Evaluation of overall gait quality in Perthes disease. Are global gait indices of value for a local musculoskeletal disorder?

Gait deviation index (GDI) Gillette gait index (GGI) Hip flexor index (HFI) Legg–Calvé–Perthes disease Summary measures

Journal

Clinical biomechanics (Bristol, Avon)
ISSN: 1879-1271
Titre abrégé: Clin Biomech (Bristol, Avon)
Pays: England
ID NLM: 8611877

Informations de publication

Date de publication:
07 2022
Historique:
received: 07 07 2021
revised: 30 03 2022
accepted: 11 05 2022
pubmed: 7 6 2022
medline: 26 7 2022
entrez: 6 6 2022
Statut: ppublish

Résumé

Until now follow-up- and outcome evaluations in Perthes disease are analysing predominantly subjective results and clinical/radiological parameters. To enlarge the assessment by quantitative, functional aspects a summary measure for overall gait quality would be helpful. Therefore, the objective of this study is to evaluate whether commonly used global gait indices are sensitive to detect gait deviations during the early stages of the Perthes disease. 3D gait data of 70 patients scheduled for containment improving surgery with the diagnosis of Perthes were included. A group of 31 healthy children served as a control group. Based on 4 gait cycles of each subject the Gait Deviation Index, the Gillette Gait Index, the Hip Flexor Index and the Gait Deviation Index-Kinetic were calculated for the involved and non-involved side. The gait indices were compared (1) between patients and controls, (2) among patients sub-grouped by ROM/radiological classifications and (3) between the two limbs. All applied gait indices besides the Gait Deviation Index-Kinetic of the patient-group are significantly different from the controls. The subgroup-analysis resulted only in significant differences between the radiological groups Herring B and C for the Gillette Gait Index. Comparing involved and non-involved side showed no significant differences. The evaluated gait indices are sensitive to identify a pathologic gait pattern in Perthes disease, so they can be used as a functional outcome parameter evaluating treatment concepts. Nevertheless, these are not applicable to identify the pathologic side indicating that a local hip problem leads to global gait deviations.

Sections du résumé

BACKGROUND
Until now follow-up- and outcome evaluations in Perthes disease are analysing predominantly subjective results and clinical/radiological parameters. To enlarge the assessment by quantitative, functional aspects a summary measure for overall gait quality would be helpful. Therefore, the objective of this study is to evaluate whether commonly used global gait indices are sensitive to detect gait deviations during the early stages of the Perthes disease.
METHODS
3D gait data of 70 patients scheduled for containment improving surgery with the diagnosis of Perthes were included. A group of 31 healthy children served as a control group. Based on 4 gait cycles of each subject the Gait Deviation Index, the Gillette Gait Index, the Hip Flexor Index and the Gait Deviation Index-Kinetic were calculated for the involved and non-involved side. The gait indices were compared (1) between patients and controls, (2) among patients sub-grouped by ROM/radiological classifications and (3) between the two limbs.
FINDINGS
All applied gait indices besides the Gait Deviation Index-Kinetic of the patient-group are significantly different from the controls. The subgroup-analysis resulted only in significant differences between the radiological groups Herring B and C for the Gillette Gait Index. Comparing involved and non-involved side showed no significant differences.
INTERPRETATION
The evaluated gait indices are sensitive to identify a pathologic gait pattern in Perthes disease, so they can be used as a functional outcome parameter evaluating treatment concepts. Nevertheless, these are not applicable to identify the pathologic side indicating that a local hip problem leads to global gait deviations.

Identifiants

pubmed: 35661893
pii: S0268-0033(22)00100-0
doi: 10.1016/j.clinbiomech.2022.105670
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105670

Informations de copyright

Copyright © 2022 Elsevier Ltd. All rights reserved.

Auteurs

Bettina Westhoff (B)

University of Duesseldorf, Medical Faculty, Department of Orthopaedics and Traumatology, Moorenstr. 5, D-40225 Duesseldorf, Germany. Electronic address: westhoff@med.uni-duesseldorf.de.

Linda Hegemann (L)

University of Duesseldorf, Medical Faculty, Department of Orthopaedics and Traumatology, Moorenstr. 5, D-40225 Duesseldorf, Germany.

Caroline Lederer (C)

University of Duesseldorf, Medical Faculty, Department of Orthopaedics and Traumatology, Moorenstr. 5, D-40225 Duesseldorf, Germany.

Dominik Raab (D)

University of Duisburg-Essen, Engineering Faculty, Chair of Mechanics and Robotics, Lotharstr. 1, D-47057 Duisburg, Germany.

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Classifications MeSH