Gait analysis in bladder exstrophy patients with and without pelvic osteotomy: a controlled experimental study

Area of Science:

• Orthopedics
• Biomechanics
• Pediatric Surgery

Background:

• Bony pelvic anomalies are known to cause walking problems in bladder exstrophy patients.
• Previous studies focused on kinematics, but direct kinetic gait evaluation and upper body effects were unexplored.

Purpose of the Study:

• To perform a direct kinetic gait evaluation in bladder exstrophy patients.
• To investigate the effect of pelvic dimorphism on the upper body during gait.
• To compare gait parameters between patients with and without pelvic osteotomy.

Main Methods:

• Controlled experimental study involving 19 bladder exstrophy patients and 25 healthy controls.
• Standard gait analysis, including clinical evaluation, was performed.
• Kinematic and kinetic parameters of the trunk, spine, pelvis, hip, knee, and foot were analyzed.

Main Results:

• Bladder exstrophy significantly impacts trunk, spine, pelvis, knee, and foot kinematics and kinetics.
• Patients undergoing pelvic osteotomy (OT) showed increased trunk retroversion and knee flexion.
• Patients without OT exhibited increased spine angle deviations and foot external rotation.
• Overall kinetic parameters were lower in the exstrophy patient group compared to controls.

Conclusions:

• Gait in bladder exstrophy is characterized by pelvic retroversion and spinal or knee deviations depending on surgical history (OT vs. no-OT).
• Gait analysis is crucial for early detection of walking deviations.
• Early identification and rehabilitative treatment are recommended to prevent secondary spine and knee diseases.