Hip kinetics during gait are clinically meaningful outcomes in young boys with Duchenne muscular dystrophy

Kent Heberer, Eileen Fowler, Loretta Staudt, Susan Sienko, Cathleen E. Buckon, Anita Bagley, Mitell Sison-Williamson, Craig M McDonald, Michael D. Sussman

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Duchenne muscular dystrophy (DMD) is an X-linked genetic neuromuscular disorder characterized by progressive proximal to distal muscle weakness. The success of randomized clinical trials for novel therapeutics depends on outcome measurements that are sensitive to change. As the development of motor skills may lead to functional improvements in young boys with DMD, their inclusion may potentially confound clinical trials. Three-dimensional gait analysis is an under-utilized approach that can quantify joint moments and powers, which reflect functional muscle strength. In this study, gait kinetics, kinematics, spatial-temporal parameters, and timed functional tests were quantified over a one-year period for 21 boys between 4 and 8 years old who were enrolled in a multisite natural history study. At baseline, hip moments and powers were inadequate. Between the two visits, 12 boys began a corticosteroid regimen (mean duration 10.8 ± 2.4 months) while 9 boys remained steroid-naïve. Significant between-group differences favoring steroid use were found for primary kinetic outcomes (peak hip extensor moments (p = .007), duration of hip extensor moments (p = .007), peak hip power generation (p = .028)), and spatial-temporal parameters (walking speed (p = .016) and cadence (p = .021)). Significant between-group differences were not found for kinematics or timed functional tests with the exception of the 10 m walk test (p = .03), which improves in typically developing children within this age range. These results indicate that hip joint kinetics can be used to identify weakness in young boys with DMD and are sensitive to corticosteroid intervention. Inclusion of gait analysis may enhance detection of a treatment effect in clinical trials particularly for young boys with more preserved muscle function.

Original languageEnglish (US)
Pages (from-to)159-164
Number of pages6
JournalGait and Posture
Volume48
DOIs
StatePublished - Jul 1 2016

Fingerprint

Duchenne Muscular Dystrophy
Gait
Hip
Biomechanical Phenomena
Adrenal Cortex Hormones
Steroids
Clinical Trials
Inborn Genetic Diseases
Motor Skills
Muscle Weakness
Hip Joint
Muscle Strength
Natural History
Randomized Controlled Trials
Joints
Muscles
Therapeutics

Keywords

  • Corticosteroids
  • Duchenne muscular dystrophy
  • Gait analysis
  • Kinetics
  • Outcome measure

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Rehabilitation
  • Biophysics

Cite this

Heberer, K., Fowler, E., Staudt, L., Sienko, S., Buckon, C. E., Bagley, A., ... Sussman, M. D. (2016). Hip kinetics during gait are clinically meaningful outcomes in young boys with Duchenne muscular dystrophy. Gait and Posture, 48, 159-164. https://doi.org/10.1016/j.gaitpost.2016.05.013

Hip kinetics during gait are clinically meaningful outcomes in young boys with Duchenne muscular dystrophy. / Heberer, Kent; Fowler, Eileen; Staudt, Loretta; Sienko, Susan; Buckon, Cathleen E.; Bagley, Anita; Sison-Williamson, Mitell; McDonald, Craig M; Sussman, Michael D.

In: Gait and Posture, Vol. 48, 01.07.2016, p. 159-164.

Research output: Contribution to journalArticle

Heberer, K, Fowler, E, Staudt, L, Sienko, S, Buckon, CE, Bagley, A, Sison-Williamson, M, McDonald, CM & Sussman, MD 2016, 'Hip kinetics during gait are clinically meaningful outcomes in young boys with Duchenne muscular dystrophy', Gait and Posture, vol. 48, pp. 159-164. https://doi.org/10.1016/j.gaitpost.2016.05.013
Heberer, Kent ; Fowler, Eileen ; Staudt, Loretta ; Sienko, Susan ; Buckon, Cathleen E. ; Bagley, Anita ; Sison-Williamson, Mitell ; McDonald, Craig M ; Sussman, Michael D. / Hip kinetics during gait are clinically meaningful outcomes in young boys with Duchenne muscular dystrophy. In: Gait and Posture. 2016 ; Vol. 48. pp. 159-164.
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