Gao Shunxiang, Song Yang, Sun Dong, Cen Xuanzhen, Wang Meizi, Lu Zhenghui, Gu Yaodong
Faculty of Sports Science, Ningbo University, Ningbo, China.
Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong.
Gait Posture. 2025 Sep;121:160-165. doi: 10.1016/j.gaitpost.2025.05.008. Epub 2025 May 24.
Current research on muscular dystrophy primarily focuses on Duchenne muscular dystrophy (DMD) with early onset. However, studies on gait characteristics in Becker muscular dystrophy (BMD) patients with later onset, particularly those diagnosed after the age of 16, remain limited. The late onset of symptoms may disrupt previously established gait patterns, potentially leading to unique compensatory mechanisms and clinical outcomes.
This study aims to investigate gait characteristics and plantar pressure distribution in BMD patients with symptom onset after the age of 16.
Seven male BMD patients diagnosed after the age of 16 and ten healthy male controls were recruited. Changes in gait kinematics and kinetics were analyzed using statistical nonparametric mapping (SnPM), plantar pressure was measured, and symmetry angles (SA) were calculated.
BMD patients exhibited greater anterior pelvic tilt and increased hip flexion during the stance phase (StP), along with higher peak hip extension moments in the early StP, knee hyperextension and insufficient knee extension moments in the early StP, higher knee flexion during the swing phase, and sustained ankle dorsiflexion at the end of the StP. Plantar pressure was increased at the heel, while pressures in the medial and lateral metatarsal regions, as well as the hallux and lesser toes, were significantly lower. SA results indicated a tendency to apply greater pressure on the non-dominant leg.
BMD patients with symptom onset after the age of 16 exhibit gait compensation patterns similar to those observed in some DMD patients, with distinct differences in ankle joint behavior that warrant further investigation. Plantar pressure distribution may serve as potential clinical indicators for assessing disease progression.
目前关于肌肉萎缩症的研究主要集中在早发性杜氏肌营养不良症（DMD）。然而，对于晚发性贝克型肌营养不良症（BMD）患者，尤其是16岁以后确诊的患者的步态特征研究仍然有限。症状的晚发可能会打乱先前建立的步态模式， potentially leading to unique compensatory mechanisms and clinical outcomes.
本研究旨在调查16岁以后出现症状的BMD患者的步态特征和足底压力分布。
招募了7名16岁以后确诊的男性BMD患者和10名健康男性对照。使用统计非参数映射（SnPM）分析步态运动学和动力学的变化，测量足底压力，并计算对称角（SA）。
BMD患者在站立期（StP）表现出更大的骨盆前倾和髋关节屈曲增加，同时在站立早期峰值髋关节伸展力矩更高，站立早期膝关节过度伸展和膝关节伸展力矩不足，摆动期膝关节屈曲更高，站立末期踝关节持续背屈。足跟处的足底压力增加，而内侧和外侧跖骨区域以及拇趾和小趾的压力显著降低。SA结果表明非优势腿有施加更大压力的趋势。
16岁以后出现症状的BMD患者表现出与一些DMD患者相似的步态补偿模式，踝关节行为存在明显差异，值得进一步研究。足底压力分布可能作为评估疾病进展的潜在临床指标。
