Patients with osteogenesis imperfecta disease walk with reduced ground reaction force compared to healthy subjects

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• 作者：Aline-Bregou Bourgeois ; ^{aline.bregou@chuv.ch" class="auth_mail" title="E-mail the corresponding author} ; Bé ; rengè ; re Aubry-Rozier ; Patrick Schneider ; Mia-Freymond Morisod ; Anjali Vaswani ; Sheila Unger ; Luisa Bonafe ; Pierre-Yves Zambelli ; Julien Favre ; Brigitte Jolles-Haeberli
• 刊名：Revue de Chirurgie Orthopédique et Traumatologique
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：102
• 期：7_supp_S
• 页码：S180
• 全文大小：50 K

文摘

Assessing the physical capacity of OI patients is important to evaluate disease progression and to adapt treatment, specifically rehabilitation protocol. While functional scores, such as the medical outcome study short form-36 (MOS SF-36) or the Oswestry disability index (ODI), are validated and used to assess physical capacity in this population, instrumented gait test could improve the evaluation. Analyzing ground reaction forces (GRF) during walking, which can be done with a single force plate, was shown to be an easy and efficient method to differentiate ambulatory pattern in relation to disease severity for a variety of musculoskeletal pathologies. This study tested the hypothesis that OI patients walk with smaller magnitude of vertical and fore-aft forces than control subjects. Gait analysis was performed for 6 OI patients (2 males; 27 ± 9 years old; 26 ± 3 kg m²) and 12 healthy subjects (7 males; 24 ± 2 years old; 22 ± 2 kg/m²). Each study participant walked several trials at self-selected normal speed in a lab equipped with floor-mounted forceplates (Kistler, CH). One leg was randomly selected for analysis and standard characteristic peaks in vertical and fore-aft GRF were measured for each step of the selected leg on a forceplate. To allow comparison among participants, GRF were normalized to percent bodyweight (%BW). Measurements were averaged across trials in order to have one value per GRF peak and participant. Finally, two tailed unpaired t-tests were done to compare GRF peaks between both groups at an alpha level of 5%. OI patients walked with significantly reduced vertical GRF during loading response (88 ± 19 Vs 114 ± 8%BW; P < 0.001) and during terminal stance (89 ± 14 Vs 109 ± 9%BW; P < 0.001). The magnitude of the GRF was also different in the horizontal plane, with reduced aft force during loading response (17 ± 6 Vs 23 ± 5% BW; P = 0.03) and reduced fore force during terminal stance (17 ± 3 Vs 22 ± 4%BW; P = 0.01). OI patients walked slower than controls (1.22 ± 0.14 Vs 1.47 ± 0.20 m/s; P = 0.02). This study showed a significantly lower GRF in OI patients. Smaller GRF were specifically hypothesized in this study due to muscle weakness, proprioceptive acuity diminution and fear of falling in this population. These expected results suggest that a single force plate can already provide valuable information to characterize the ambulatory function of OI patients. The case control comparison yielded results, which were congruent with gait alterations, previously reported in OI and hyperlaxity patients. Further study is needed to evaluate specific change in GFR among OI patients with functional treatment.