Gait deviations in patients with juvenile rheumatoid arthritis

The purpose of this study was to describe quantitatively the gait patterns of patients with juvenile rheumatoid arthritis (JRA). Thirty children with JRA and 30 healthy children were evaluated using a computerized gait analysis system. Time-distance characteristics and joint angle excursions were studied. The subjects with JRA walked with significantly decreased velocity, cadence, and stride length. We found no significant difference in step width nor in the percentage of time spent in each phase of the gait cycle. The anterior pelvic tilt of subjects with JRA was significantly increased throughout the gait cycle. Hip extension at the end of single-limb stance and ankle plantar flexion during weight release also were significantly decreased for subjects with JRA. No significant difference between the two groups was noted in knee joint excursion. Areas of emphasis for physical therapy of patients with JRA include increasing velocity, cadence, stride length, hip extension, and ankle plantar flexion and decreasing excessive anterior pelvic tilt.