Gait deviations in patients with juvenile rheumatoid arthritis
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Children with juvenile rheumatoid arthritis (JRA) exhibit altered gait, including slower walking speed and shorter strides. Physical therapy should focus on improving these gait parameters and reducing excessive pelvic tilt.
Area of Science:
- Orthopedics
- Pediatric Rheumatology
- Biomechanics
Background:
- Juvenile rheumatoid arthritis (JRA) is a chronic inflammatory condition affecting children.
- Understanding the specific gait abnormalities in JRA is crucial for effective management and rehabilitation.
Purpose of the Study:
- To quantitatively describe the gait patterns of children diagnosed with juvenile rheumatoid arthritis (JRA).
- To compare the gait characteristics of JRA patients with those of healthy children.
Main Methods:
- Utilized a computerized gait analysis system to evaluate 30 children with JRA and 30 healthy controls.
- Measured time-distance gait parameters and joint angle excursions during walking.
Main Results:
- JRA patients demonstrated significantly reduced walking velocity, cadence, and stride length.
- Increased anterior pelvic tilt was observed in JRA subjects throughout the gait cycle.
- Decreased hip extension and ankle plantar flexion were noted in the JRA group, with no significant differences in step width, gait cycle phases, or knee joint excursion.
Conclusions:
- Gait analysis reveals distinct quantitative differences in JRA patients compared to healthy children.
- Physical therapy interventions for JRA should target improvements in walking speed, stride length, hip extension, and ankle function, while addressing excessive anterior pelvic tilt.
Abstract:
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.