Effect of walking speed on gait parameters in individuals with myotonic dystrophy type 1

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-04-29 DOI:10.1016/j.clinbiomech.2025.106538

Barthélémy Hoerter , Laurent Ballaz , Yosra Cherni

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引用次数: 0

Abstract

Background

Myotonic dystrophy type 1 is a prevalent inherited muscular dystrophy in adults, affecting distal muscles. This leads to significant gait deviations and reduced walking speed, impacting overall well-being and increasing fall risk. This study aimed to assess how walking speed affects gait kinematics in individuals with myotonic dystrophy type 1.

Methods

Eighteen individuals with myotonic dystrophy type 1 (4 women, age: 41.0 [35.5; 47.8] years, mass: 76.8 [67.1; 94.6] kg, height: 166.0 [156.7; 173.3] cm) participated in this study. Each participant walked barefoot along a 13-m walkway at comfortable and fast speeds. Spatiotemporal parameters and joint kinematics were assessed.

Findings

The step length (p < 0.001), cycle speed (p < 0.001), and cadence (p < 0.001) increased significantly, leading to a higher walking speed. Moreover, the vertical excursion of the center of mass increased significantly (p = 0.015), while the mediolateral amplitude decreased (p = 0.001) at fast walking condition. In addition, significant kinematic changes included increased trunk tilt (p < 0.001), greater anterior pelvic tilt (p < 0.001), increased hip flexion at initial contact, and enhanced knee flexion during both stance and swing phases. Ankle dorsiflexion showed a trend towards increase during stance phase (p = 0.055) at fast walking condition.

Interpretation

Fast walking speed in individuals with myotonic dystrophy type 1 lead to significant gait changes. These changes reflect mechanisms to manage muscle weakness. The present study revealed significant changes in spatiotemporal parameters related to walking speed and highlighted kinematic changes in trunk, pelvis and lower limb joints. These findings enhance our understanding of gait mechanisms in this population.

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1型强直性肌营养不良患者步行速度对步态参数的影响

背景：1型肌强直性营养不良症是成人中普遍存在的遗传性肌肉营养不良症，影响远端肌肉。这会导致明显的步态偏差和行走速度降低，影响整体健康并增加跌倒的风险。本研究旨在评估步行速度如何影响1型肌强直性营养不良患者的步态运动学。方法18例1型强直性肌营养不良患者(女性4例，年龄41.0岁；47.8]年，质量：76.8 [67.1；94.6公斤，身高：166.0 [156.7；173.3] cm)参与本研究。每个参与者赤脚以舒适和快速的速度沿着13米长的人行道行走。评估了时空参数和关节运动学。步长(p <；0.001)，循环速度(p <；0.001)，节奏(p <；0.001)显著增加，导致更高的步行速度。此外，快速行走条件下，质心垂直偏移量显著增加（p = 0.015），而中外侧偏移量显著减少（p = 0.001）。此外，显著的运动学变化包括躯干倾斜增加(p <；0.001)，骨盆前倾较大(p <；0.001)，初次接触时髋屈度增加，站立和摇摆阶段膝关节屈度增加。快走状态下，站立阶段踝关节背屈有增加的趋势（p = 0.055）。1型强直性肌营养不良患者的快速步行速度会导致显著的步态变化。这些变化反映了控制肌肉无力的机制。本研究揭示了行走速度相关时空参数的显著变化，并强调了躯干、骨盆和下肢关节的运动学变化。这些发现增强了我们对这一人群步态机制的理解。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.