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

Patterns of walking have been analysed in 19 subjects with Juvenile Chronic Arthritis by means of a computerized method for gait analysis. Stride-temporal parameters, kinematic variables, ground reactions and kinetics have been quantitated and compared to control data from a group of normal subjects. Enhanced hip flexion, reduced knee extension at late stance phase, reduced ankle plantar flexion at late stance/early swing were the most evident kinematic changes. Accordingly the joint moments and joint powers were altered, and in particular they were enhanced at the hip and reduced at the knee and the ankle. Ground reaction forces exhibited a reduction in the peaks of load acceptance and push-off. All these alterations can be interpreted as compensations to protect the most affected joints, that were in most cases the knees. Patients who suffered from pain exhibited the larger deviations. As the changes were also observed in joints not directly affected by the disease and these changes tend to be quite symmetric, the risk of secondary alterations must be taken into consideration. In this respect gait analysis proved to be particularly suitable to detect early signs of functional alterations, to monitor the evolution of those signs, and to plan the most useful intervention.