The use of the gait profile score and gait variable score in individuals with Duchenne Muscular Dystrophy

Abstract

Therapeutic gait interventions for individuals with Duchenne Muscular Dystrophy (DMD) should be based on understanding how movement of the individual is affected and whether different clusters of individuals, determined by clinical severity, differ. Gait indexes have been developed to synthesize the data provided by the three-dimensional (3D) gait analysis such as the Gait Deviation Index (GDI) and the Gait Profile Score (GPS) where the gait variable score (GVS) can be calculated. The objective this study was to evaluate the potential use of the GDI and GPS and MAP using data from 3D gait analysis of DMD patients. The dimension 1 score of the Motor Function Measurement defined the groups that composed the cluster analysis. Twenty patients with DMD composed 2 groups according to the cluster analysis (Cluster 1, n = 10; Cluster 2, n = 10). Three-dimensional gait analysis was conducted where GDI, GPS and GVS (pelvic tilt/obliquity; hip flexion-extension/adduction-abduction/rotation; knee flexion-extension; ankle dorsiflexion-plantarflexion, foot progression angle) were calculated. Cluster 1 group presented lower hip flexion-extension and lower pelvic obliquity when compared with Cluster 2 group (p < 0.05). There was no difference between groups for GDI, GPS total and maximum isometric muscle strength of the lower limbs (p > 0.05). This study showed that GVS could detect alterations on the parameters obtained using three-dimensional gait analysis for those DMD patients separated according to motor function regarding pelvic and hip kinematic patterns. The rehabilitation of patients with DMD is recommended from the early stages of the disease (as Cluster 1, with >MFM) with the hip joint being the therapeutic target.

Keywords: Duchenne Muscular Dystrophy; Gait; Gait disorders; Gait profile score.