Duchenne gait: Difference between revisions
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== Duchenne Gait Pattern == | == Duchenne Gait Pattern == | ||
Many studies are showing evidence of proximal weakness affecting the muscle groups first and then followed by distal weakness. As this is true for both upper and lower limb muscles we are going to focus on the lower limbs only and the characterisation of the Duchenne Gait. The first evident compensations are due to gluteus maximus weakness and tightness in the hip flexors<ref name=":0" /> . | Many studies are showing evidence of proximal weakness affecting the muscle groups first and then followed by distal weakness. As this is true for both upper and lower limb muscles we are going to focus on the lower limbs only and the characterisation of the Duchenne Gait. The first evident compensations are due to gluteus maximus weakness and tightness in the hip flexors<ref name=":0" />. The consequence of this is development of lumbar lordosis, an excessive anterior pelvic tilt and a 'double bump' sagittal pelvic tilt<ref name=":0" />. Muscle wasting in the quadriceps is affecting the knee movement in loading response, when patients trying to avoid flexion of the knee. Furthermore, the knee hyperextension later in stance might be due to an attempt to keep the body stable while compensating for the weak quadriceps. D'Angelo et al., demonstrated this in their study by showing absence of extensor knee movement in patients with DMD in the gait lab. | ||
== Other disorders and dysfunctions that can produce a Duchenne gait == | == Other disorders and dysfunctions that can produce a Duchenne gait == | ||
Revision as of 16:32, 22 June 2018
Facts behind the Duchenne Gait[edit | edit source]
Duchenne muscular dystrophy (DMD) is the most common childhood muscular dystrophy caused by DMD gene mutation. The prevalence of the disease is 1 in every 3500 male live births[1]. The progressive character of the disease is due to muscle wasting and its replacement by connective tissue[2]. These changes lead to weakness, which will first affect the proximal muscle groups and the distal ones on a later stage, all of those compromising the child's posture and gait. It is very important that the physiotherapist keep an eye on the dynamic quantitative assessment of gait in patients with Duchenne Muscular Dystrophy as this would help in evaluating the progression of the disease and to adapt any appropriate therapy[3].
Duchenne Gait Pattern[edit | edit source]
Many studies are showing evidence of proximal weakness affecting the muscle groups first and then followed by distal weakness. As this is true for both upper and lower limb muscles we are going to focus on the lower limbs only and the characterisation of the Duchenne Gait. The first evident compensations are due to gluteus maximus weakness and tightness in the hip flexors[1]. The consequence of this is development of lumbar lordosis, an excessive anterior pelvic tilt and a 'double bump' sagittal pelvic tilt[1]. Muscle wasting in the quadriceps is affecting the knee movement in loading response, when patients trying to avoid flexion of the knee. Furthermore, the knee hyperextension later in stance might be due to an attempt to keep the body stable while compensating for the weak quadriceps. D'Angelo et al., demonstrated this in their study by showing absence of extensor knee movement in patients with DMD in the gait lab.
Other disorders and dysfunctions that can produce a Duchenne gait[edit | edit source]
| [4] |
- Legg-Calvé-Perthes Disease: [5]
The Duchenne gait in LCP is characterized by:
- A trunk lean toward the affected stance limb.
- The pelvis is either level or elevated on the swinging limb side, during the single stance phace.
- A reduced hip abductor moment, producing a hip-unloading effect.
References[edit | edit source]
- ↑ 1.0 1.1 1.2 D'Angelo, M. G., et al. (2009). "Gait pattern in Duchenne muscular dystrophy." Gait Posture 29(1): 36-41.
- ↑ Liang, W. C., et al. (2018). "The natural history of the patients with Duchenne muscular dystrophy in Taiwan: A medical center experience." Pediatr Neonatol 59(2): 176-183.
- ↑ Hsu JD, Furumasu J. Gait and posture changes in the Duchenne muscular dystrophy child. Clin Orthop Relat Res 1993;288(March):122–5.
- ↑ Ambroise Holland. Duchenne looppatroon. Available from: http://www.youtube.com/watch?v=qbKcjeqdNvk[last accessed 25/05/13]
- ↑ Bettina Westhoff, Andrea Petermann, Mark A. Hirsch, Reinhart Willers, Rudiger Krauspe. Computerized gait analysis in Legg Calve Perthes disease - Analysis of the frontal plane. Gait & Posture October 2006; 24 (2):196-202
