Linking Joint Impairment and Gait Biomechanics in Patients with Juvenile Idiopathic Arthritis

MD-Paedigree consortium

Research output: Contribution to journalArticle

Abstract

Juvenile Idiopathic Arthritis (JIA) is a paediatric musculoskeletal disease of unknown aetiology, leading to walking alterations when the lower-limb joints are involved. Diagnosis of JIA is mostly clinical. Imaging can quantify impairments associated to inflammation and joint damage. However, treatment planning could be better supported using dynamic information, such as joint contact forces (JCFs). To this purpose, we used a musculoskeletal model to predict JCFs and investigate how JCFs varied as a result of joint impairment in eighteen children with JIA. Gait analysis data and magnetic resonance images (MRI) were used to develop patient-specific lower-limb musculoskeletal models, which were evaluated for operator-dependent variability (< 3.6°, 0.05 N kg-1 and 0.5 BW for joint angles, moments, and JCFs, respectively). Gait alterations and JCF patterns showed high between-subjects variability reflecting the pathology heterogeneity in the cohort. Higher joint impairment, assessed with MRI-based evaluation, was weakly associated to overall joint overloading. A stronger correlation was observed between impairment of one limb and overload of the contralateral limb, suggesting risky compensatory strategies being adopted, especially at the knee level. This suggests that knee overloading during gait might be a good predictor of disease progression and gait biomechanics should be used to inform treatment planning.

Original languageEnglish
JournalAnnals of Biomedical Engineering
DOIs
Publication statusE-pub ahead of print - May 20 2019

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Biomechanics
Magnetic resonance
Gait analysis
Planning
Pediatrics
Pathology
Imaging techniques

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Linking Joint Impairment and Gait Biomechanics in Patients with Juvenile Idiopathic Arthritis. / MD-Paedigree consortium.

In: Annals of Biomedical Engineering, 20.05.2019.

Research output: Contribution to journalArticle

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title = "Linking Joint Impairment and Gait Biomechanics in Patients with Juvenile Idiopathic Arthritis",
abstract = "Juvenile Idiopathic Arthritis (JIA) is a paediatric musculoskeletal disease of unknown aetiology, leading to walking alterations when the lower-limb joints are involved. Diagnosis of JIA is mostly clinical. Imaging can quantify impairments associated to inflammation and joint damage. However, treatment planning could be better supported using dynamic information, such as joint contact forces (JCFs). To this purpose, we used a musculoskeletal model to predict JCFs and investigate how JCFs varied as a result of joint impairment in eighteen children with JIA. Gait analysis data and magnetic resonance images (MRI) were used to develop patient-specific lower-limb musculoskeletal models, which were evaluated for operator-dependent variability (< 3.6°, 0.05 N kg-1 and 0.5 BW for joint angles, moments, and JCFs, respectively). Gait alterations and JCF patterns showed high between-subjects variability reflecting the pathology heterogeneity in the cohort. Higher joint impairment, assessed with MRI-based evaluation, was weakly associated to overall joint overloading. A stronger correlation was observed between impairment of one limb and overload of the contralateral limb, suggesting risky compensatory strategies being adopted, especially at the knee level. This suggests that knee overloading during gait might be a good predictor of disease progression and gait biomechanics should be used to inform treatment planning.",
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AU - Montefiori, Erica

AU - Modenese, Luca

AU - Di Marco, Roberto

AU - Magni-Manzoni, Silvia

AU - Malattia, Clara

AU - Petrarca, Maurizio

AU - Ronchetti, Anna

AU - de Horatio, Laura Tanturri

AU - van Dijkhuizen, Pieter

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AU - Wesarg, Stefan

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