Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy.
IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Strada Luigi Cadorna 90, 28824, Piancavallo, Italy.
J Endocrinol Invest. 2024 Oct;47(10):2469-2476. doi: 10.1007/s40618-024-02340-3. Epub 2024 Feb 28.
In acromegaly, skeletal complications resulted to be associated with low quality of life (QoL) and high risk of falls. The aim of the present study was to perform a quantitative assessment of movement through gait analysis technique in patients with acromegaly.
Thirty-three acromegalic patients [9 with active disease (AD), 14 with controlled disease (CD) and 10 with disease remission (RD)] and 20 healthy subjects were enrolled for the study.
Kinetic and kinematic data were collected with 3D-gait analysis. Kinematic data were processed to compute the Gait Profile Score (GPS), a parameter that summarizes the overall deviation of kinematic gait data relative to unaffected population.
The acromegalic group showed longer stance phase duration (p < 0.0001) compared to controls. The GPS and several gait variable scores resulted to be statistically higher in the acromegalic group compared to healthy controls. GPS values were significantly higher in AD compared to CD (p < 0.05) and RD groups (p = 0.001). The AD group presented significantly higher values in terms of hip rotation and ankle dorsiflexion compared to CD and RD groups and with regard to the foot progression compared to RD. Interestingly, patients with RD exhibited a more physiological gait pattern.
Acromegalic patients showed quantitative alterations of gait pattern, suggesting instability and increased risk of falls. Arthropathy, along with its associated abnormal joint loading, proprioceptive impairment and hyperkyphosis could be contributing factors. Disease control and remission appear to improve postural balance. A better knowledge on walking performance in acromegaly would help to develop specific rehabilitation programmes to reduce falls' risk and improve QoL.
肢端肥大症可导致骨骼并发症,与生活质量(QoL)降低和跌倒风险增加相关。本研究旨在通过步态分析技术对肢端肥大症患者的运动进行定量评估。
本研究纳入 33 例肢端肥大症患者[9 例疾病活动(AD),14 例疾病控制(CD),10 例疾病缓解(RD)]和 20 例健康对照者。
使用三维步态分析收集动力学和运动学数据。对运动学数据进行处理以计算步态轮廓评分(GPS),该参数可总结运动学步态数据相对于未受影响人群的整体偏差。
与对照组相比,肢端肥大症组的站立相持续时间更长(p<0.0001)。与健康对照组相比,肢端肥大症组的 GPS 和多个步态变量评分显著更高。AD 组的 GPS 值明显高于 CD 组(p<0.05)和 RD 组(p=0.001)。AD 组与 CD 组和 RD 组相比,髋关节旋转和踝关节背屈角度明显更大,与 RD 组相比,足前进步幅明显更大。有趣的是,RD 组患者表现出更生理性的步态模式。
肢端肥大症患者的步态模式存在定量改变,提示其存在不稳定和跌倒风险增加。关节病以及相关的关节异常负荷、本体感觉障碍和脊柱后凸可能是促成因素。疾病控制和缓解似乎可改善姿势平衡。更深入地了解肢端肥大症患者的步行表现有助于制定特定的康复计划,以降低跌倒风险和提高生活质量。