The Effect of Improvement in Function on Foot Pressure, Balance and Gait in Children With Upper Extremity Affected

NCT04671524 | Completed

• 1 other identifier: IstanbulUC_34_2
• Study Type: interventional
• Target: 39
• Locations: 1 country
• Sites: 1

Brief Summary

It has been shown that movements of the upper extremity during walking are associated with lower extremity mobility. For example, when walking at a slow pace, the swing frequency of the arms is 2: 1 compared to the legs, while the limb frequency decreases to 1: 1 as the walking speed increases. That is, in order to walk fast, the lower extremity takes advantage of the acceleration of the upper extremity \[1\]. It is known that the muscles of the shoulder girdle also support this oscillating movement in the upper extremity during walking. Thus, it is thought that blocking or restricting shoulder girdle and arm movements during walking increases energy expenditure and heart rate, decreases gait stability, and decreases stride length and walking speed \[2,3\]. However, the possible effects that the upper limb can aid in movement include decreasing vertical displacement of the center of mass, decreasing angular momentum or decreasing ground reaction moment, and increasing walking stability \[2-4\]. In these studies that restrict arm swing, methods such as crossing the arms on the chest \[5\], holding the arm in a sling or pocket \[6\], or fixing the arms to the trunk with a bandage \[7\] were used. Studies have generally been conducted on healthy individuals or on the biomechanical model, and arm swing during walking has not been investigated in pathologies with only upper extremity involvement (upper extremity fractures, Juvenile Idiopathic Arthritis) without any problems with lower extremity and/or walking. This study is aimed to reveal the effects of decreased upper extremity functionality on walking and balance.

Conditions

Upper Extremity Dysfunction; Gait, Unsteady; Juvenile Idiopathic Arthritis; Balance

Keywords

Upper Extremity; Physiotherapy; Exercise; Gait; Balance

Outcome Measures

Primary Outcomes (4)

• Fall risk

  These test results will be evaluated with Biodex Balance device. The test trials are completed on the device at two different conditions, eyes open comfortable stance and eyes closed comfortable stance. The outcome is the sway variation index (SVI).

  immediately after exercise protocol

• Postural Stability

  These test results will be evaluated with Biodex Balance device. The test trials are completed on the device at one condition, eyes open, and automatic foot placement stance. The outcome is the stability index.

  immediately after exercise protocol

• Bilateral Comparison

  These test results will be evaluated with Biodex Balance device. The test trials are completed on the device at two different conditions, the right leg stance and left leg stance. The outcome is the sway index.

  immediately after exercise protocol

• Single limb stance

  This outcome will be evaluated with foot pressure analysis. The time between first and second peak forces during walking is the single-limb stance duration.

  immediately after exercise protocol

Secondary Outcomes (2)

• Arm Swing Amplitude

  immediately after exercise protocol

• Jebsen-Taylor Hand Function Test

  immediately after exercise protocol

Study Arms (2)

pediatric patients diagnosed with rheumatic diseases.

EXPERIMENTAL

Exercise group; a combination of stretching, range of motion, and strengthening exercise. The exercise program will take 8 weeks, 3 days per week, and 45 minutes.

Other: Exercise protocol

healthy controls

NO INTERVENTION

The healthy control group will be examined and the outcomes will be compared with the experimental group.

Interventions

Exercise protocol OTHER

a combination of stretching, range of motion, and strengthening exercise.

pediatric patients diagnosed with rheumatic diseases.

Eligibility Criteria

• Age: 10 Years - 18 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• To be in the 10-18 ages group (In order for the devices to comply with the minimum measurement criteria and to be able to cooperate with the study)
• Being diagnosed with rheumatic diseases at least 6 months ago with only upper extremity affected
• Unilateral upper extremity involvement

You may not qualify if:

• Having an acute pathology that could affect walking
• To be diagnosed with orthopedic/neurological pathology that will affect work and cooperation

Sponsors & Collaborators

• Istanbul University - Cerrahpasa: lead

Study Sites (1)

Istanbul University-Cerrahpaşa

Istanbul, Turkey (Türkiye)

Location

Related Publications (15)

• Wagenaar RC, van Emmerik RE. Resonant frequencies of arms and legs identify different walking patterns. J Biomech. 2000 Jul;33(7):853-61. doi: 10.1016/s0021-9290(00)00020-8.

  PMID: 10831760 BACKGROUND

• Bruijn SM, Meijer OG, Beek PJ, van Dieen JH. The effects of arm swing on human gait stability. J Exp Biol. 2010 Dec 1;213(Pt 23):3945-52. doi: 10.1242/jeb.045112.

  PMID: 21075935 BACKGROUND

• Meyns P, Bruijn SM, Duysens J. The how and why of arm swing during human walking. Gait Posture. 2013 Sep;38(4):555-62. doi: 10.1016/j.gaitpost.2013.02.006. Epub 2013 Mar 13.

  PMID: 23489950 BACKGROUND

• Collins SH, Adamczyk PG, Kuo AD. Dynamic arm swinging in human walking. Proc Biol Sci. 2009 Oct 22;276(1673):3679-88. doi: 10.1098/rspb.2009.0664. Epub 2009 Jul 29.

  PMID: 19640879 BACKGROUND

• Pontzer H, Holloway JH 4th, Raichlen DA, Lieberman DE. Control and function of arm swing in human walking and running. J Exp Biol. 2009 Feb;212(Pt 4):523-34. doi: 10.1242/jeb.024927.

  PMID: 19181900 BACKGROUND

• Kuhtz-Buschbeck JP, Jing B. Activity of upper limb muscles during human walking. J Electromyogr Kinesiol. 2012 Apr;22(2):199-206. doi: 10.1016/j.jelekin.2011.08.014. Epub 2011 Sep 25.

  PMID: 21945656 BACKGROUND

• Yizhar Z, Boulos S, Inbar O, Carmeli E. The effect of restricted arm swing on energy expenditure in healthy men. Int J Rehabil Res. 2009 Jun;32(2):115-23. doi: 10.1097/MRR.0b013e32830d3675.

  PMID: 19065107 BACKGROUND

• Behrman AL, Harkema SJ. Locomotor training after human spinal cord injury: a series of case studies. Phys Ther. 2000 Jul;80(7):688-700.

  PMID: 10869131 BACKGROUND

• Meyns P, Van Gestel L, Massaad F, Desloovere K, Molenaers G, Duysens J. Arm swing during walking at different speeds in children with Cerebral Palsy and typically developing children. Res Dev Disabil. 2011 Sep-Oct;32(5):1957-64. doi: 10.1016/j.ridd.2011.03.029. Epub 2011 May 4.

  PMID: 21531534 BACKGROUND

• Stephenson JL, Lamontagne A, De Serres SJ. The coordination of upper and lower limb movements during gait in healthy and stroke individuals. Gait Posture. 2009 Jan;29(1):11-6. doi: 10.1016/j.gaitpost.2008.05.013. Epub 2008 Jul 11.

  PMID: 18620861 BACKGROUND

• Ford MP, Wagenaar RC, Newell KM. Arm constraint and walking in healthy adults. Gait Posture. 2007 Jun;26(1):135-41. doi: 10.1016/j.gaitpost.2006.08.008. Epub 2006 Sep 25.

  PMID: 16997561 BACKGROUND

• Kim HD, Kim JG, Jeon DM, Shin MH, Han N, Eom MJ, Jo GY. Analysis of Vertical Ground Reaction Force Variables Using Foot Scans in Hemiplegic Patients. Ann Rehabil Med. 2015 Jun;39(3):409-15. doi: 10.5535/arm.2015.39.3.409. Epub 2015 Jun 30.

  PMID: 26161347 BACKGROUND

• Grodner MR, Dudzinski K, Zdrajkowski Z, Molik A, Nosarzewska A. Selected gait parameters in children with obstetric brachial plexus injury (OBPI) - a pilot study. Ortop Traumatol Rehabil. 2012 Nov-Dec;14(6):555-68. doi: 10.5604/15093492.1024721.

  PMID: 23382283 BACKGROUND

• Cohen-Holzer M, Sorek G, Schless S, Kerem J, Katz-Leurer M. The Influence of a Constraint and Bimanual Training Program Using a Variety of Modalities, on Upper Extremity Functions and Gait Parameters Among Children with Hemiparetic Cerebral Palsy: A Case Series. Phys Occup Ther Pediatr. 2016;36(1):17-27. doi: 10.3109/01942638.2014.990549. Epub 2014 Dec 18.

  PMID: 25521486 BACKGROUND

• Zhou R, Alvarado L, Ogilvie R, Chong SL, Shaw O, Mushahwar VK. Non-gait-specific intervention for the rehabilitation of walking after SCI: role of the arms. J Neurophysiol. 2018 Jun 1;119(6):2194-2211. doi: 10.1152/jn.00569.2017. Epub 2018 Jan 24.

  PMID: 29364074 BACKGROUND

MeSH Terms

Conditions

Gait Disorders, Neurologic; Arthritis, Juvenile; Motor Activity

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Connective Tissue Diseases; Skin and Connective Tissue Diseases; Autoimmune Diseases; Immune System Diseases; Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physiotherapist

Study Record Dates

• First Submitted: December 5, 2020
• First Posted: December 17, 2020
• Study Start: September 15, 2020
• Primary Completion: July 1, 2021
• Study Completion: July 1, 2021
• Last Updated: April 5, 2022

Record last verified: 2022-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)