La marcha en niños con AMC

Las contracturas de los miembros inferiores y la debilidad muscular son comunes en los niños con artrogriposis múltiple congénita (AMC). Para facilitar la marcha se deben utilizar férulas. El estudio de la marcha según el uso de ortosis en 3D muestra diferencias entre los grupos estudiados en cuanto al movimiento del tronco, pelvis y rodilla y en el ritmo y rapidez de la marcha, si bien la longitud del paso es similar.

Gait in children with arthrogryposis multiplex congenita.
Eriksson M, Gutierrez-Farewik EM, Broström E, Bartonek A.

Abstract
PURPOSE: Lower limb contractures and muscle weakness are common in children with arthrogryposis multiplex congenita (AMC). To enhance or facilitate ambulation, orthoses may be used. The aim of this study was to describe gait pattern among individuals wearing their habitual orthotic devices.

METHODS: Fifteen children with AMC, mean age 12.4 (4.3) years, with some lower limb involvement underwent 3-D gait analysis. Three groups were defined based on orthosis use; Group 1 used knee-ankle-foot orthoses with locked knee joints, Group 2 used ankle-foot orthoses or knee-ankle-foot orthoses with open knee joints and Group 3 used no orthoses.

RESULTS: The greatest trunk and pelvis movements in all planes and the greatest hip abduction were observed in Group 1, compared to Groups 2 and 3, as well as to the gait laboratory control group. Maximum hip extension was similar in Groups 1 and 2, but in Group 3, there was less hip extension and large deviations from the control data. Lower cadence and walking speed were observed in Group 1 than in Groups 2 and 3. The step length was similar in all groups and also with respect to the gait laboratory reference values.