FARKLI NÖROMUSKÜLER HASTALIKLARDA AYAK BİLEĞİ LİMİTASYONUNUN YÜRÜME BECERİSİ ÜZERİNE ETKİSİ
Türk Fizyoterapi ve Rehabilitasyon Dergisi/Turkish Journal of Physiotherapy and Rehabilitation - Tập 25 - Trang 1-6 - 2014
Tóm tắt
In this study, we aimed to investigate the impact of the ankle limitation on the walking ability among two groups that have different spatial distribution of the weakness. In total, 40 children at the levels 1-3 of the Brooke Lower Extremity Scale are included in this study. 20 of them have been diagnosed distal muscle weakness (mean ages: 12.9±3.3 year), and the other 20 have been proximal muscle weakness (mean ages: 9±3.1). The demographic information were recorded. Ankle joint limitation were measured with goniometer. Their ambulatory capacities were evaluated with the 6 minutes walk test (6MWT). Total walking distances in 6 minutes, strolls that taken, step counts, stride lengths, and cadences were saved. There was not any significant difference between the groups with respect to the limitations in ankle joints’ movement and 6 minute total walking distance (p > 0.05). For the other 6MWT walking parametres, there was a statistically significant difference on the stride lengths in the test in favour of (to the good) the group with distal muscle weakness (p< 0.01). There was a negative correlation between the right (r=-0.579, p=0.01) and left (r=-0.445, p= 0.05) ankle dorsiflexion limitations and 6MWT results in the group with proximal muscle weakness. The study showed the importance of the ankle joint motion on walking performance of the individuals beginning from early stages of their neuromuscular diseases (NMD), particularly on the walking performance of the children with muscular dystrophy with proximal muscle weakness.
Tài liệu tham khảo
McDonald CM, Abresch RT, Carter GT, Fowler WM Jr, Johnson ER, Kilmer DD, et al. Profiles of neuromuscular diseases. Duchenne muscular dystrophy. Am J Phys Med Rehabil. 1995;74(5):70–92.
Rose KJ, Burns J, Wheeler DM, North KN. Interventions for increasing ankle range of motion in patients with neuromuscular disease. Cochrane Database Syst Rev. 2010;17(2):CD006973.
Newman CJ, Walsh M, O’Sullivan R, Jenkinson A, Bennett D, Lynch B, et al. The characteristics of gait in Charcot-Marie-Tooth disease types I and II. Gait Posture. 2007;26(1):120–7.
McDonald CM. Limb contractures in progressive neuromuscular disease and the role of stretching, orthotics and surgery. Phys Med Rehabil Clin N Am. 1998;9(1):187–211.
Vignos PJ, Wagner MB, Karlinchak B, Katirji B. Evaluation of a program for long-term treatment of Duchenne muscular dystrophy. Experience at the University Hospitals of Cleveland. J BoneJoint Surg Am. 1996;78(12):1844–52.
Guyton GP. Current concepts review: orthopaedic aspects of Charcot-Marie-Tooth disease. Foot & Ankle International. 2006;27(11):1003–10.
Burns J, Ryan MM, Ouvrier RA. Quality of life in children with Charcot-Marie-Tooth disease. Journal of Child Neurology., 2010;25(3):343-347.
Burns J, Ryan MM, Ouvrier R. Evolution of foot and ankle manifestations in children with CMT type 1A. Muscle and Nerve. 2009a;39:158–66.
Vignos PJ, Spencer GE, Archbald KC. Management of progressive muscular dystrophy of childhood. JAMA. 1963;184(2):89–96.
Farmer SE, Pearce G, Whittall J, Quinlivan RC, Patrick JH. The use of stock orthoses to assist gait in neuromuscular disorders: a pilot study. Prosthet Orthot Int. 2006;30(2):145–54.
Sackley C, Disler PB, Turner-Stokes L, Wade DT, Brittle N, Hoppitt T. Rehabilitation interventions for foot drop in neuromuscular disease. Cochrane Database Syst Rev. 2009;8(3):CD003908.
Brooke MH, Griggs RC, Mendell JR, Fenichel GM, Shumate JB, Pellegrino RJ. Clinical trial in Duchenne dystrophy. I. The design of the protocol. Muscle Nerve. 1981;4(3):186-97.
Otman S, Demirel H, Sade A. Tedavi Hareketlerinde Temel Değerlendirme Prensipleri. H.Ü. Fizik Tedavi ve Rehabilitasyon Yüksekokulu Yayınları; 2003.
Aras B. Musküler distrofili olgularda motor fonksiyon ve dengedeki değişikliklerin incelenmesi. Hacettepe Üniversitesi Doktora Tezi; 2007.
Eng JJ, Chu KS, Dawson AS, Kim CM, Hepburn KE. Functional walk tests in individuals with stroke: relation to perceived exertion and myocardial exertion. Stroke. 2002;33(3):756-61.
McDonald CM, Henricson EK, Han JJ, Abresch RT, Nicorici A, Elfring GL, et al. The 6-minute walk test as a new outcome measure in Duchenne muscular dystrophy. Muscle Nevre. 2010;41(4):500-10.
Am J. ATS statement: guidelines for the six-minute walk test. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. Respir Crit Care Med. 2002;166(1):111-7.
Geiger R, Strasak A, Treml B, Gasser K, Kleinsasser A, Fischer V, et al. Six-minute walk test in children and adolescents. J Pediatr. 2007;150(7):395-99.
Alpar R. Spor Bilimlerinde Uygulamalı İstatistik. Nobel Yayın Dağıtımı. 2006.
Saguil A. Evaluation of the patient with muscle weakness. Am Fam Physician. 2005;71(7):1327-36.
Mastaglia FL, Laing NG. Distal myopathies: clinical and molecular diagnosis and classification. J Neurol Neurosurg Psychiatry. 1999;67(6):703-7.
Horlings CG, Küng UM, van Engelen BG, Voermans NC, Hengstman GJ, van der Kooi AJ, et al. Balance control in patients with distal versus proximal muscle weakness. Neuroscience. 2009;164(4):1876-86.
Horlings CG, van Engelen BG, Allum JH, Bloem BR. A weak balance: the contribution of muscle weakness to postural instability and falls. Nat Clin Pract Neurol. 2008;4(9):504-15.
Hsu JD, Furumasu J. Gait and posture changes in the Duchenne muscular dystrophy child. Clin Orthop Relat Res. 1993;288:122–5.
Hyde SA, Filytrup I, Glent S, Kroksmark AK, Salling B, Steffensen BF, et al. A randomized comparative study of two methods for controlling Tendo Achillescontracture in Duchenne muscular dystrophy. Neuromuscul Disord. 2000;10(4–5):257-63.
Gazendam MG, Hof AL. Averaged EMG profiles in jogging and running at different speeds. Gait Posture. 2007;25(4):604-14.
Sutherland DH, Cooper L, Daniel D. The role of the ankle plantar flexors in normal walking. J Bone Joint Surg Am. 1980;62(3):354-63.
Rose KJ, Burns J, North KN. Relationship between foot strength and motor function in preschool-age children. Neuromuscul Disord. 2009;19(2):104-7.
Carter GT, Abresch RT, Fowler WM, Jr Johnson ER, Kimler DD, McDonald CM. Profiles of neuromuscular diseases. Hereditary motor and sensory neuropathy, types I and II. Am J Phys Med Rehabil. 1995;74(5):140-49.
Burns J, Crosbie J, Hunt A, Ouvrier R. The effect of pes cavus on foot pain and plantar pressure. Clin Biomech. 2005;20(9):877-82.