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Pathologic motion patterns in patients with progressive pseudorheumatoid arthropathy of childhood
© Hartmann et al; licensee BioMed Central Ltd. 2011
- Published: 14 September 2011
- Muscle Weakness
- Knee Flexion
- Plantar Flexion
- Joint Stiffness
- Step Width
Progressive pseudorheumatoid arthropathy of childhood (PPAC) is a specific subtype of spondyloepiphyseal dysplasie (SED) tarda. The skeletal disorder and is characterized by polyarthropathy of large and small joints. Typical signs are prominent epiphysis, progressive joint stiffness, muscle weakness and early fatigue . Optimized physiotherapy is the only effective strategy to slow down the progress of functional disability.
Quantification of pathologic motion patterns during walking.
In a retrospective study eight adolescents suffering from PPAC (sex:female=1; male=7; age:14.6y; weight:50.0kg; size:1.42m; BMI:25) were compared with 20 healthy young person (cg) (sex:female=17, male=3; age:17.9y; weight:53.8kg; size:1.59m; BMI:21). 3D-gaitanalysis was performed with infrared cameras and the Plug-in-Gait Model. Analyses focused spatio-temporal and kinematic parameters in the sagittal plane. Mann-Whitney-U-Tests (p<0.05) and correlation calculations (Pearson) between age, body-mass-index (BMI), kinematic and spatio-temporal-parameters were used for statistical analysis.
Selection of kenematic results in pelvis, knee and ankle joint.
Control Group (n=20)
M.-W. –U-Test Sign. (2-tailed)
Hip ROM (Flex/Ext)
Knee ROM (Flex, loading response)
Knee ROM (Ext, single support1)
Ankle ROM (Plan-Flex, push off)
The results are determined by very small ROM in the lower limb due to distinctive joint stiffness and muscle weakness. The effects of muscular weakness are intensified by high body weight.
The use of 3D-gaitanalysis is a helpful tool to individualize functional treatment to decelerate the progressive joint destruction in the lower limb.
The authors wish to thank the German foundation for children’s rheumatism for supporting this study.
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