title: Gait pattern in myotonic dystrophy (Steinert disease): a kinematic, kinetic and EMG evaluation using 3D gait analysis.
abstract: We investigated the gait pattern of 10 patients with myotonic dystrophy (Steinert disease; 4 females, 6 males; age: 41.5+7.6 years), compared to 20 healthy controls, through manual muscle test and gait analysis, in terms of kinematic, kinetic and EMG data. In most of patients (80%) distal muscle groups were weaker than proximal ones. Weakness at lower limbs was in general moderate to severe and MRC values evidenced a significant correlation between tibialis anterior and gastrocnemius medialis (R=0.91). An overall observation of gait pattern in patients when compared to controls showed that most spatio-temporal parameters (velocity, step length and cadence) were significantly different. As concerns kinematics, patients' pelvic tilt was globally in a higher position than control group, with reduced hip extension ability in stance phase and limited range of motion; 60% of the limbs revealed knee hyperextension during midstance and ankle joints showed a quite physiological position at initial contact and higher dorsiflexion during stance phase if compared to healthy individuals. Kinetic plots evidenced higher hip power during loading response and lower ankle power generation in terminal stance. The main EMG abnormalities were seen in tibialis anterior and gastrocnemius medialis muscles. In this study gait analysis gives objective and quantitative information about the gait pattern and the deviations due to the muscular situation of these patients; these results are important from a clinical point of view and suggest that rehabilitation programs for them should take these findings into account.
authors: Bioengineering Department, Politecnico di Milano, Milan, Italy.
authors: Manuela
authors: M
authors: Galli
authors: Veronica
authors: V
authors: Cimolin
authors: Veronica
authors: V
authors: Crugnola
authors: Lorenzo
authors: L
authors: Priano
authors: Francesco
authors: F
authors: Menegoni
authors: Claudio
authors: C
authors: Trotti
authors: Eva
authors: E
authors: Milano
authors: Alessandro
authors: A
authors: Mauro
mesh_terms: D000328:Adult; D000842:Ankle / Q000503:physiopathology; D001696:Biomechanical Phenomena; D002985:Clinical Protocols; D003627:Data Interpretation, Statistical; D004576:Electromyography; D005260:Female; D005684:Gait / Q000502:physiology*; D006615:Hip / Q000503:physiopathology; D006801:Humans; D021621:Imaging, Three-Dimensional; D007700:Kinetics; D007717:Knee / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000503:physiopathology; D009223:Myotonic Dystrophy / Q000503:physiopathology* / Q000534:rehabilitation