Clinical implications of gait analysis in the rehabilitation of adult patients with "Prader-Willi" Syndrome: a cross-sectional comparative study ("Prader-Willi" Syndrome vs matched obese patients and healthy subjects).
BACKGROUND
Being severely overweight is a distinctive clinical feature of Prader-Willi Syndrome (PWS). PWS is a complex multisystem disorder, representing the most common form of genetic obesity. The aim of this study was the analysis of the gait pattern of adult subjects with PWS by using three-Dimensional Gait Analysis. The results were compared with those obtained in a group of obese patients and in a group of healthy subjects.


METHODS
Cross-sectional, comparative study: 19 patients with PWS (11 males and 8 females, age: 18-40 years, BMI: 29.3-50.3 kg/m2); 14 obese matched patients (5 males and 9 females, age: 18-40 years, BMI: 34.3-45.2 kg/m2); 20 healthy subjects (10 males and 10 females, age: 21-41 years, BMI: 19.3-25.4 kg/m2). Kinematic and kinetic parameters during walking were assessed by an optoelectronic system and two force platforms.


RESULTS
PWS adult patients walked slower, had a shorter stride length, a lower cadence and a longer stance phase compared with both matched obese, and healthy subjects. Obese matched patients showed spatio-temporal parameters significantly different from healthy subjects.Furthermore, Range Of Motion (ROM) at knee and ankle, and plantaflexor activity of PWS patients were significantly different between obese and healthy subjects. Obese subjects revealed kinematic and kinetic data similar to healthy subjects.


CONCLUSIONS
PWS subjects had a gait pattern significantly different from obese patients. Despite that, both groups had a similar BMI. We suggest that PWS gait abnormalities may be related to abnormalities in the development of motor skills in childhood, due to precocious obesity. A tailored rehabilitation program in early childhood of PWS patients could prevent gait pattern changes.
Vismara
Luca
L
Physical Medicine and Rehabilitation Unit and Clinical Lab for Gait Analysis and Posture, Istituto Scientifico Ospedale San Giuseppe, Verbania, Italy. lucavisma@libero.it
Romei
Marianna
M
Galli
Manuela
M
Montesano
Angelo
A
Baccalaro
Gabriele
G
Crivellini
Marcello
M
Grugni
Graziano
G
D000293:Adolescent; D000328:Adult; D002648:Child; D002657:Child Development; D003430:Cross-Sectional Studies; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology*; D006801:Humans; D008297:Male; D019957:Motor Skills Disorders / Q000150:complications / Q000209:etiology; D009765:Obesity / Q000209:etiology; D011218:Prader-Willi Syndrome / Q000150:complications* / Q000534:rehabilitation*; D016138:Walking