The influence of walking speed on the Gait Deviation Index in individuals with Rheumatoid Arthritis

Abstract

groups: Orthopaedic uni-/bilateral (OUni/OBi); neurological flaccid uni-bilateral (NflaUni/NflaBi); neurological spastic uni-/bilateral with/without adequate trunk control (NspUni/NspBi/NspBiNTC). The gait profile score (GPS) [1] was calculated. The mean MMS, derived by clinical testing [2], was the mean over all leg muscle groups. General least square models (software R 2.12.0) were used to assess whether the effects of MMS on GPS differ among patient groups. The GPS offsets at a MMS of 5 were compared between OUni and the other patient groups (Fig. 1). Results:MMS had a strong, negative effect on GPS score (MMS: −3.0±0.2, p< .001). There were no significant differences in this effect among patient groups (p= .848). However, they strongly differed in GPS offset at a MMS of 5 (p< .001) (Table 1). Discussion and conclusions: The amount of gait deviation increased with the loss of muscle strength, and this behaviour seemed to be independent of the pathology. The severity of the pathologywas reflected in the higher GPS (i.e. kinematic deviation) at normal MMS. Note that NflaUni is an exception, possibly biased by the small patient number (n=12). We conclude that gait deviationsmainly result frommuscleweakness. This knowledge canfind clinical implication in treatment planning and in the interpretation of gait compensations in patientswith various constraints. The role of the basic disease should not be overemphasised.