DMP: Worsening of kinetic and kinematic patterns in disease progression

Abstract

Kinematic and kinetic normal range of shoulder and elbow joints were defined; the same experimental set up was studied in patients, in order to find differences with CG. According to Rodda’s classification, patients were divided into two groups: GROUP1 (Type I; four patients with mild limitation at ankle joint) and GROUP2 (Type III; eight patients with functional limitation at distal and proximal joints). The most significant parameter to characterise pathological upper limb movement during gait is range of motion of shoulder abd-adduction (ROMs). This index pointed out a good correlation with ROM of pelvic rotation (ROMp) (R = 0.78). In particular, patients with high values of ROMs and ROMp were the more compromised subjects at lower limbs (GROUP2): these patients adopted a strategy with excessive ROMs and ROMp to progress their body. ROMs was the parameter significant to differentiate two groups. GROUP1 presented ROMs close to normality, with an asymmetry between the two sides (6.98 2.48 versus 3.88 1.38; p < 0.05; CG: 5.88 3.78): the most compromised upper limb side revealed the highest limitation on lower limb as for ankle propulsion ability during terminal stance ( p < 0.05). Elbow flex-extension showed ROM limited. GROUP2 generally highlighted ROMs values above normality, without any significant differences between the two sides (12.28 1.38 versus 9.68 3.18); the lack of significant asymmetries was confirmed by lower limb pattern, too. ROM of elbow flex-extension was close to normal value.