Linking joint impairment and gait biomechanics in patients with juvenile idiopathic arthritis
File(s)Montefiori2019_Article_LinkingJointImpairmentAndGaitB.pdf (1.36 MB)
Published version
Author(s)
Type
Journal Article
Abstract
Juvenile Idiopathic Arthritis (JIA) is a paediatric musculoskeletal disease of unknown aetiology, leading to walking alterations when the lower-limb joints are involved. Diagnosis of JIA is mostly clinical. Imaging can quantify impairments associated to inflammation and joint damage. However, treatment planning could be better supported using dynamic information, such as joint contact forces (JCFs). To this purpose, we used a musculoskeletal model to predict JCFs and investigate how JCFs varied as a result of joint impairment in eighteen children with JIA. Gait analysis data and magnetic resonance images (MRI) were used to develop patient-specific lower-limb musculoskeletal models, which were evaluated for operator-dependent variability (< 3.6°, 0.05 N kg-1 and 0.5 BW for joint angles, moments, and JCFs, respectively). Gait alterations and JCF patterns showed high between-subjects variability reflecting the pathology heterogeneity in the cohort. Higher joint impairment, assessed with MRI-based evaluation, was weakly associated to overall joint overloading. A stronger correlation was observed between impairment of one limb and overload of the contralateral limb, suggesting risky compensatory strategies being adopted, especially at the knee level. This suggests that knee overloading during gait might be a good predictor of disease progression and gait biomechanics should be used to inform treatment planning.
Date Issued
2019-11
Date Acceptance
2019-05-08
Citation
Annual Review of Biomedical Engineering, 2019, 47 (11), pp.2155-2167
ISSN
1523-9829
Publisher
Springer US
Start Page
2155
End Page
2167
Journal / Book Title
Annual Review of Biomedical Engineering
Volume
47
Issue
11
Copyright Statement
© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/31111329
PII: 10.1007/s10439-019-02287-0
Subjects
Biomechanics
Gait analysis
Juvenile arthritis
Lower-limb
MRI
Musculoskeletal
Musculoskeletal modelling
Opensim
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2019-05-20