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

Erica Montefiori1,2, Luca Modenese3,4, Roberto Di Marco3,5

  • 1Department of Mechanical Engineering, University of Sheffield, Sheffield, UK. e.montefiori@sheffield.ac.uk.

Annals of Biomedical Engineering
|May 22, 2019
PubMed

Insights

Juvenile Idiopathic Arthritis (JIA) in children can cause walking changes. Predicting joint contact forces reveals compensatory limb overloading, particularly at the knee, informing better treatment strategies.

Area of Science:

  • Paediatric Rheumatology
  • Biomechanics
  • Musculoskeletal Modeling

Background:

  • Juvenile Idiopathic Arthritis (JIA) is a common childhood rheumatic disease affecting lower limbs and causing gait alterations.
  • Current diagnosis relies on clinical assessment and imaging, but dynamic joint loading information is lacking for treatment planning.

Purpose of the Study:

  • To predict joint contact forces (JCFs) in children with JIA using patient-specific musculoskeletal models.
  • To investigate the relationship between joint impairment and JCFs during gait.
  • To explore how JIA-related gait alterations and JCF patterns vary.

Main Methods:

  • Developed patient-specific lower-limb musculoskeletal models using gait analysis and MRI data from 18 children with JIA.
  • Validated models for operator-dependent variability in joint angles, moments, and JCFs.
  • Analyzed gait alterations and predicted JCFs to assess joint loading patterns.

Main Results:

  • High variability in gait alterations and JCF patterns was observed, reflecting JIA heterogeneity.
  • Higher joint impairment showed a weak association with overall joint overloading.
  • A stronger correlation was found between ipsilateral limb impairment and contralateral limb overloading, especially at the knee.

Conclusions:

  • Contralateral limb overloading during gait in JIA patients suggests compensatory strategies.
  • Knee overloading may predict disease progression.
  • Gait biomechanics and JCF prediction can enhance JIA treatment planning.

Keywords:
BiomechanicsGait analysisJuvenile arthritisLower-limbMRIMusculoskeletalMusculoskeletal modellingOpensim

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