Akademik Veri Yönetim Sistemi
Annual Meeting of the European Society for Movement Analysis in Adults and Children (ESMAC), Oslo, Norveç, 9 - 14 Eylül 2024, cilt.113, (Tam Metin Bildiri)
Introduction
Increased femoral anteversion (IFA) and hypermobility syndrome often coexist in healthy children, affecting standing posture, spine and lower extremity biomechanics [1]. These changes can result in back pain, tripping, falling, and higher risk of musculoskeletal injuries during activities such as jumping and running [2-4]. However, little is known about kinematic trunk alterations during walking in hypermobile individuals with or without IFA. Therefore this study aimed to explore the impact of IFA on trunk and pelvis kinematics during walking in hypermobile children.Research Question
How does increased femoral anteversion affect trunk and pelvic kinematics during walking in hypermobile children?Methods
The study included 24 children divided into three groups: Hyper mobiles with IFA (H-IFA) (male/female:4/6 11±2.44y.o, Trochanteric Prominence Test (TPAT): 39.7°±10.62°), only hypermobiles (H Group; male/female:7/3, 9.7±2.11y.o, TPAT: 17.25°±5.22°) and controls (no-IFA, no-hypermobility; male/female:2/2,11.66±0.57y.o, TPAT:17.16°±4.11°). Hypermobility was defined by Beighton (score ≥5) and lower-extremity hypermobility (score ≥12) tests [5]. Gait kinematics were analyzed by a 3D motion analysis system (VICON Plug-in Gait Model) [6]. Kinematics and spatiotemporal parameters were compared with Student's t-tests.Results
All groups walked at similar gait velocities (p>0.05). In the sagittal plane, hypermobility alone increases the pelvic and trunk ranges and tends to elevate trunk extension. IFA reduced the increased trunk extension (p<0.05). Similarly, hypermobility selectively increases ranges of trunk lateral flexion, pelvic obliquity and hip abd-add in the coronal plane. In the transverse plane, rotational ranges at pelvis and trunk increased by hypermobility, additionally, pelvic rotation increased significantly when combined with the IFA (p<0.05). IFA by itself reduces the peak hip extension and increases both internal rotation of the hip and foot progression. The other interested parameters were shown in Table 1.
Discussion
Hypermobility alone can alter trunk and pelvic kinematics by itself leading to increased ranges of trunk extension, lateral flexion, rotation and pelvic tilt. These alterations pose risks for joint injuries on lower extremity joints and upper body. Therefore, for the hypermobile IFA children, the main kinematic alterations may have originated from hypermobility. However, IFA may be a factor that reduces the increased trunk extension and helps to normalize the sagittal plane trunk kinematics during walking. As expected, the major IFA effects for hyper-mobiles were seen on transverse plane kinematics; pelvis, hip and related foot progression angles. Therefore, for hypermobile children with IFA, IFA itself may not be a contributory factor for rotational trunk-pelvis instabilities. Moreover, IFA may minimize the damaging factor in sagittal plane trunk kinematics. Moreover, due to IFA and hypermobility is commonly seen together in clinics, literature revealed kinematic alterations during walking for children with IFA may be also influenced by hypermobility.References
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