Discipline of Podiatry, College of Science, Health, and Engineering, La Trobe University, Melbourne, VIC, 3086, Australia.
Department of Pediatrics (Physiotherapy), Jaslok Hospital and Research Center, Mumbai, India.
Rheumatol Int. 2018 Jul;38(7):1251-1258. doi: 10.1007/s00296-018-4056-7. Epub 2018 May 24.
Paediatric leg pains, long described as 'growing pains', frequently present to clinicians, are prevalent in early childhood, disrupt sleep, and distress affected children and parents. There are many cited associations, but no defined leg pain sub-types, nor revealed predictive factors. We explored the implicated factors (viz. foot arches, foot strength, joint mobility, vitamin D, iron) in children with leg pain versus a control group. Leg pain sub-groups-growing pains (GP), restless legs (RLS), both (mixed)-are defined for the first time. A case controlled study design, in a primary care setting, Mumbai, India. A total of 77 children with leg pains (n = 64) and controls (n = 13), aged 3-12 years, identified by paediatricians, completed data collection. Blood assays for iron and vitamin D, pain, Beighton score, foot arch, foot strength and anthropometrical data were collected. All outcome measures were validated, with standardised protocols. Leg pain (all groups) was predicted by increased joint mobility and increased ankle dorsiflexion strength (β = 0.56, P < 0.05). GP sub-group was predicted by increased ankle dorsiflexion strength (β = - 0.06, P < 0.05). Mixed (GP/RLS) and RLS sub-groups were predicted by increased ankle dorsiflexion strength (β = 0.66, P < 0.05) and pain questionnaire (β = 0.11, P < 0.05). Hypovitaminosis D was detected in 87% of the sample, and anaemia in 13%. Increased strength of ankle dorsiflexors and joint flexibility were each found predictive for leg pain. Increased body weight, waist girth, and BMI were all associated with leg pain.
儿科腿部疼痛，长期以来被描述为“生长痛”，经常会向临床医生报告，在幼儿中很普遍，会扰乱睡眠，并使受影响的儿童和家长感到痛苦。有许多相关的关联，但没有定义腿部疼痛的亚型，也没有揭示预测因素。我们探讨了腿部疼痛患儿与对照组之间涉及的因素（即足弓、足部力量、关节活动度、维生素 D、铁）。首次定义了腿部疼痛的亚组-生长痛（GP）、不宁腿综合征（RLS）、两者（混合）。在印度孟买的初级保健环境中，采用病例对照研究设计。共 77 名腿部疼痛儿童（n=64）和对照组（n=13），年龄 3-12 岁，由儿科医生确定，完成了数据收集。采集了铁和维生素 D、疼痛、Beighton 评分、足弓、足部力量和人体测量学数据的血液检测。所有的结果测量都是经过验证的，有标准化的方案。腿部疼痛（所有组）由关节活动度增加和踝关节背屈力量增加预测（β=0.56，P<0.05）。GP 亚组由踝关节背屈力量增加预测（β=-0.06，P<0.05）。混合（GP/RLS）和 RLS 亚组由踝关节背屈力量增加（β=0.66，P<0.05）和疼痛问卷（β=0.11，P<0.05）预测。在样本中检测到 87%的维生素 D 缺乏症和 13%的贫血。踝关节背屈肌力量增加和关节柔韧性增加都被发现与腿部疼痛有关。体重增加、腰围增加和 BMI 增加都与腿部疼痛有关。
