Document Detail

Gait pattern classification in children with Charcot-Marie-Tooth disease type 1A.
MedLine Citation:
PMID:  21944474     Owner:  NLM     Status:  MEDLINE    
Gait pattern classification may assist in clinical decision making and cluster analysis (CA) has been often adopted to this aim. The goal of this study was to identify, through CA, typical walking patterns in a group of 21 young subjects with CMT1A, a hereditary progressive neuropathy, and to study possible correlation with the disease's clinical status. The protocol included kinematic/kinetic analysis of natural walking and more demanding locomotor tasks, i.e. toe- and heel-walking. Hierarchical cluster analysis was carried out on parameters related to primary signs (foot-drop and push-off deficit) and, separately, to compensatory mechanisms at proximal (pelvis, hip and knee) or distal (ankle) level. CA on primary signs during natural walking identified three clusters: (1) pseudo-normal patients (PN), not significantly different from controls; (2) patients showing only foot-drop (FD); (3) patients with foot-drop and push-off deficit (FD&POD). Patients belonging to the PN subgroup showed distal abnormalities during heel-walking. The FD&POD subgroup was associated to a significantly worse clinical score (CMTES, p<0.05). The main compensatory strategies, which occurred independently from primary clusterization, included augmented hip/knee flexion in swing (steppage) and early ankle plantarflexion at mid stance (vaulting). We concluded that, although a number of young CMT1A patients do not show typical primary deviations during natural walking, they do show significant abnormalities in more demanding locomotor tasks that should be therefore considered. It is also hypothesized that progression of this degenerative condition may be associated to the migration of patients to more severe clusters, with possible appearance of compensatory strategies.
M Ferrarin; G Bovi; M Rabuffetti; P Mazzoleni; A Montesano; E Pagliano; A Marchi; A Magro; C Marchesi; D Pareyson; I Moroni
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-09-22
Journal Detail:
Title:  Gait & posture     Volume:  35     ISSN:  1879-2219     ISO Abbreviation:  Gait Posture     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-20     Completed Date:  2012-05-21     Revised Date:  2014-02-05    
Medline Journal Info:
Nlm Unique ID:  9416830     Medline TA:  Gait Posture     Country:  England    
Other Details:
Languages:  eng     Pagination:  131-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2011. Published by Elsevier B.V.
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MeSH Terms
Biomechanical Phenomena
Charcot-Marie-Tooth Disease / complications*,  physiopathology
Gait / physiology
Gait Disorders, Neurologic / classification,  complications*,  physiopathology*
Walking / physiology
Grant Support

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