Duchenne gait: Difference between revisions
Evelin Milev (talk | contribs) No edit summary |
Evelin Milev (talk | contribs) No edit summary |
||
| Line 1: | Line 1: | ||
<div class="editorbox"> '''Original Editor '''- [[User:Evelyne Bahire|Evelyne Bahire]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div> | |||
== Facts behind the Duchenne Gait == | == Facts behind the Duchenne Gait == | ||
[[Duchenne Muscular Dystrophy|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<ref name=":0">D'Angelo, M. G., et al. (2009). "Gait pattern in Duchenne muscular dystrophy." Gait Posture 29(1): 36-41.</ref>. The progressive character of the disease is due to muscle wasting and its replacement by connective tissue<ref>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.</ref>. 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<ref>Hsu JD, Furumasu J. Gait and posture changes in the Duchenne muscular dystrophy child. Clin Orthop Relat Res 1993;288(March):122–5.</ref>. | [[Duchenne Muscular Dystrophy|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<ref name=":0">D'Angelo, M. G., et al. (2009). "Gait pattern in Duchenne muscular dystrophy." Gait Posture 29(1): 36-41.</ref>. The progressive character of the disease is due to muscle wasting and its replacement by connective tissue<ref>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.</ref>. 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<ref>Hsu JD, Furumasu J. Gait and posture changes in the Duchenne muscular dystrophy child. Clin Orthop Relat Res 1993;288(March):122–5.</ref>. | ||
Revision as of 18:06, 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.
Looking at the distal lower limb, it has been found that there is an excessive foot plantarflexion during swing phase and this was due to compensatory movement in the flexors and abductors of the hip, in order to aid floor clearance. However, velocity and cadence in this population group is similar to those in healthy subjects but stride length is known to be reduced and step width increased[1]. It is expected the gait pattern to get more severely affected once the children start developing ankle tightness and contractures of the hips.
Outcome Measures used in the assessment of Duchenne Gait[edit | edit source]
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 1.3 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
