Juvenile idiopathic arthritis, gait characteristics and relation to function (2022)

Table of Contents
Abstract Background Methods Results Conclusions Introduction Section snippets Protocol and registration Definition of phases and events in the gait cycle Search results and included studies Conclusion Declaration of Competing Interest References (64) Arch. Phys. Med. Rehabil. Arch. Phys. Med. Rehabil. Hum. Mov. Sci. Gait Posture Gait Posture Gait Posture J. Biomech. J. Biomech. Man. Ther. Genetic architecture distinguishes systemic juvenile idiopathic arthritis from other forms of juvenile idiopathic arthritis: clinical and therapeutic implications Ann. Rheum. Dis. Gait alteration in patients with juvenile chronic arthritis: a computerized analysis J. Orthopaedic Rheumatology Health-related quality of life in adolescents with juvenile idiopathic arthritis Arthritis Rheum. Early disease course and predictors of disability in juvenile rheumatoid arthritis and juvenile spondyloarthropathy: a 3 year prospective study J. Rheumatol. Prognostic factors in juvenile rheumatoid arthritis: a case-control study revealing early predictors and outcome after 14.9 years J. Rheumatol. Burden of childhood-onset arthritis Pediatr. Rheumatol. Online J. Functioning and preferences for improvement of health among patients with juvenile idiopathic arthritis in early adulthood using the WHO ICF model J. Rheumatol. The natural history of juvenile chronic arthritis: a population based cohort study. I. Onset and disease process J. Rheumatol. Lower limb osteoarthritis: biomechanical alterations and implications for therapy Curr. Opin. Rheumatol. Linking joint impairment and gait biomechanics in patients with juvenile idiopathic arthritis Ann. Biomed. Eng. Gait mechanics contribute to exercise induced pain flares in knee osteoarthritis BMC Musculoskelet. Disord. Health-related quality of life, physical function, fatigue, and disease activity in children with established polyarticular juvenile idiopathic arthritis J. Rheumatol. Interpreting spatiotemporal parameters, symmetry, and variability in clinical gait analysis Handbook of Human Motion Gait analysis: normal and pathological function J. Sports Sci. Med. Gait characteristics associated with the foot and ankle in inflammatory arthritis: a systematic review and meta-analysis BMC Musculoskelet. Disord. Evidence for updating the core domain set of outcome measures for juvenile idiopathic arthritis: report from a special interest group at OMERACT 2016 J. Rheumatol. Interpreting joint moments and powers in gait Handbook of Human Motion How do anti-TNF therapies affect gait function in patients with rheumatoid arthritis? Int. J. Rheum. Dis. A study of classification criteria for a diagnosis of juvenile rheumatoid arthritis Arthritis Rheum. Against Rheumatism: EULAR Bulletin No. 4: Nomenclature and Classification of Arthritis in Children, in National Zeitung Proposal for the development of classification criteria for idiopathic arthritides of childhood J. Rheumatol. Revision of the proposed classification criteria for juvenile idiopathic arthritis: durban, 1997 J. Rheumatol. International league of associations for rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001 J. Rheumatol. Cited by (3) Reference Values for the Six Minute Walk Test in Children with Juvenile Idiopathic Arthritis Recommended articles (6) FAQs Videos
ScienceDirect

RegisterSign in

ViewPDF

  • Access throughyour institution

Volume 85,

March 2021

, Pages 38-54

Abstract

Background

Juvenile Idiopathic Arthritis (JIA) is a chronic inflammatory arthritis that impacts biomechanical features of gait. This systematic review describes the effects of JIA on gait motion parameters and walking performance.

Methods

Six databases were searched (PubMed/Medline, Cochrane, the EBSCOHost database SPORTDiscus, Web of Science, and Embase). Studies were restricted to children with any subtype of JIA who were assessed for gait motion features (kinematic, kinetic, temporalspatial) or walking performance (velocity or distance covered); could include intervention or treatment exposure with measures of gait and gait speed; could involve comparison of gait in JIA to healthy controls. Quality of evidence was assessed using the GRADE system. This systematic review was registered at PROSPERO (CRD42018109582)

Results

The search yielded 625 papers, 23 of which described biomechanical features of gait and/or assessed walking performance. Twenty studies measured walking velocity and walking ability using simple field tests or laboratory methods. Eleven studies measured temporalspatial parameters such as cadence, step length, stride length, step width, single and double support time. Nine studies evaluated kinetic measurements including joint power, flexion and extension and joint moments. Nine studies evaluated kinematic parameters including range of motion, pelvic tilt, center of motion and trunk sway.

Conclusions

Key features of gait in children with JIA include slower gait velocity, shortened step length, decreased range of motion at the hip, knee and ankle with trend towards flexion, decreased joint power, anteriorly tilted pelvis and trunk with shifted center of motion. There is a potential to ameliorate JIA-related gait changes with exercise and/or pharmaceutical interventions.

Introduction

Juvenile Idiopathic Arthritis (JIA) is a heterogeneous group of diseases characterized by chronic joint swelling, limitation, and painful range of motion (ROM) [1]. Despite treatment, some children with JIA may have functional limitations including interference with the normal activities of daily living, mobility and impaired health [[2], [3], [4], [5], [6], [7]]. While any joint can be affected by arthritis, the joints of the lower extremities, such as the knee and ankle, are commonly involved [8]. Arthritis may alter loading in unaccustomed joints [9,10]. This alters the kinetic chain [11] and changes systemic gait motion parameters, such as trunk lean or posture [12]. Long-term effects of these alterations include joint pain, difficulty participating in physical activity [13] or early onset of fatigue during activity [14]. Therapeutic interventions to improve or maintain gait and mobility in JIA can be advanced with identification of clinically-meaningful standardized gait measures. Critical appraisal of existing evidence of the effects of JIA on walking gait mechanics and effectiveness of interventions on key gait parameters is first required. We systematically reviewed the literature of the relationship between JIA and walking gait biomechanics and provide insight on effectiveness of treatment on temporal spatial, kinetic and kinematic parameters.

Section snippets

Protocol and registration

The protocol of this systematic review was registered on the International Prospective Register of Systematic Reviews PROSPERO (CRD42018109582).

Definition of phases and events in the gait cycle

The phases and events of the gait cycle are shown in Figs 1, 2. Phases include stance (foot contact on ground) and swing (when a foot is in the air) [15]. For example, when a right foot makes initial ground contact, this event initiates the double support phase; as the left foot pushes off from the ground behind the center of mass after terminal stance,

Search results and included studies

Fig. 1 provides search details. 625 studies were initially retrieved after duplicates were removed. After screening, 57 full-text articles were deemed potentially relevant and examined for eligibility by two reviewers (L.W., H.K.V.) Following the review of 57 manuscripts meeting initial criteria based on title and abstract, 29 were found to be relevant to this topic. Among these studies, six were excluded for: provided only computer modeling of gait mechanics, [10,[27], [28], [29]] evaluated a

Conclusion

Gait analysis is useful to determine degree and severity of biomechanical alterations in JIA. Gait measures have potential diagnostic, therapeutic, and prognostic implications. Understanding gait adaptations can enable clinicians to identify areas amenable to therapy to allow children with JIA, safely participate in activities, and track response to therapy.

Declaration of Competing Interest

The authors report no declarations of interest.

(Video) Juvenile Idiopathic Arthritis (JIA): Pathology & Clinical Presentation – Pediatrics | Lecturio

References (64)

  • D.E. Thorpe et al.Repeatability of temporospatial gait measures in children using the GAITRite electronic walkway

    Arch. Phys. Med. Rehabil.

    (2005)

  • S. CavalloOttawa panel evidence-based clinical practice guidelines for structured physical activity in the management of juvenile idiopathic arthritis

    Arch. Phys. Med. Rehabil.

    (2017)

  • E. BrostromTrunk and center of mass movements during gait in children with juvenile idiopathic arthritis

    Hum. Mov. Sci.

    (2007)

  • J. MerkerCombined three-dimensional gait and plantar pressure analyses detecting significant functional deficits in children with juvenile idiopathic arthritis

    Gait Posture

    (2018)

  • M.D. IversenSelf-rated walking disability and dynamic ankle joint stiffness in children and adolescents with Juvenile Idiopathic Arthritis receiving intraarticular corticosteroid joint injections of the foot

    Gait Posture

    (2019)

  • G.J. HendryFoot function is well preserved in children and adolescents with juvenile idiopathic arthritis who are optimally managed

    Gait Posture

    (2013)

  • E. MontefioriAn image-based kinematic model of the tibiotalar and subtalar joints and its application to gait analysis in children with Juvenile Idiopathic Arthritis

    J. Biomech.

    (2019)

  • K. TokudaBiomechanical mechanism of lateral trunk lean gait for knee osteoarthritis patients

    J. Biomech.

    (2018)

  • P.W. HodgesIncreased duration of co-contraction of medial knee muscles is associated with greater progression of knee osteoarthritis

    Man. Ther.

    (2016)

  • M.J. Ombrello

    Genetic architecture distinguishes systemic juvenile idiopathic arthritis from other forms of juvenile idiopathic arthritis: clinical and therapeutic implications

    Ann. Rheum. Dis.

    (2017)

  • C. Frigo

    Gait alteration in patients with juvenile chronic arthritis: a computerized analysis

    J. Orthopaedic Rheumatology

    (1996)

  • K.L. Shaw

    Health-related quality of life in adolescents with juvenile idiopathic arthritis

    Arthritis Rheum.

    (2006)

  • A.M. Selvaag

    Early disease course and predictors of disability in juvenile rheumatoid arthritis and juvenile spondyloarthropathy: a 3 year prospective study

    J. Rheumatol.

    (2005)

  • B. Flato

    Prognostic factors in juvenile rheumatoid arthritis: a case-control study revealing early predictors and outcome after 14.9 years

    J. Rheumatol.

    (2003)

  • L.N. Moorthy

    Burden of childhood-onset arthritis

    Pediatr. Rheumatol. Online J.

    (2010)

  • M. Arkela-Kautiainen

    Functioning and preferences for improvement of health among patients with juvenile idiopathic arthritis in early adulthood using the WHO ICF model

    J. Rheumatol.

    (2006)

  • B.A. Gare et al.

    The natural history of juvenile chronic arthritis: a population based cohort study. I. Onset and disease process

    J. Rheumatol.

    (1995)

    (Video) Juvenile Idiopathic Arthritis

  • J.A. Block et al.

    Lower limb osteoarthritis: biomechanical alterations and implications for therapy

    Curr. Opin. Rheumatol.

    (2010)

  • E. Montefiori et al.

    Linking joint impairment and gait biomechanics in patients with juvenile idiopathic arthritis

    Ann. Biomed. Eng.

    (2019)

  • K.A. Boyer et al.

    Gait mechanics contribute to exercise induced pain flares in knee osteoarthritis

    BMC Musculoskelet. Disord.

    (2019)

  • S. Ringold et al.

    Health-related quality of life, physical function, fatigue, and disease activity in children with established polyarticular juvenile idiopathic arthritis

    J. Rheumatol.

    (2009)

  • A. Gouelle et al.

    Interpreting spatiotemporal parameters, symmetry, and variability in clinical gait analysis

    Handbook of Human Motion

    (2018)

  • Gait analysis: normal and pathological function

    J. Sports Sci. Med.

    (2010)

  • M. Carroll

    Gait characteristics associated with the foot and ankle in inflammatory arthritis: a systematic review and meta-analysis

    BMC Musculoskelet. Disord.

    (2015)

  • E.M. Morgan

    Evidence for updating the core domain set of outcome measures for juvenile idiopathic arthritis: report from a special interest group at OMERACT 2016

    J. Rheumatol.

    (2017)

  • L.H. Sloot et al.

    Interpreting joint moments and powers in gait

    Handbook of Human Motion

    (2018)

  • R. Oda

    How do anti-TNF therapies affect gait function in patients with rheumatoid arthritis?

    Int. J. Rheum. Dis.

    (2014)

  • J.T. Cassidy

    A study of classification criteria for a diagnosis of juvenile rheumatoid arthritis

    Arthritis Rheum.

    (1986)

  • European League

    Against Rheumatism: EULAR Bulletin No. 4: Nomenclature and Classification of Arthritis in Children, in National Zeitung

    (1977)

  • C.W. Fink

    Proposal for the development of classification criteria for idiopathic arthritides of childhood

    J. Rheumatol.

    (1995)

  • R.E. Petty

    Revision of the proposed classification criteria for juvenile idiopathic arthritis: durban, 1997

    J. Rheumatol.

    (1998)

  • R.E. Petty

    International league of associations for rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001

    J. Rheumatol.

    (2004)

  • Cited by (3)

    • Effect of customised preformed foot orthoses on gait parameters in children with juvenile idiopathic arthritis: A multicentre randomised clinical trial

      2022, Gait and Posture

      Children with juvenile idiopathic arthritis (JIA) can experience significant physical impairment of the lower extremity. Prolonged joint disease and symptoms may cause gait alterations such as reduced walking speed and increased plantar pressures in diseased areas of their feet. There is limited robust clinical trials investigating the effect of non-invasive mechanical therapies such as foot orthoses (FOs) on improving gait parameters in children with JIA.

      Are customised preformed FOs effective in improving gait parameters in children with JIA?

      A multicentre, parallel design, single-blinded randomised clinical trial was used to assess the gait impacts of customised preformed FOs on children with JIA. Children with a diagnosis of JIA, exhibiting lower limb symptoms and aged 5–18 were eligible. The trial group received a low-density full length, Slimflex Simple device which was customised chair side and the control group received a sham device. Peak pressure and pressure time integrals were used as the main gait outcomes and were measured using portable Tekscan gait analysis technology at baseline, 3 and 6 months. Differences at each follow-up were assessed using the Wilcoxon rank sum test.

      66 participants were recruited. Customised preformed FOs were effective in altering plantar pressures in children with JIA versus a control device. Reductions of peak pressures and pressure time integrals in the heel, forefoot and 5th metatarsophalangeal joint were statistically significant in favour of the trial group. This was associated with statistically significant increased midfoot contact with the trial device at baseline, 3 and 6-month data collections. The trial intervention was safe and well accepted by participants, which is reflected in the high retention rate (92%).

      Clinicians may prescribe customised preformed FOs in children with JIA to deflect pressure from painful joints and redistribute from high pressure areas such as the rearfoot and forefoot.

    • Gait biomechanics evaluation of the treatment effects for hallux valgus patients: A systematic review and meta-analysis

      2022, Gait and Posture

      (Video) Juvenile Idiopathic Arthritis

      Hallux valgus (HV) is a foot deformity characterized by lateral deviation of the big toe and medial deviation of the first metatarsal.

      This study aimed to shed light on the treatment effects of different interventions and surgical procedures for HV deformity to determine the effectiveness of gait biomechanics correction.

      English-language searches of the electronic databases were conducted in the Cochrane Library, Web of Science, PubMed, Scopus, and Embase. Gait biomechanics evaluation before and after conservative or operative treatments was essential for inclusion in this review. Methodological quality was assessed by the Institute of Health Economics (IHE) quality appraisal tool. All pooled analysis was based on the random-effects model.

      Twenty-five articles (1003 participants) were identified in this review. Three studies chose conservative therapies for HV deformity, incorporating foot orthotics and minimalist running intervention, and surgeries were performed in twenty-two studies. For the pressure parameter alteration under the hallux, the effect size (ES) in the conservative treatment subgroup was −0.95 with 95%CI [−1.69, −0.21]. It demonstrated a moderate ES of −0.44% and 95%CI [−0.81, −0.07] in the surgery subgroup. The five operations’ peak pressure alteration under the hallux demonstrated a moderate ES of −0.45% and 95%CI [−0.54, −0.36].

      Both non-operative and operative treatments could achieve the forefoot pressure redistribution, decreasing loading beneath the hallux and first metatarsal regions,However, the treatment effects of surgeries were not very robust. The percutaneous DSTR-Akin technique is recommended as an adequate operative treatment, with a large ES and moderate heterogeneity. The negative gait return effect should be noticed while using Scarf osteotomy, despite positive clinical and radiographic outcomes.

    Recommended articles (6)

    • Research article

      Age-associated increase in postural variability relate to greater low-frequency center of pressure oscillations

      Gait & Posture, Volume 85, 2021, pp. 103-109

      Postural control is impaired in older adults, as evidenced from greater variability of the center of pressure (COP) during postural tasks. Although COP variability associates with low-frequency COP oscillations (<1 Hz) in young adults, it remains unknown if the age-associated increase in COP variability relates to greater low-frequency COP oscillations.

      Do low-frequency oscillations contribute to greater postural sway (center of pressure (COP) variability) in older adults when attempting to voluntarily maintain posture in a forward leaning position compared to young adults?

      Seven young (25.7 ± 4.8) and seven older (71.0 ± 7.0) adults performed a postural lean forward task and attempted to match a COP target in the anterior-posterior direction as steady as possible. We quantified the COP variability as the standard deviation (SD) of COP displacements in the anterior-posterior and medial-lateral directions and quantified the frequency modulation of COP as the power in COP displacement spectra from 0-1 Hz.

      We found that older adults had significantly greater anterior-posterior SD of COP (p = 0.027) and power below 0.5 Hz (p = 0.048) than young adults, but power from 0.5-1 Hz was similar (p = 0.083). In contrast, the medial-lateral SD of COP (p = 0.5) and power from 0-1 Hz (p = 0.228) was similar for the two age groups. For both the anterior-posterior and medial-lateral direction, the SD of COP was related to low frequency oscillations below 0.5 Hz.

      For the first time, we show that the age-associated increase in postural variability relates to greater COP oscillations below 0.5 Hz.

    • Research article

      Assessing the contribution of lower limb mobilization, in the supine position, on shoulder-pelvis girdles dissociation

      Gait & Posture, Volume 85, 2021, pp. 224-231

      Several articular, muscular and neurological diseases generate mobility loss in the shoulder and pelvis girdles. Joint mobilization contributes to improving shoulder-pelvis girdles dissociation, but current mobilization techniques are not always successful and standardized. A robotic medical device, DPA Med®, by inducing trunk mobilization through lower limb oscillation has been developed for producing such a shoulder-pelvis girdles dissociation and is already used worldwide in rehabilitation hospitals.

      To determine the optimal lower limb oscillation frequency that generated the best shoulder-pelvis girdles dissociation using the DPA Med® device.

      Thirty healthy adult volunteers (mean age: 38.6 [SD 15.2] years, mean height: 174 [SD 11.9] cm, mean body mass: 70.3 [SD 14.7] kg) participated in this prospective study. A kinematic analysis quantified pelvic and shoulder girdle mobility (rotation and lateral tilt) at different DPA Med® frequencies, from 0.5 Hz to 1 Hz. A visual analysis of the lower limb movement was also performed, using video sensors, to better understand the kinematics involved.

      All DPA Med® frequencies have shown significant shoulder-pelvis girdles dissociation (p < 0.05). This study established an optimal oscillation frequency with the minimal interindividual variability at 0.808 Hz. It induced pelvic mobility similar to that of normal gait, in the transverse and frontal planes (10.3°, SD 2.9°, and 12.0°, SD 2.2°, respectively). This trunk mobility was achieved by producing a lemniscate-shaped motion in the lower limbs (an eight-shaped motion in the transverse plane).

      This study has shown that the DPA Med® device is able to induce shoulder-pelvis girdles dissociation similar to that of normal gait and allowed to establish the existence of an optimal DPA Med® oscillation frequency for lower limb mobility at 0.808 Hz. Further studies are required to evaluate its potentially benefits on gait disorders.

    • Research article

      Excellent reliability of toe strength measurements in children aged ten to twelve years achieved with a novel fixed dynamometer

      Gait & Posture, Volume 85, 2021, pp. 20-24

      (Video) Case Based Overview of Pediatric Juvenile Idiopathic Arthritis

      Stronger toe flexor muscles improve performance outcomes in children, including balance, sprinting, jumping and side stepping. Toe flexor strength (TFS) is recommended as part of the clinical assessment of foot function in children. Fixed dynamometry, rather than handheld, is the gold standard of measurement; however, it can be prohibitively costly. No fixed dynamometer reliability studies on toe flexion have been conducted in children to date.

      Does the novel fixed hand-held dynamometer (HHD) protocol provide reliable intra-rater and test-retest measurements of toe flexor strength in children aged 10 to 12?

      Two trials were recorded from 14 healthy children (10–12 years), 7–14 days apart by the same rater. A Lafayette HHD (model 01163) measured peak force. The HHD was secured in a mobile custom mould below a step with a strap, which secured the foot of the participant. The receptor pads of the HHD were level with the upper surface of the step, maintaining neutral toe joints at rest. The participant was seated on an adjustable stool to ensure the hip, knee and ankle were each at 90° flexion, with the testing foot flat on the upper surface of the step. The averages of three maximal five second efforts were used for data analysis using a two-way mixed effects model with repeated measures ANOVA (intraclass correlation coefficient ICC 3,3). Standard error of measurement (SEM) was calculated to determine the absolute between trial variability.

      The novel fixed HHD protocol provided excellent test-retest reliability with small measurement error for hallux (ICC 3,3 = 0.93, 95 % CI 0.78−0.98, SEM = 4.31 N) and lesser toe flexor strength testing (ICC 3,3 = 0.96, 95 % CI 0.87−0.99, SEM = 1.86 N).

      The fixed HHD protocol described in this study has excellent reliability for the test-retest evaluation of children’s toe flexor strength.

    • Research article

      Slow walking synergies reveal a functional role for arm swing asymmetry in healthy adults: A principal component analysis with relation to mechanical work

      Gait & Posture, Volume 85, 2021, pp. 126-130

      The purpose of this study was to reveal a functional role for arm-swing asymmetry during gait in healthy adults. To this end, the primary aim was to investigate the role of neuromuscular control on the asymmetry of propulsive and collision joint work at either end of the double-support phase (WDS) in the context of sidedness. The secondary aim was to investigate the effect of neuromuscular control on propulsive and collision joint work at either end of the single-support phase (WSS) in the context of arm-swing asymmetry.

      Slow -walking trials of 25 participants were analysed using principal component analysis to generate movement synergies (PMk). Independent variables included the tightness of neuromuscular control (N1) formulated from the first PMk and the directional Arm-swing asymmetry index (dASI). Dependent variables included the difference between double-support collision and propulsive joint work (WDS) and a ratio consisting of the difference between single-support collision and propulsive work of both sides (WSS). A linear mixed-effects model was utilized for aim 1 while a multiple linear regression analysis was undertaken for aim 2.

      Healthy adult gait was accompanied by a left-side dominant arm-swing on average. For aim 1, N1 demonstrated a significant negative effect on WDS while sidedness had a negative direct effect and positive indirect effect through N1 on WDS. The most notable finding was the interaction between dASI and N1 which demonstrated a highly significant positive effect on WSS.

      Evidence was put forward that arm-swing asymmetry during gait is related to footedness among healthy adults. Future studies should look to formally confirm this finding.

    • Research article

      The effect of laboratory and real world gait training with vibration feedback on center of pressure during gait in people with chronic ankle instability

      Gait & Posture, Volume 85, 2021, pp. 238-243

      External feedback has can medially shift the center of pressure (COP) location in people with chronic ankle instability(CAI) during walking. However, previous modalities are restricted to controlled environments which limits motor learning. Vibration feedback during gait may maximize motor learning by allowing for training in the laboratory and real world (RW) but has not been investigated in those with CAI.

      Does vibration feedback change COP location in people with CAI following laboratory and RW training?

      Nineteen CAI participants walked for 10 min on a treadmill (lab training) and a one mile loop on a sidewalk (RW training) with vibration feedback. When pressure under the 5th metatarsal exceeded a threshold, a vibration stimulus was applied to the lateral malleolus encouraging the participant to medially shift the COP. One minute baseline, posttest, and short term retention gait assessments were taken for each environment. The stance phase of gait was divided into 10 subphases and data were averaged within each subphase. Repeated measures ANOVAs were completed for each subphase to compare COP location over time.

      After lab based training the COP was more medial at posttest for the first 90 % of stance versus baseline (Mean differences (MD): −0.57 to −5.12 mm, p < 0.023). Relative to baseline, the COP remained more medial at retention from 20 to 90% of stance (MD: −1.69 to −4.40 mm, p < 0.049). For RW training, the COP was more medial at posttest for the first 70 % of stance versus baseline (MD: −4.24 to −8.27 mm, p < 0.017) and the first 60 % of stance at retention versus baseline (MD: −4.14 to −6.42 mm, p < 0.049).

      Vibration feedback during laboratory and RW gait training has the ability to immediately shift the COP location medially and retain this shift for a short period in individuals with CAI.

    • Research article

      ‘Haste makes waste’: The tradeoff between walking speed and target-stepping accuracy

      Gait & Posture, Volume 85, 2021, pp. 110-116

      When environmental conditions require accurate foot placement during walking (e.g., on a rough path), we typically walk slower to avoid tripping, slipping or stumbling. Likewise, hurrying too much is a common situational circumstance of walking-related falls. This suggests a tradeoff between walking speed and stepping accuracy in situations that demand precise foot placement.

      How can this expected tradeoff between walking speed and stepping accuracy best be parameterized?

      In Experiment 1, participants (n = 20) walked at five different speeds over an irregularly spaced sequence of projected stepping targets. Participants were instructed to place their feet accurately onto the targets, while following a constant-speed cue running alongside the walkway. Stepping accuracy was parameterized as overall (RMSE, root mean square error), variable (VE) and constant (CE) stepping errors, quantified over targets as well as per target. In Experiment 2, we determined preferred walking speed and stepping accuracy for regularly and irregularly spaced stepping targets.

      Repeated-measures ANOVAs revealed that RMSE and VE grew linearly with increasing speeds, both over targets as well as per target. Per target CE varied in magnitude and sign with variations in inter-target spacing: for shorter inter-target spacing targets were overshot (CE > 0), while for longer inter-target spacing targets were undershot (CE < 0). This effect was stronger for faster speeds and for targets preceded by the shortest and longest inter-target spacing. Preferred walking speed and per-target VE did not differ between regularly and irregularly spaced targets.

      (Video) MIMICS of juvenile idiopathic arthritis. prof Sualiman Almayouf

      Participants stepped less precisely when walking faster. The linear increase in VE with faster speeds was consistent with Schmidt’s law regarding the speed-accuracy tradeoff. The systematic comparison of stepping errors over regularly and irregularly spaced stepping-target conditions further provided important clues on how to best parameterize stepping accuracy: per stepping target using VE (i.e., stepping inconsistency), complemented with CE (i.e., stepping bias) in case of irregular inter-target spacing.

    View full text

    © 2021 Elsevier B.V. All rights reserved.

    FAQs

    Juvenile idiopathic arthritis, gait characteristics and relation to function? ›

    Conclusions: Key features of gait in children with JIA include slower gait velocity, shortened step length, decreased range of motion at the hip, knee and ankle with trend towards flexion, decreased joint power, anteriorly tilted pelvis and trunk with shifted center of motion.

    How does RA affect gait? ›

    How does RA affect gait?

    What does juvenile idiopathic arthritis do to your body? ›

    What does juvenile idiopathic arthritis do to your body?

    What are the symptoms of juvenile idiopathic arthritis? ›

    What are the symptoms of juvenile idiopathic arthritis?

    What is the pathophysiology of juvenile idiopathic arthritis? ›

    What is the pathophysiology of juvenile idiopathic arthritis?

    Videos

    1. Juvenile Idiopathic Arthritis (Polyarticular and Oligoarticular )
    (Arab Tube for Rheumatology and Rehabilitation)
    2. Pediatric Gait Analysis Research Excerpts from Dr. Andrea Coda (PhD, Hons (BSc), Pod)
    (Tekscan Medical)
    3. Dr. Gregor Kuntze
    (UofC Kinesiology Seminar Series)
    4. Juvenile rheumatoid arthritis & Marfan
    (Data of our modules)
    5. Wrist Involvement and Etanercept-Related Remission in JIA
    (MDedge: news and insights for busy physicians)
    6. Juvenile Rheumatoid Arthritis: A Case Report
    (DrToddTurnbull)

    You might also like

    Latest Posts

    Article information

    Author: Ouida Strosin DO

    Last Updated: 08/19/2022

    Views: 6232

    Rating: 4.6 / 5 (76 voted)

    Reviews: 91% of readers found this page helpful

    Author information

    Name: Ouida Strosin DO

    Birthday: 1995-04-27

    Address: Suite 927 930 Kilback Radial, Candidaville, TN 87795

    Phone: +8561498978366

    Job: Legacy Manufacturing Specialist

    Hobby: Singing, Mountain biking, Water sports, Water sports, Taxidermy, Polo, Pet

    Introduction: My name is Ouida Strosin DO, I am a precious, combative, spotless, modern, spotless, beautiful, precious person who loves writing and wants to share my knowledge and understanding with you.