title: Gait Patterns in Patients with Hereditary Spastic Paraparesis.
abstract: BACKGROUND
  Spastic gait is a key feature in patients with hereditary spastic paraparesis, but the gait characterization and the relationship between the gait impairment and clinical characteristics have not been investigated.
  
  
  OBJECTIVE
  To describe the gait patterns in hereditary spastic paraparesis and to identify subgroups of patients according to specific kinematic features of walking.
  
  
  METHODS
  We evaluated fifty patients by computerized gait analysis and compared them to healthy participants. We computed time-distance parameters of walking and the range of angular motion at hip, knee, and ankle joints, and at the trunk and pelvis. Lower limb joint moments and muscle co-activation values were also evaluated.
  
  
  RESULTS
  We identified three distinct subgroups of patients based on the range of motion values. Subgroup one was characterized by reduced hip, knee, and ankle joint range of motion. These patients were the most severely affected from a clinical standpoint, had the highest spasticity, and walked at the slowest speed. Subgroup three was characterized by an increased hip joint range of motion, but knee and ankle joint range of motion values close to control values. These patients were the most mildly affected and had the highest walking speed. Finally, subgroup two showed reduced knee and ankle joint range of motion, and hip range of motion values close to control values. Disease severity and gait speed in subgroup two were between those of subgroups one and three.
  
  
  CONCLUSIONS
  We identified three distinctive gait patterns in patients with hereditary spastic paraparesis that correlated robustly with clinical data. Distinguishing specific features in the gait patterns of these patients may help tailor pharmacological and rehabilitative treatments and may help evaluate therapeutic effects over time.
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy.|Rehabilitation Centre, Policlinico Italia, Rome, Italy.
authors.forename: Mariano
authors.initials: M
authors.lastname: Serrao
authors.affiliation: Department of Engineering, Roma TRE University, Rome, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Rinaldi
authors.affiliation: Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ranavolo
authors.affiliation: Centre of Space Bio-Medicine, University of Rome Tor Vergata, Rome, Italy.|Laboratory of Neuromotor Physiology, Istituto Di Ricovero e Cura a Carattere Scientifico Santa Lucia Foundation, Rome, Italy.|Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Lacquaniti
authors.affiliation: Centre of Space Bio-Medicine, University of Rome Tor Vergata, Rome, Italy.|Laboratory of Neuromotor Physiology, Istituto Di Ricovero e Cura a Carattere Scientifico Santa Lucia Foundation, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martino
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Leonardi
authors.affiliation: Fondazione Don Gnocchi, Milan, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Conte
authors.affiliation: Department of Engineering, Roma TRE University, Rome, Italy.
authors.forename: Tiwana
authors.initials: T
authors.lastname: Varrecchia
authors.affiliation: Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Draicchio
authors.affiliation: G.B. Bietti Foundation-IRCCS, Department of Neurophysiology of Vision and Neurophthalmology, Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Coppola
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Casali
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy.|IRCCS, Neuromed, Pozzilli, Isernia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pierelli
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D004576:Electromyography; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000503:physiopathology; D020336:Paraparesis, Spastic / Q000503:physiopathology*; D016059:Range of Motion, Articular; D016138:Walking