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Paediatric patients with blood‐induced ankle joint arthritis demonstrate physiological foot joint mechanics and energetics during walking
Author(s) -
Tijskens Dorien,
Lobet Sébastien,
Eerdekens Maarten,
Peerlinck Kathelijne,
Hermans Cédric,
Van Damme An,
Staes Filip,
Deschamps Kevin
Publication year - 2020
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/hae.14128
Subject(s) - medicine , barefoot , ankle , gait , gait analysis , foot (prosody) , physical medicine and rehabilitation , physical therapy , surgery , linguistics , philosophy
Aim To compare foot joint kinetics and energetics in male paediatric boys with and without blood‐induced ankle joint destruction to these of matched control groups. Methods A cross‐sectional study was conducted in which 3D gait analysis data were collected from thirty‐five male children (6‐21 years) with severe or moderate haemophilia and twenty‐six typically developing boys. Structural integrity of the tarsal foot joints of all haemophilic patients was assessed using the IPSG‐MRI scale. All participants walked barefoot while adopting a physiological gait pattern. Three subgroups were created based on the IPSG‐MRI scores: a group with no joint involvement (HealthyHaemo), with uni‐ or bilaterally involvement (PathoHaemo) and with only unilaterally involvement (Haemo_Unilateral_Patho). Results The PathoHaemo group presented a significant lower Lisfranc peak dorsiflexion angular velocity (34.7°/s vs 71.4°/s, P = .000, Cohen d = 1.31) and a significantly higher Lisfranc peak plantarflexion angular velocity (−130.5°/s vs −51.8°/s, P = .000, Cohen d = 0.98) compared to the control group. The Haemo_Unilateral_Patho side had a significant higher Chopart peak dorsiflexion angular velocity compared to the Haemo_Unilateral_Healthy side (41.7°/s vs 31.9°/s, P = .002, Cohen d = 1.16). Conclusion No evidence for mild and severe gait deviations could be demonstrated. Internal moments, used as a surrogate measure of joint loading, quantified by the multi‐segment foot model were found to be similar within the three subanalyses. We suggest that the ongoing musculoskeletal development in children compensates for structural damage to the ankle joint.