Article

A better understanding of gait dysfunction for children and youth with
Charcot-Marie-Tooth (CMT) will assist in developing appropriate treatments and
understanding prognosis for ambulation. The purpose of this retrospective study
was to document the typical gait patterns in children and youth
(12+/-4 years)
with CMT using motion analysis and relate these findings back to the clinical
assessment at the ankle. All patients underwent a motion analysis as a component
of treatment decision-making. Lower extremity kinematics and kinetics were
evaluated in comparison to a typically developing age-matched reference control
group collected in the same gait laboratory. Three patient subgroups were defined
based on peak ankle dorsiflexion in terminal stance: greater than typical (n=23),
within typical range (n=30) and less than typical (n=13).
The three subgroups
showed statistically significant differences (p<0.004) in degree of impairment
for ankle plantar flexor and dorsiflexor weakness and ankle plantar flexor
contracture. Patients with excessive dorsiflexion in terminal stance had the
greatest ankle plantar flexor weakness (median 2) and the greatest dorsiflexor
weakness (median 4). Patients with less than typical dorsiflexion in terminal
stance were the only patients with a plantar flexor contracture
(-2+/-9 degrees). Delayed peak dorsiflexion in stance was the most common kinematic finding and
consistent with ankle plantar flexor weakness. All patients showed significantly
less (p<0.001) peak ankle moments and power generation in terminal stance than
the typically developing controls. We concluded that children and youth with CMT
present differently in terms of impairment and associated gait issues which
therefore require patient specific treatment strategies.
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Langue : ANGLAIS