Comparison of the Gait Biomechanical Constraints in Three Different Type of Neuromotor Damages

Abstract

Background and ObjectiveAbsolute angle represents the inclination of a body segment relative to a fixed reference in space. This work compares the absolute and relative angles for exploring biomechanical gait constraints.MethodsGait patterns of different neuromotor conditions were analyzed using 3D gait analysis: normal gait (healthy, H), Cerebral Palsy (CP), Charcot Marie Tooth (CMT) and Duchenne Muscular Dystrophy (DMD), representing central and peripheral nervous system and muscular disorders, respectively. Forty-two children underwent gait analysis: 10 children affected by CP, 10 children by CMT, 10 children by DMD and 12 healthy children. The kinematic and kinetic parameters were collected to describe the biomechanical pattern of participants’ lower limbs. The absolute angles of thigh, leg and foot were calculated using the trigonometric relationship of the tangent. For each absolute series, the mean, range, maximum, minimum and initial contact were calculated. Kinematic and kinetic gait data were studied, and the results were compared with the literature.ResultsStatistical analysis of the absolute angles showed how, at the local level, the single segments (thigh, leg and foot) behave differently depending on the pathology. However, if the lower limb is studied globally (sum of the kinematics of the three segments: thigh, leg and foot), a biomechanical constraint emerges.ConclusionEach segment compensates separately for the disease deficit so as to maintain a global biomechanical invariance. Using a model of inter-joint co-variation could improve the interpretation of the clinical gait pattern.

Gait asymmetry in children with Duchenne muscular dystrophy: evaluated through kinematic synergies and muscle synergies of lower limbs

“…Combined with the lack of significant findings about symmetric spatiotemporal variables, it is possible that the progressive joint contractures observed in children with DMD may not affect both sides symmetrically. Instead, it is plausible that each joint segment may compensate separately for the disease deficit to preserve a global spatiotemporal invariance [ 46 ].…”

Wearable Inertial Devices in Duchenne Muscular Dystrophy: A Scoping Review

“…A technological outcome measure can be defined as "the outcome of instrumented clinical tests performed in standardized settings to objectively measure specific movements or self-administered by patients to detect and monitor impairments during specific daily activities" [23]. In DMD, several previous studies focused on the biomechanical analysis of human movement impairments through objective and technological measures [24][25][26], proposed the potential use of indexes and scores as clinical descriptors [27,28], and correlated the objective outcomes with the clinical functional assessment [29]. Nevertheless, only a few recent studies have proposed the application of IMU sensors and the identification of suitable outcome measures.…”