Rachel A Kennedy1, Jennifer L McGinley2, Kade L Paterson3, Monique M Ryan4, Kate Carroll5. 1. Department of Neurology, The Royal Children's Hospital, Parkville, Victoria, Australia; Physiotherapy Department, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia. Electronic address: rachel.kennedy@rch.org.au. 2. Physiotherapy Department, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia. Electronic address: mcginley@unimelb.edu.au. 3. Physiotherapy Department, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia. Electronic address: kade.paterson@unimelb.edu.au. 4. Department of Neurology, The Royal Children's Hospital, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia. Electronic address: monique.ryan@rch.org.au. 5. Department of Neurology, The Royal Children's Hospital, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Parkville, Victoria, Australia. Electronic address: kate.carroll@rch.org.au.
Abstract
OBJECTIVE: Children with Charcot-Marie-Tooth disease (CMT) report problems with gait and footwear. We evaluated differences in spatio-temporal gait variables and gait variability between children with CMT and typically developing (TD) children, and investigated the effect of footwear upon gait. METHOD: A cross-sectional study of 30 children with CMT and 30 age- and gender-matched TD children aged 4-18 years. Gait was assessed at self-selected speed on an electronic walkway while barefoot and in two types of the child's own footwear; optimal (e.g., athletic-type runners) and suboptimal (e.g., flip-flops). RESULTS: Children with CMT walked more slowly (mean (SD) -13.81 (3.61) cm/s), with shorter steps (-6.28 (1.37) cm), wider base of support (+2.47 (0.66) cm; all p < 0.001) and greater base of support variability (0.48 (0.15) cm, p = 0.002) compared to TD children. Gait was faster in optimal footwear than suboptimal (-7.55 (1.31) cm/s) and barefoot (-7.42 (1.07) cm/sec; both p < 0.001) in the combined group of children. Gait in suboptimal footwear was more variable compared to barefoot and optimal footwear. Greater base of support variability and reduced balance was moderately correlated for both groups (CMT and TD). CONCLUSION: Gait is slower with shorter, wider steps and greater base of support variability in children with CMT. Poor balance is associated with greater base of support gait variability. Suboptimal footwear negatively affects gait in all children (CMT and TD), which has clinical implications for children and adolescents with CMT who have weaker feet and ankles, and poor balance.
OBJECTIVE:Children with Charcot-Marie-Tooth disease (CMT) report problems with gait and footwear. We evaluated differences in spatio-temporal gait variables and gait variability between children with CMT and typically developing (TD) children, and investigated the effect of footwear upon gait. METHOD: A cross-sectional study of 30 children with CMT and 30 age- and gender-matched TD children aged 4-18 years. Gait was assessed at self-selected speed on an electronic walkway while barefoot and in two types of the child's own footwear; optimal (e.g., athletic-type runners) and suboptimal (e.g., flip-flops). RESULTS:Children with CMT walked more slowly (mean (SD) -13.81 (3.61) cm/s), with shorter steps (-6.28 (1.37) cm), wider base of support (+2.47 (0.66) cm; all p < 0.001) and greater base of support variability (0.48 (0.15) cm, p = 0.002) compared to TD children. Gait was faster in optimal footwear than suboptimal (-7.55 (1.31) cm/s) and barefoot (-7.42 (1.07) cm/sec; both p < 0.001) in the combined group of children. Gait in suboptimal footwear was more variable compared to barefoot and optimal footwear. Greater base of support variability and reduced balance was moderately correlated for both groups (CMT and TD). CONCLUSION: Gait is slower with shorter, wider steps and greater base of support variability in children with CMT. Poor balance is associated with greater base of support gait variability. Suboptimal footwear negatively affects gait in all children (CMT and TD), which has clinical implications for children and adolescents with CMT who have weaker feet and ankles, and poor balance.
Authors: Rachel A Kennedy; Kate Carroll; Kade L Paterson; Monique M Ryan; Joshua Burns; Kristy Rose; Jennifer L McGinley Journal: PLoS One Date: 2019-06-12 Impact factor: 3.240
Authors: Jorik Nonnekes; Cheriel Hofstad; Annemieke de Greef-Rotteveel; Heleen van der Wielen; Janke H van Gelder; Christian Plaats; Viola Altmann; Fabian Krause; Noël Keijsers; Alexander Geurts; Jan Willem K Louwerens Journal: J Rehabil Med Date: 2021-05-21 Impact factor: 2.912