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Evaluation of Gait Pattern and Lower Extremity Kinematics of Children with Morquio Syndrome (MPS IV)
Jose J Salazar-Torres1, Chris Church1, Thomas Shields1
1Nemours A.I. duPont Hospital for Children, 1600 Rockland Rd., Wilmington, DE 19803, USA.
Insights
Children with Morquio syndrome (mucopolysaccharidosis IV) exhibit distinct gait abnormalities, including altered pelvic tilt, knee alignment, and reduced speed. Dynamic 3D analysis reveals knee instability not captured by static measures.
Area of Science:
- Orthopedics
- Genetics
- Biomechanical Engineering
Background:
- Morquio syndrome (mucopolysaccharidosis IV/MPS IV) is a rare genetic disorder causing significant skeletal dysplasia.
- Limited research exists on the specific gait patterns and lower extremity biomechanics in children with MPS IV.
Purpose of the Study:
- To establish baseline gait patterns and lower limb skeletal alignment in children with MPS IV.
- To compare gait kinematics between children with MPS IV and typically developing children.
Main Methods:
- Retrospective study utilizing three-dimensional instrumented gait analysis.
- Evaluated lower extremity kinematics during gait in 33 children with MPS IV and an age-matched control group.
Main Results:
- Children with MPS IV demonstrated increased anterior pelvic tilt, knee valgus, knee flexion, and external tibial torsion.
- Reduced walking speed and stride length were observed in the MPS IV group (p < 0.001).
- Abnormal multiplanar alignment led to altered knee moments (p < 0.001).
Conclusions:
- Dynamic 3D gait analysis reveals significant kinematic deviations in children with MPS IV.
- Poor correlation between dynamic and static measures suggests potential knee instability during gait.
- Dynamic assessment offers valuable insights beyond traditional static evaluations for MPS IV patients.
Abstract:
Morquio syndrome (mucopolysaccharidosis IV/MPS IV) is a genetic disorder leading to skeletal abnormalities and gait deviations. Research on the gait patterns and lower extremity physical characteristics associated with skeletal dysplasia in children with MPS IV is currently limited. This research aimed to provide baseline gait patterns and lower limb skeletal alignment of children with MPS IV utilizing three-dimensional instrumented gait analysis. This Institutional Review Board-approved retrospective study evaluates the kinematics of the lower extremities of children with MPS IV during gait, comparing them with an age-matched group of typically developing children. Thirty-three children with MPS IV were included (8.6 ± 4.0 years old). Children with MPS IV walk with increased anterior pelvic tilt, knee valgus, knee flexion, external tibial torsion, and reduced walking speed and stride length (p < 0.001). Multiplanar abnormal alignment results in abnormal knee moments (p < 0.001). Limited correlations exist (r = 0.69-0.28) between dynamic three-dimensional measurements of knee varus/valgus and rotational alignment and traditional static two-dimensional measures (physical examination or radiographs) suggesting the possibility of knee instability during gait and the benefits of dynamic assessment.
