Article

Patients with FSHD suffer from progressive skeletal muscle weakness, which is
associated with an elevated fall risk. To obtain insight into fall mechanisms in
this patient group, we aimed to assess dynamic stability during level walking and
obstacle crossing in patients at different disease stages. Ten patients with at
least some lower extremity weakness were included, of whom six were classified as
moderately affected and four as mildly affected. Ten healthy controls were also
included. Level walking at comfortable speed was assessed, as well as crossing a
10 cm high wooden obstacle. We assessed forward and lateral dynamic stability, as
well as spatiotemporal and kinematics variables. During level walking, the
moderately affected group demonstrated a lower walking speed, which was
accompanied by longer step times and smaller step lengths, yet dynamic stability
was unaffected. When crossing the obstacle, however, the moderately affected
patients demonstrated reduced forward stability margins during the trailing step,
which was accompanied by an increased toe clearance and greater trunk and hip
flexion. This suggests that during level walking, the patients effectively
utilized compensatory strategies for maintaining dynamic stability, but that the
moderately affected group lacked the capacity to fully compensate for the greater
stability demands imposed by obstacle crossing, rendering them unable to maintain
optimal stability levels. The present results highlight the difficulties that
FSHD patients experience in performing this common activity of daily living and
may help explain their propensity to fall in the forward direction.
CI - Copyright (c) 2015 Elsevier B.V. All rights reserved.

Langue : ANGLAIS