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Introduction: Scoliosis influences the body and the pelvic region, a major determinant of gait. The effect on pelvic locomotion throughout the gait cycle of this entity is of major interesting. Purpose: To study the hip joint and center of gravity (CoG) locomotion in young adults with Moderate Idiopathic Scoliosis (MIS) compared to healthy population during the gait cycle. Aim of the study was also the differences in-between lower extremities of scoliosis patients. Methods: A cohort of twenty young adults (group A) having MIS and a control group (B) of fifteen healthy individuals were submitted in 3-D gait analysis with direct linear transformation method. The parameters examined were concerning the displacement of the hip joint (greater trochanter) and the CoG on x, y and z axes. Additionally, the gait cycle duration was examined. Results: Mid leg length discrepancy (1.2 cm ± 0.2, C.I 95%) was evident in scoliosis patients. Regarding side to side comparison of the lower extremities in group A the following outcomes were identified: Hip and CoG had increased sagittal (forward/backward) displacement on the ipsilateral side (to scoliosis curve) compared to the controlateral side, p < 0.05. When comparing group A to group B the following differences were found (p < 0.05): (a) gait cycle in group A had increased duration compared to group B (an average from both extremities), (b) the hip in the ipsilateral side demonstrated increased frontal displacement (medial/lateral), (c) the hip in the controlateral side had increased frontal displacement and decreased sagittal displacement and (d) the CoG in the controlateral side had decreased sagittal displacement. Discussion: Scoliosis patients presented asymmetries in-between sides of the body regarding hip and CoG displacement at the sagittal axis. Produced higher lateral sway area and controlateral reduced sagittal motion than normal subjects. The gait cycle had increased duration compared to healthy people. The kinematic analysis combined to the clinical examination can create a basis for conservative intervention as well as further studies on biomechanics of MIS.

Článek

Behaviour of the knee and ankle joint during gait cycle of young adults with moderate idiopathic scoliosis. A controlled study [Chování kolenního a hlezenního kloubu při chůzi mladých dospělých se střední idiopatickou skoliózou, řízená studie]

Acta Universitatis Carolinae. Kinanthropologica. 2012 ; 48 (1) : 5-26. (Kinanthropologica)

Acta Univ. Carol., Kinanthropologica
ISSN 1212-1428
Medvik
Zdroj

Introduction: Scoliosis influences the optimal posture of the human body. The effect on the gait cycle of this entity is of major interesting. Purpose: Young adults with moderate idiopathic scoliosis (MIS) present kinematic modifications regarding the convex or concave side of the body compared to healthy people. Aim was to identify these variations. Methods: A cohort of twenty young adults (group A) having MIS and a control group (B) of fifteen healthy individuals were submitted in 3-D gait analysis with direct linear transformation method. The parameters examined were concerning the displacement of the knee and the ankle joints on x, y and z axes. The gait cycle and the knee range of motion were examined. Results: Gait cycle in scoliosis patients showed increased duration compared to healthy people, p<0,05. Regarding side to side comparison of the lower extremities in scoliosis patients the following outcomes were identified: Knee and ankle joint displacement in the ipsilateral (convex) side was increased regarding sagittal axis (x), p<0,05. When compared both groups the following differences found, p<0,05: The knee joint in the ipsilateral side (group A) had increased mean (z) frontal displacement. In the controlateral side (concave) of group A had decreased mean sagittal displacement and increased mean frontal and mean vertical (y) displacement. The ankle joint in the ipsilateral side had increased mean sagittal and frontal displacement. In the controlateral side had increased mean frontal displacement. The knee range of motion during the phases of gait cycle in scoliosis patients was seriously reduced compared to control group, p<0,05. Discussion: Asymmetries observed amongst the lower extremities during the gait cycle of scoliosis patients. Also asymmetries observed in comparison to healthy people. Some of these asymmetries agree to other studies. A compensatory walking close to normal walking existed. These observations might prove to be helpful in treating the gait cycle of young adults with MIS.

Klíčová slova
kolenní a hlezenní kloub,
MeSH
audiovizuální záznam MeSH
biomechanika MeSH
chůze (způsob) fyziologie MeSH
chůze * fyziologie statistika a číselné údaje MeSH
dospělí MeSH
fyziologická adaptace MeSH
hlezenní kloub fyziologie patofyziologie MeSH
kolenní kloub * fyziologie patofyziologie MeSH
lidé MeSH
mladý dospělý MeSH
počítačové zpracování obrazu MeSH
rozsah kloubních pohybů MeSH
skolióza * komplikace patofyziologie MeSH
statistika jako téma MeSH
studie případů a kontrol MeSH
zatížení muskuloskeletálního systému MeSH
Check Tag
dospělí MeSH
lidé MeSH
mladý dospělý MeSH
mužské pohlaví MeSH
ženské pohlaví MeSH

Článek

Fatální komplikace tracheostomie u třináctiletého pacienta s Duchenneovou svalovou dystrofií – kazuistika
[Fatal complication of tracheostomy in a 13-year-old patient with Duchenne Muscular Dystrophy – case report]

Stříteská, Jana
Autor Autorita
Černá Pařízková, Renata, 1962-
Autor Autorita ORCID
Dostál, Pavel, 1966-
Autor Autorita
Hoffmann, Petr
Autor Autorita
Černý, Vladimír, 1960-
Autor Autorita

Anesteziologie a intenzivní medicína. 2009 ; 20 (2) : 107-112.

ISSN 1214-2158
Medvik
Zdroj

Autoři popisují případ třináctiletého chlapce s Duchenneovou svalovou dystrofií, u něhož došlo při progresi základního onemocnění k rozvoji chronické respirační insuficience s nutností trvalé ventilační podpory. Provedená tracheostomie byla komplikována zúžením průdušnice, řešeném konzervativně speciálními typy tracheostomických kanyl. Při progresi deformit skeletu hrudníku a zúžení průdušnice došlo ke vzniku tracheoarteriální komunikace. Pacient zemřel v důsledku masivního arteriálního krvácení z píštěle mezi průdušnicí a truncus brachiocephalicus.

The authors describe a case of a 13-year-old boy suffering from Duchenne muscular dystrophy. Permanent mechanical ventilation was necessary due to the patient's progressive chronic respiratory insufficiency. A surgical tracheostomy was complicated by the development of tracheal stenosis managed with special types of tracheostomy tubes. A tracheo-arterial fistula developed as a result of progression of skeletal chest deformities and the tracheal stenosis. The patient died of massive arterial haemorrhage from the fistula formed between the trachea and the brachiocephalic trunk.

MeSH
cévní píštěle komplikace MeSH
dítě MeSH
Duchennova muskulární dystrofie komplikace MeSH
krvácení při operaci mortalita MeSH
lidé MeSH
respirační insuficience terapie MeSH
skolióza komplikace MeSH
stenóza průdušnice komplikace MeSH
tracheostomie škodlivé účinky MeSH
Check Tag
dítě MeSH
lidé MeSH
Publikační typ
kazuistiky MeSH

Článek

Novel EGR2 mutation R359Q is associated with CMT type 1 and progressive scoliosis

Neuromuscular disorders. 2005 ; 15 (11) : 764-767.

ISSN 0960-8966
Medvik
Zdroj

Mutations in the early growth response 2 gene (EGR2) cause demyelinating neuropathies differing in severity and age of onset. We tested 46 unrelated Czech patients with dominant or sporadic demyelinating CMT neuropathy for mutations in the EGR2 gene. One novel de-novo mutation (Arg359Gln, R359Q) was identified in heterozygous state in a patient with a typical CMT1 phenotype, progressive moderate thoracolumbar scoliosis and without clinical signs of cranial nerve dysfunction. This patient is presently less affected compared to previously described Dejerine-Sottas neuropathy (DSN) patients carrying another substitution at codon 359 (Arg359Trp, R359W). This report shows that EGR2 mutations are rare in Czech patients with demyelinating type of CMT and suggests that different substitutions at codon 359 of EGR2 can cause significantly different phenotypes.