot at their usual cadence, along a 10-m walkway, where one force platform (Kistler, Switzerland), embedded in the middle portion of the pathway, measured the foot-ground reaction forces. Retroreflective markers were placed on the subjects according to the protocol described in Davis et al. Population. A group of 15 patients aging from 5 to 6.8 years was compared with a similar age control group composed of 9 healthy children. Results. Spatial and temporal parameters showed significant differences between the two groups: cadence was increased and step length was decreased significantly in the DMD group. We found a significant increase in the range of anterior-posterior pelvic tilt and in pelvic rotation. In the frontal plane there was a tendency for an increased pelvic obliquity. Dynamic range of motion in sagittal plane showed a significant difference at the ankle, with an increased plantarflexion in swing in the dystrophic patients. Maximum dorsiflexion was reduced in the DMD group. Kinetic analysis showed significant differences in power generation and absorption at the hip joint and at the ankle joint. At knee there was a reduced flexor moment in mid-stance. Ankle showed a reduced dorsiflexor moment in terminal stance and pre-swing with a consequent reduction in the peakto-peak excursion. Conclusion and clinical rehabilitation impact. It was shown that instrumented gait analysis, being more sensitive than other clinical and functional assessment methods, allowed to quantify the very early modifications characterizing locomotion worsening in the first stage of the DMD.

Original languageEnglish
Pages (from-to)587-594
Number of pages8
JournalEuropean Journal of Physical and Rehabilitation Medicine
Volume47
Issue number4
Publication statusPublished - Dec 2011

Fingerprint

Duchenne Muscular Dystrophy
Gait
Locomotion
Articular Range of Motion
Ankle
Ankle Joint
Muscle Weakness
Hip Joint
Posture
Switzerland
Walking
Foot
Knee
Rehabilitation
Age Groups
Control Groups
Population

Keywords

  • Duchenne biomechanics
  • Gait
  • Muscular dystrophy
  • Posaire

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Doglio, L., Pavan, E., Pernigotti, I., Petralia, P., Frigo, C., & Minetti, C. (2011). Early signs of gait deviation in Duchenne muscular dystrophy. European Journal of Physical and Rehabilitation Medicine, 47(4), 587-594.

Early signs of gait deviation in Duchenne muscular dystrophy. / Doglio, L.; Pavan, E.; Pernigotti, I.; Petralia, P.; Frigo, C.; Minetti, C.

In: European Journal of Physical and Rehabilitation Medicine, Vol. 47, No. 4, 12.2011, p. 587-594.

Research output: Contribution to journalArticle

Doglio, L, Pavan, E, Pernigotti, I, Petralia, P, Frigo, C & Minetti, C 2011, 'Early signs of gait deviation in Duchenne muscular dystrophy', European Journal of Physical and Rehabilitation Medicine, vol. 47, no. 4, pp. 587-594.
Doglio, L. ; Pavan, E. ; Pernigotti, I. ; Petralia, P. ; Frigo, C. ; Minetti, C. / Early signs of gait deviation in Duchenne muscular dystrophy. In: European Journal of Physical and Rehabilitation Medicine. 2011 ; Vol. 47, No. 4. pp. 587-594.
@article{baeaa2d360ea41989f1facb11f7772f3,
title = "Early signs of gait deviation in Duchenne muscular dystrophy",
abstract = "Background. Most analytical studies found in literature only focus on specific aspects of Duchenne muscular dystrophy (DMD) gait and posture (joint range of motion, standing balance, variations of gait spatial-temporal parameters). Some of them analyze single cases and do not provide a comprehensive evaluation of locomotion. There are few studies about DMD gait patterns, most of them concerning small groups of patients, sometimes not homogeneous, in which the clinical manifestations of the next stages of DMD were present. Aim. The goal of our study was to analyze the characteristics of gait patterns in early stage patients, when clinical and functional evaluation do not allow to quantify initial walking worsening or to identify the changes adopted to compensate for muscle weakness. Setting. Gait Analysis Laboratory by using a sixcamera motion capture system (Vicon, Oxford Metrics, UK), set at a sampling rate of 60 Hz. Subjects were asked to walk barefoot at their usual cadence, along a 10-m walkway, where one force platform (Kistler, Switzerland), embedded in the middle portion of the pathway, measured the foot-ground reaction forces. Retroreflective markers were placed on the subjects according to the protocol described in Davis et al. Population. A group of 15 patients aging from 5 to 6.8 years was compared with a similar age control group composed of 9 healthy children. Results. Spatial and temporal parameters showed significant differences between the two groups: cadence was increased and step length was decreased significantly in the DMD group. We found a significant increase in the range of anterior-posterior pelvic tilt and in pelvic rotation. In the frontal plane there was a tendency for an increased pelvic obliquity. Dynamic range of motion in sagittal plane showed a significant difference at the ankle, with an increased plantarflexion in swing in the dystrophic patients. Maximum dorsiflexion was reduced in the DMD group. Kinetic analysis showed significant differences in power generation and absorption at the hip joint and at the ankle joint. At knee there was a reduced flexor moment in mid-stance. Ankle showed a reduced dorsiflexor moment in terminal stance and pre-swing with a consequent reduction in the peakto-peak excursion. Conclusion and clinical rehabilitation impact. It was shown that instrumented gait analysis, being more sensitive than other clinical and functional assessment methods, allowed to quantify the very early modifications characterizing locomotion worsening in the first stage of the DMD.",
keywords = "Duchenne biomechanics, Gait, Muscular dystrophy, Posaire",
author = "L. Doglio and E. Pavan and I. Pernigotti and P. Petralia and C. Frigo and C. Minetti",
year = "2011",
month = "12",
language = "English",
volume = "47",
pages = "587--594",
journal = "European Journal of Physical and Rehabilitation Medicine",
issn = "1973-9087",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "4",

}

TY - JOUR

T1 - Early signs of gait deviation in Duchenne muscular dystrophy

AU - Doglio, L.

AU - Pavan, E.

AU - Pernigotti, I.

AU - Petralia, P.

AU - Frigo, C.

AU - Minetti, C.

PY - 2011/12

Y1 - 2011/12

N2 - Background. Most analytical studies found in literature only focus on specific aspects of Duchenne muscular dystrophy (DMD) gait and posture (joint range of motion, standing balance, variations of gait spatial-temporal parameters). Some of them analyze single cases and do not provide a comprehensive evaluation of locomotion. There are few studies about DMD gait patterns, most of them concerning small groups of patients, sometimes not homogeneous, in which the clinical manifestations of the next stages of DMD were present. Aim. The goal of our study was to analyze the characteristics of gait patterns in early stage patients, when clinical and functional evaluation do not allow to quantify initial walking worsening or to identify the changes adopted to compensate for muscle weakness. Setting. Gait Analysis Laboratory by using a sixcamera motion capture system (Vicon, Oxford Metrics, UK), set at a sampling rate of 60 Hz. Subjects were asked to walk barefoot at their usual cadence, along a 10-m walkway, where one force platform (Kistler, Switzerland), embedded in the middle portion of the pathway, measured the foot-ground reaction forces. Retroreflective markers were placed on the subjects according to the protocol described in Davis et al. Population. A group of 15 patients aging from 5 to 6.8 years was compared with a similar age control group composed of 9 healthy children. Results. Spatial and temporal parameters showed significant differences between the two groups: cadence was increased and step length was decreased significantly in the DMD group. We found a significant increase in the range of anterior-posterior pelvic tilt and in pelvic rotation. In the frontal plane there was a tendency for an increased pelvic obliquity. Dynamic range of motion in sagittal plane showed a significant difference at the ankle, with an increased plantarflexion in swing in the dystrophic patients. Maximum dorsiflexion was reduced in the DMD group. Kinetic analysis showed significant differences in power generation and absorption at the hip joint and at the ankle joint. At knee there was a reduced flexor moment in mid-stance. Ankle showed a reduced dorsiflexor moment in terminal stance and pre-swing with a consequent reduction in the peakto-peak excursion. Conclusion and clinical rehabilitation impact. It was shown that instrumented gait analysis, being more sensitive than other clinical and functional assessment methods, allowed to quantify the very early modifications characterizing locomotion worsening in the first stage of the DMD.

AB - Background. Most analytical studies found in literature only focus on specific aspects of Duchenne muscular dystrophy (DMD) gait and posture (joint range of motion, standing balance, variations of gait spatial-temporal parameters). Some of them analyze single cases and do not provide a comprehensive evaluation of locomotion. There are few studies about DMD gait patterns, most of them concerning small groups of patients, sometimes not homogeneous, in which the clinical manifestations of the next stages of DMD were present. Aim. The goal of our study was to analyze the characteristics of gait patterns in early stage patients, when clinical and functional evaluation do not allow to quantify initial walking worsening or to identify the changes adopted to compensate for muscle weakness. Setting. Gait Analysis Laboratory by using a sixcamera motion capture system (Vicon, Oxford Metrics, UK), set at a sampling rate of 60 Hz. Subjects were asked to walk barefoot at their usual cadence, along a 10-m walkway, where one force platform (Kistler, Switzerland), embedded in the middle portion of the pathway, measured the foot-ground reaction forces. Retroreflective markers were placed on the subjects according to the protocol described in Davis et al. Population. A group of 15 patients aging from 5 to 6.8 years was compared with a similar age control group composed of 9 healthy children. Results. Spatial and temporal parameters showed significant differences between the two groups: cadence was increased and step length was decreased significantly in the DMD group. We found a significant increase in the range of anterior-posterior pelvic tilt and in pelvic rotation. In the frontal plane there was a tendency for an increased pelvic obliquity. Dynamic range of motion in sagittal plane showed a significant difference at the ankle, with an increased plantarflexion in swing in the dystrophic patients. Maximum dorsiflexion was reduced in the DMD group. Kinetic analysis showed significant differences in power generation and absorption at the hip joint and at the ankle joint. At knee there was a reduced flexor moment in mid-stance. Ankle showed a reduced dorsiflexor moment in terminal stance and pre-swing with a consequent reduction in the peakto-peak excursion. Conclusion and clinical rehabilitation impact. It was shown that instrumented gait analysis, being more sensitive than other clinical and functional assessment methods, allowed to quantify the very early modifications characterizing locomotion worsening in the first stage of the DMD.

KW - Duchenne biomechanics

KW - Gait

KW - Muscular dystrophy

KW - Posaire

UR - http://www.scopus.com/inward/record.url?scp=84859336704&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859336704&partnerID=8YFLogxK

M3 - Article

C2 - 21912365

AN - SCOPUS:84859336704

VL - 47

SP - 587

EP - 594

JO - European Journal of Physical and Rehabilitation Medicine

JF - European Journal of Physical and Rehabilitation Medicine

SN - 1973-9087

IS - 4

ER -