Abstract
Objectives: Runner’s dystonia is a task-specific dystonia that occurs in the lower limbs and trunk, with diverse symptomatology. We aimed to identify the origin of a dystonic movement abnormality using combined three-dimensional kinematic analysis and electromyographic (EMG) assessment during treadmill running.Participant: A 20-year-old female runner who complained of right-foot collision with the left-leg during right-leg swing-phase, which mimicked right-ankle focal dystonia.Results: Kinematic and EMG assessment of her running motion was performed, which showed a significant drop of the left pelvis during right-leg stance-phase, and a simultaneous increase of right hip adductor muscle activity. This resulted in a pronounced adduction of the entire right lower limb with respect to the pelvis segment. Trajectories of right foot were seen to encroach upon left-leg area.Discussion: These findings suggested that the symptom of this runner was most likely a form of segmental dystonia originating from an impaired control of hip and pelvis, rather than a distal focal ankle dystonia.Conclusion: We conclude that, for individualized symptom assessment, deconstructing the symptom origin from its secondary compensatory movement is crucial for characterizing dystonia. Kinematic and EMG evaluation will therefore be a prerequisite to distinguish symptom origin from secondary compensatory movement.
Highlights
Focal task-specific dystonia (FTSD) is a type of movement disorder that results in an abnormal involuntary muscle contraction of a focal body part during a specific well-learned task (Stahl and Frucht, 2017)
Origin Identification in Runner’s Dystonia (RD), symptoms characterized by an involuntary lower limb movement during running such as toe clawing/extension, ankle supination/inversion/eversion, and knee hyperextension (Leveille and Clement, 2008; Martino et al, 2009; CutsforthGregory et al, 2016; Ahmad et al, 2018)
Our findings were supported by the results of kinematic simulation analysis which illustrated that the abducted and dorsiflexed right-foot position contributed significantly to widening the distance between the right foot and left leg (Figure 5)
Summary
Focal task-specific dystonia (FTSD) is a type of movement disorder that results in an abnormal involuntary muscle contraction of a focal body part during a specific well-learned task (Stahl and Frucht, 2017). Origin Identification in Runner’s Dystonia (RD), symptoms characterized by an involuntary lower limb movement during running such as toe clawing/extension, ankle supination/inversion/eversion, and knee hyperextension (Leveille and Clement, 2008; Martino et al, 2009; CutsforthGregory et al, 2016; Ahmad et al, 2018). Foot and the lower limb muscles are commonly affected (Leveille and Clement, 2008), which may spread to the pelvis and trunk (Suzuki et al, 2011; Cutsforth-Gregory et al, 2016; Ahmad et al, 2018). Runners older than 40 years of age or those trained for a long time tend to suffer from this symptom (Schneider et al, 2006; Wu and Jankovic, 2006; Ramdhani and Frucht, 2013; Ahmad et al, 2018)
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