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Upper and Lower Limb Strength and Body Posture in Children with Congenital Hypothyroidism: An Observational
Jessica Brusa1, Maria Cristina Maggio2, Valerio Giustino1
1Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy.
Insights
Congenital hypothyroidism (CH) in children does not impact muscle strength when treated early. However, it is linked to poorer postural control and uneven weight distribution, suggesting physical activity may help improve posture.
Area of Science:
- Pediatric Endocrinology
- Developmental Biology
- Musculoskeletal Physiology
Background:
- Congenital hypothyroidism (CH) is an endocrine disorder impacting growth and neuromotor development.
- Thyroid hormones are crucial for central nervous system maturation and musculoskeletal function.
- CH affects 1 in 2000-3000 newborns, necessitating research into its long-term effects.
Purpose of the Study:
- To investigate differences in limb strength, postural sway, and plantar loading in children with CH compared to healthy peers.
- To assess the impact of early CH treatment on musculoskeletal and neuromotor outcomes.
Main Methods:
- A comparative study involving children with CH (CHG) and healthy controls (CG).
- Assessment of upper and lower limb strength using handgrip and Sargent tests.
- Evaluation of postural control via stabilometric analysis (Center of Pressure) and plantar loading distribution using baropodometric analysis.
Main Results:
- Children with CH were shorter and thinner than controls.
- No significant differences in upper or lower limb strength were observed between groups.
- CHG demonstrated significantly greater postural sway and asymmetric plantar loading, with reduced weight on the right foot compared to controls.
Conclusions:
- Early treatment of CH appears to preserve muscle strength.
- Children with CH exhibit impaired postural control and altered plantar loading patterns.
- Increased physical activity may be beneficial for improving posture in children with CH.
Background:
Congenital hypothyroidism (CH) is an endocrine disease with a precocious significant impairment of growth and neuromotor development. Thyroid hormones are essential for central nervous system development, maturation, and myelination. Furthermore, thyroid hormone deficiency affects the function of several systems, including the musculoskeletal system. The disease has a significant incidence in the general population (1:3000-1:2000 newborns in Italy). The aim of the present study was to evaluate any differences in upper and lower limb strength, body sway, and plantar loading distribution in children with CH compared to healthy children.
Methods:
In this study, the case group was composed of children with CH (CHG), while the control group included healthy children (CG). Both groups comprised 19 children (CHG: female = 12; CG: female = 9). The maximum isometric handgrip strength and explosive-elastic lower limb strength were assessed with the handgrip test and the Sargent test, respectively. The stabilometric and baropodometric analyses were used to measure the Center of Pressure displacements and the plantar loading distribution between feet, respectively. The differences between groups were analyzed by a univariate analysis of covariance using as covariates weight and height with the significant level set at < 0.05.
Results:
We found that CHG children were shorter and thinner than CG ones (p < 0.05). No significant difference in the upper and lower limb strength was found between groups. CHG exhibited a significant greater Sway Path Length (p < 0.01) and Ellipse Surface (p < 0.05) than CG. Moreover, CHG displayed an asymmetric plantar loading distribution with a significant lower percentage in the right than in the left foot (p < 0.05). Moreover, a significant lower plantar loading percentage in the right foot of CHG than in the right foot of CG was observed (p < 0.05).
Conclusions:
These findings seem to suggest that CH does not affect muscle strength in early treated children. However, these patients show poor postural control ability and asymmetric plantar loading distribution. Increasing the physical activity in these children could improve their body posture.
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