Characteristics of Gait Parameters Evaluated with Three Dimensional Gait Analysis Technique in Children with Intoeing Gait
Gait and Motion Analysis Center,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine
Abstract:Objective To study the gait characteristics of the intoeing children and the influencing factors of intoeing children and provide a scientific basis for early assessment and intervention of intoeing children.Methods From January 2019 to September 2021,48 children with intoeing were selected from the outpatient department of Gait and Motion Analysis Center of Yueyang Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.23 males and 25 females were included.The age ranged from 5 to 10 years,with an average of (7.75±1.55)years.At the same time,the 3D gait data of 48 healthy children were collected from the database of normal children,including 29 males and 19 females.The age ranged from 5 to 10 years,with an average of (7.81±2.13)years.To analyze and summarize the characteristics and influencing factors of gait parameters in children with intoeing.Results (1)The spatial and temporal parameters of children with intoeing were increased by step width (P<0.01).(2)The kinematic parameters of children with intoeing group showed that the maximum internal rotation angle of hip joint increased (P<0.05),the maximum flexion angle of hip joint,the maximum internal rotation angle of knee joint and the maximum internal rotation angle of ankle joint increased significantly (P<0.01),and the maximum dorsiflexion angle of ankle joint decreased (P<0.05).(3)The kinetic parameters of children with intoeing showed that the maximum flexion moment of the hip joint increased (P<0.05),the maximum abductor moment and the maximum power decreased (P<0.05),the peak adduction moment and maximum power of knee joint support phase increased significantly (P<0.01)and the maximum plantar-flexion moment of the ankle joint decreased significantly (P<0.01).(4)There was a significant linear relationship between the maximum internal rotation angle of hip,knee and ankle,the maximum dorsiflexion angle of ankle and the maximum abduction moment of hip joint and intoeing (P<0.05).Conclusion The spatiotemporal,kinematic and kinetic parameters of the children with intoeing are significantly different from those of the healthy children.The influencing factors of intoeing are the maximum internal rotation angle of the hip,knee and ankle,the maximum dorsiflexion angle of the ankle and the maximum abduction moment of the hip joint.
[1]曹丹丹,张秀丽,杜高山,等.儿童内八字足底压力特点及矫正效果探析[J].体育科学,2014,34(4):78-83.
[2]Harris E.The intoeing child:Etiology,prognosis,and current treatment options[J].Clin Podiatr Med Surg,2013,30(4):531-565.
[3]Ronald V,Anja H,Juliane M,et al.Is in-toing gait physiological in children?—Results of a large cohort study in 5910 healthy (pre-)school children[J].Gait Posture,2018(66):70-75.
[4]Ahn JK,Kwon DR,Park GY,et al.Therapeutic effect of microcurrent therapy in children with in-toeing gait caused by increased femoral anteversion:A pilot study[J].Ann Rehabil Med,2017,41(1):104-112.
[5]Roth T,Rahm S,Jungwirth-Weinberger A,et al.Restoring range of motion in reduced acetabular version by increasing femoral antetorsion—What about joint load?[J].Clin Biomech,2021(87):105409.
[6]李勇.反向穿鞋治疗儿童内八字足易致踇外翻[D].南京:南京医科大学,2018.
[7]Collins TD,Ghoussayni SN,Ewins DJ,et al.A six degrees-of-freedom marker set for gait analysis:Repeatability and comparison with a modified Helen Hayes set[J].Gait Posture,2009,30(2):173-180.
[8]Byrnes SK,Kunic D,Rethwilm R,et al.Compensatory mechanisms in children with idiopathic lower extremity internal rotational malalignment during walking and running[J].Gait Posture,2020(79):46-52.
[9]Kim H,Son SJ,Seeley MK,et al.Altered movement strategies during jump landing/cutting in patients with chronic ankle instability[J].Scand J Med Sci Sports,2019,29(8):1130-1140.
[10]Pierz KA,Lloyd JR,Solomito MJ,et al.Lower extremity characteristics in recurrent clubfoot:Clinical and gait analysis findings that may influence decisions for additional surgery[J].Gait Posture,2020(75):85-92.
[11]Lima YL,Ferreira VMLM,de Paula Lima PO,et al.The association of ankle dorsiflexion and dynamic knee valgus:A systematic review and metaanalysis[J].Phys Ther Sport,2018(29):61-69.
[12]Müller J,Müller S,Baur H,et al.Intra-individual gait speed variability in healthy children aged 1~15 years[J].Gait Posture,2013,38(4):631-636.
[13]刘宏,肖晟.儿童骨科治疗决策[M].北京:人民卫生出版社,2019:62-110.
[14]Nérot A,Nicholls M.Clinical study on the unloading effect of hip bracing on gait in patients with hip osteoarthritis[J].Prosthet Orthot Int,2017,41(2):127-133.
[15]吕欣,苏日娜,张志峰,等.自体股骨头移植重建髋臼治疗髋关节发育不良的中期疗效[J].实用骨科杂志,2022,28(1):16-19.
[16]张博闻,赵其纯.关节镜下内侧支持带紧缩联合外侧松解术治疗青少年复发性髌骨脱位[J].实用骨科杂志,2022,28(1):80-82.
[17]Lewis CL,Ferris DP.Walking with increased ankle pushoff decreases hip muscle moments[J].J Biomech.2008;41(10):2082-2089.
[18]Pierz KA,Lloyd JR,Solomito MJ,et al.Lower extremity characteristics in recurrent clubfoot:Clinical and gait analysis findings that may influence decisions for additional surgery[J].Gait Posture,2020(75):85-92.
[19]Koshino Y,Ishida T,Yamanaka M,et al.Toe-in landing increases the ankle inversion angle and moment during single-leg landing:implications in the prevention of lateral ankle sprains[J].J Sport Rehabil,2017,26(6):530-535.
[20]Kahf H,Kesbeh Y,van Baarsel E,et al.Approach to pediatric rotational limb deformities[J].Orthop Rev (Pavia),2019,11(3):8118.
[21]DeVita P,Hortobagyi T.Age causes a redistribution of joint torques and powers during gait[J].J Appl Physiol (1985),2000,88(5):1804-1811.
[22]Piitulainen H,Kulmala JP,Maenpaa H,et al.The gait is less stable in children with cerebral palsy in normal and dual-task gait compared to typically developed peers[J].J Biomech,2021(117):110244.
[23]Scorcelletti M,Reeves ND,Rittweger J,et al.Femoral anteversion:significance and measurement[J].J Anat,2020,237(5):811-826.
[24]Mohammad WS,Elsais WM.Association between hip rotation and activation of the quadriceps and gluteus maximus in male runners[J].Orthop J Sports Med,2020,8(11):2325967120962802.
[25]Jacquelin Perry.Gait analysis:Normal and pathological function[M].姜淑云 译.上海:上海科学技术出版社,2017:385-387.