Three-dimensional analysis of gait in children and adolescents with juvenile idiopathic arthritis

Abstract

Purpose: The paper aimed to assess the gait pattern in children and adolescents with juvenile idiopathic arthritis (JIA) treated at the rehabilitation center and to assess changes in this pattern after the end of treatment and 9 months later. Methods: 50 children with JIA were enrolled into the study. 35 healthy volunteers were enrolled into the study for a comparison. Spatiotemporal and kinematic gait parameters were obtained using a movement analysis system. The Gait Deviation Index (GDI) was calculated. The assessment was performed three times: on the day of admission to the rehabilitation center, after the end of a 4-week treatment period and 9 months later. Results: With regard to the majority of spatiotemporal and kinematic parameters, differences in their distribution were highly statistically significant between the study group and the control group (p < 0.001). In two subsequent tests, differences were less significant when compared to the control group (p < 0.01). In the study group, ranges of motion in the sagittal plane in the hip (p < 0.01), knee (p < 0.001) and ankle joints (p < 0.01) increased significantly between tests 1 and 2, and 1 and 3. A significantly lower value of GDI was observed in the study group (right limb; p = 0.036). Conclusions: The gait pattern of children with JIA is significantly different from the one observed in healthy children. A rehabilitation program significantly improved gait in children with JIA, but differences compared to healthy children were still observed, and it indicates that the abnormal gait pattern became permanent in this group of subjects.

Application of the Gait Deviation Index to Study Gait Impairment in Adult Population With Spinal Cord Injury: Comparison With the Walking Index for Spinal Cord Injury Levels

“…The GDI has been used as an outcome measure to study gait in several conditions such as: CP ( Schwartz and Rozumalski, 2008 ; Molloy et al, 2010 ; Cimolin et al, 2011 ; Sagawa et al, 2013 ; Massaad et al, 2014 ; Wilson et al, 2015 ; Malt et al, 2016 ; Ito et al, 2019 ; Rasmussen et al, 2019 ), post-stroke hemiparetic gait ( Correa et al, 2017 ; Guzik and Drużbicki, 2020 ), Duchenne muscular dystrophy ( Sienko Thomas et al, 2010 ), Parkinson’s disease ( Galli et al, 2012 ; Speciali et al, 2013 ), arthritis ( Broström et al, 2013 ; Esbjörnsson et al, 2014 ; Rosenlund et al, 2016 ; Kobsar et al, 2019 ; Bazarnik-Mucha et al, 2020 ), lower limb amputations ( Eshraghi et al, 2014 ; Kark et al, 2016 ), degenerative spinal pathologies ( Mar et al, 2019 ; Trivedi et al, 2021 ; Zhou et al, 2021 ), diverse genetic ( Ito et al, 2020 ; Mindler et al, 2020 ) and congenital disorders ( Eriksson et al, 2015 ; Garman et al, 2019 ), and even the effect of the COVID-19 on physical function ( Ito et al, 2021 ), among others. A recently published article by Hwang et al (2021) used the GDI as a way to quantify and characterize gait patterns in ambulatory children and adolescents with transverse myelitis, whose gait showed moderate kinematic deviations from normal gait pattern.…”

Gait Alterations in Two Young Siblings with Progressive Pseudorheumatoid Dysplasia

“…The pattern described in these two patients seems not very different from the kinematic gait pattern in children and adolescents with juvenile idiopathic arthritis, in which a slow gait, an increased pelvic tilt and hip flexion during the whole gait cycle, limited hip extension and limited plantar flexion in the ankle were reported [ 16 ]. As stated, these similarities can be interpreted as compensatory changes in response to arthralgia and limb deformations.…”

Association Between Patient‐Reported Outcomes and Treatment Failure in Juvenile Idiopathic Arthritis

“…It is possible that children with low energy are unable to successfully complete daily activities or participate in extracurricular activities because of their disease. It is also possible that decreased physical activity promotes muscle atrophy and stiffness, which can intensify abnormal biomechanics which are present in youth with JIA ( 30 , 31 , 32 , 33 ). Similarly, both JIA alone, as well as imposed or perceived physical activity limitations, may contribute to this finding.…”