Early signs of pathological pattern evaluated by gait analysis in Duchenne muscular dystrophy patients

Abstract

walking velocity was found to be similar in both groups. The pelvis showed significant differences in the range of anterior–posterior tilt, which was increased in the dystrophic patients (p < 0.01). The external rotation during terminal stance and internal rotation in mid and terminal swing were increased in patients group (p < 0.05). In the frontal plane, during terminal stance and preswing phase, there was an increased pelvic obliquity. Range of motion in sagittal plane showed a significant difference at the ankle, with an increased plantarflexion in swing in the dystrophic patients (� 1.86 � 5.98, control group: 7.5 � 2.28; p < 0.01). Maximum dorsiflexion in terminal stance/pre-swing phase was less in patient group (11.8+/5.38 control group: 18.3+/4.48; p < 0.01). Kinetic analysis showed significant differences in power generation and absorption at the hip joint in mid, and in terminal stance and terminal swing (p < 0.01); at the ankle in loading response (bigger absorption), and mid and terminal stance (less production) (p < 0.01. At knee there was a less flexor moment in mid-stance (p < 0.01). Ankle showed a less dorsiflexor moment in terminal stance-pre-swing and minor range from maximum to minimum (p < 0.01). Discussion: Gait analysis was a useful instrument for evaluating and quantifying the early modifications in the gait pattern of these dystrophic patients, when the clinical evaluation could not clearly evidence specific modification. This analysis can be considered an initial stage during the evaluation and quantification in the progressive weak pattern, and can be useful at evaluating the disease’s progression during clinical treatment. Clinical interpretation of early gait pattern, in terms of compensation or weakness, can be useful to define more focused, early rehabilitative program.