The Impact of Postural and Anthropometric Properties of the Foot and Ankle on the Physical Performance and Ambulation of Patients with Duchenne Muscular Dystrophy.

Abstract

Background: Abnormal foot anthropometry and posture of patients with Duchenne muscular dystrophy (DMD) can be considered as possible risk factors for performance and ambulation. We aimed to examine the effects of foot posture and anthropometric characteristics, which deteriorated from the early period, on the ambulation and performance of patients with DMD.

Methods: The foot arch height, metatarsal width, subtalar pronation angle, and ankle limitation degree were evaluated to determine the foot anthropometric characteristics of the patients. The Foot Posture Index-6 was used to evaluate foot posture. Performance of the patients was determined by the 6-minute walk test (6MWT), the 10-meter walk test, and the ascend/descend four standard steps test, and ambulation was determined by the North Star Ambulatory Assessment (NSAA). Spearman correlation coefficient was calculated to assess the relationship between foot anthropometric characteristics and posture and performance and ambulation.

Results: The sample consisted of 48 patients with DMD aged 5.5 to 12 years. Foot Posture Index-6 scores for both the right and left feet were associated with all the parameters except descending four steps. Left foot arch height was associated with 6MWT and NSAA, and left metatarsal width was associated with 6MWT. Ankle limitation degree of the right foot was associated with 6MWT, ascending/descending four steps, and NSAA and of the left foot was associated with NSAA (P < .05). There was no relationship between other parameters.

Conclusions: These findings suggest that postural disorders in the foot and ankle may contribute to the decrease in performance and ambulation in patients with DMD.