Gait deviations in Duchenne muscular dystrophy-Part 1. A systematic review

Area of Science:

• Pediatric Neurology
• Biomechanical Engineering
• Rehabilitation Science

Background:

• Prolonged ambulation is crucial for children with Duchenne muscular dystrophy (DMD).
• Existing literature on specific gait deviations in DMD is limited.
• Understanding these deviations is essential for maintaining mobility in DMD patients.

Purpose of the Study:

• To identify consistently reported spatiotemporal, kinematic, kinetic, and muscle activity deviations in children with DMD.
• To assess the quality of existing research on DMD gait deviations.
• To determine the need for further research in this area.

Main Methods:

• A systematic literature search was conducted across six databases for studies published before June 2017.
• A data extraction form was used to collect information on study methods and gait parameters.
• Standardized mean differences (SMDs) were calculated where sufficient data were available.

Main Results:

• Nine articles were included, but generalizability was poor.
• Seventy-nine parameters were analyzed, with consensus on decreased walking speed (SMD: 1.26) and stride length (SMD: 1.83).
• Other reported deviations include reduced dorsiflexion during swing, decreased hip power generation, and altered knee motion.

Conclusions:

• Gait deviations in DMD are not well-defined, hindering efforts to maintain ambulation.
• Previous studies were exploratory and prone to bias, indicating a need for more rigorous research.
• Further investigation is required to accurately characterize the altered gait pattern in children with DMD.