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Sensory and Motor Function, Pain, and Health Status in Children with Arthrogryposis and Myelomeningocele
Åsa Bartonek1, Marie Eriksson1
1Department of Women's and Children's Health, Division of Paediatric Neurology, Karolinska Institutet, Karolinska University Hospital, S-17176 Stockholm, Sweden.
Insights
Children with arthrogryposis multiplex congenita (AMC) and myelomeningocele (MMC) show significant somatosensory deficits in their legs and feet compared to typically developing peers. These sensory impairments impact their ability to perceive stimuli and identify surfaces.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Neuroscience
Background:
- Proprioception and sensory disorders are common in children with arthrogryposis multiplex congenita (AMC) and myelomeningocele (MMC).
- Existing assessment tools for sensory aspects of motor disorders in these populations are limited.
- This study addresses the need for better understanding of somatosensory status in children with AMC and MMC.
Purpose of the Study:
- To investigate the somatosensory status in the feet and legs of children with AMC and MMC.
- To explore associated pain, skin irritations, and overall health status in these children.
- To compare sensory perception between children with AMC, MMC, and typically developing (TD) peers.
Main Methods:
- A somatosensory test battery was administered to 19 children with AMC, 23 with MMC, and 22 TD children (aged 7-18).
- Tests included ankle kinesthesia and the ability to identify four different types of floors.
- Participants' pain, skin irritation, and health status (EQ-5D-Y) were also assessed.
Main Results:
- Children with MMC demonstrated significantly poorer somatosensory perception than TD children, particularly with higher lesion levels and more affected ambulation.
- The AMC group performed better than the MMC group in tests of two-point discrimination, vibration, and light-touch pressure.
- No significant differences were found in ankle kinesthesia or overall health status across the groups.
Conclusions:
- Sensory deficits are a prominent feature distinguishing children with AMC and MMC from TD children.
- While sensory assessments are crucial, evaluating activity and participation levels is also recommended for comprehensive rehabilitation planning.
- The findings highlight the need for tailored interventions addressing sensory impairments in pediatric neuromuscular conditions.
Background/Objectives:
Proprioception and sensory disorders have been reported in children with arthrogryposis multiplex congenita (AMC) and myelomeningocele (MMC), but valid and reliable assessment tools are limited in accurately identifying the sensory aspects of motor disorders. This study aimed to investigate the somatosensory status in the feet and legs. An additional purpose of this study was to explore pain, skin irritations, and health status.
Methods:
Nineteen children with AMC, twenty-three with MMC, and twenty-two typically developing (TD) children (7-18 years old) were tested using a somatosensory test battery in ankle kinesthesia and in identifying four different types of floors.
Results:
In the AMC and MMC groups, the threshold to perceive the somatosensory stimuli was not achieved by all participants. MMC participants perceived somatosensory stimuli less than TD participants in all tests, with a higher level of the lesion and more affected ambulation. The MMC group identified one floor significantly less often than the TD group. The AMC group performed better than the MMC group in two-point discrimination, vibration sensation, and some light-touch pressure tests. There were no differences among the TD, AMC, and MMC groups in ankle kinesthesia. Pain was reported by four (21%) subjects in the AMC group and five (22%) in the MMC group, and skin irritations were reported by three (13%) participants in the MMC group. There was no difference among the TD, AMC, and MMC groups in health status as reported using the EQ-5D-Y visual analog scale.
Conclusions:
Although differences in sensory aspects were the most evident between the groups, assessments of activity and participation levels in the rehabilitation of children with disabilities are also recommended.
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