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Lower-Limb Biomechanical Characteristics Associated with Unplanned Gait Termination Under Different Walking Speeds
Published on: August 25, 2020
Musculotendinous morphological differences and their relationship with walking biomechanics in children with and
S Cardiel-Sánchez1, A Rubio-Peirotén1, E Bravo-Viñuales1
1Faculty of Health Sciences, Universidad San Jorge Villanueva de Gállego, Zaragoza, Spain.
Insights
Children with Sever disease show altered Achilles tendon and plantar fascia morphology. Affected feet exhibit increased impact and braking forces during walking, aiding in early detection and management.
Area of Science:
- Pediatric orthopedics
- Biomechanics
- Sports medicine
Background:
- Sever disease is a common cause of activity-related heel pain in growing children.
- Limited evidence exists on the morphological and biomechanical characteristics of children with Sever disease.
Purpose of the Study:
- To compare morphological and walking biomechanical differences between children with and without Sever disease.
- To explore the relationship between structural impairments and walking biomechanics in Sever disease.
Main Methods:
- Ultrasound assessment of Achilles tendon (AT), plantar fascia (PF), and gastrocnemius medialis (GM) in Sever (n=20) and control (n=14) groups.
- Analysis of spatiotemporal parameters and ground reaction forces (GRF) during walking at 5 km/h.
- Statistical analysis including inter-subject comparisons, adjusted linear modeling, and intra-subject correlational analyses.
Main Results:
- Children with Sever disease had significantly thicker AT and thinner PF compared to controls.
- The affected foot in Sever subjects showed higher impact and braking forces during walking compared to the unaffected foot.
Conclusions:
- Sever disease is associated with distinct morphological changes in the AT and PF.
- Biomechanical adaptations, including altered gait patterns and increased impact forces, are observed in children with Sever disease.
- Findings may assist in the prevention, early detection, and management of Sever disease.
Purpose:
Sever disease is a common condition in growing children, which causes activity-related heel pain. To contribute to the limited evidence on the topic, this study aimed to describe the morphological and walking biomechanical differences (spatiotemporal parameters and ground reaction forces (GRF)) between children with and without Sever disease, and to investigate the relationship between these variables to determine the implications of structural impairments on walking biomechanics.
Methods:
Participants were divided into Sever (n = 20; 10.74 ± 1.93 years) and control (n = 14; 11.21 ± 2.08 years) groups. Ultrasound measures (thickness, cross-sectional area, echogenicity) of the Achilles tendon (AT), plantar fascia (PF) and gastrocnemius medialis (GM) were studied. A set of biomechanical measures was acquired during walking at 5 km·h-1 on a monitorized treadmill, including spatiotemporal parameters and GRF. The study included inter-subject comparisons, adjusted linear modelling with covariates, and within-group correlational analyses, as well as intra-subject assessment. Data analysis was conducted using Python 3.10.10.
Results:
Children with Sever disease presented a significantly thicker AT (p = 0.014; ES=0.4) and thinner PF (p = 0.024; ES=0.6) compared to controls. Moreover, the intrasubject comparison in Sever subjects revealed that the affected foot exhibited higher impact (p = 0.001; ES=1.2) and braking forces (p = 0.003; ES=1.7) compared to the unaffected foot.
Conclusion:
Children with Sever disease present morphological changes in the AT and PF, as well as biomechanical adaptations while walking. This study identifies key features associated to Sever disease which may be useful for prevention, early detection and appropriate management of the condition.
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