The Association Between Lumbar Lordosis and Functional Performance in Children with Duchenne Muscular Dystrophy
Year 2024,
Volume: 8 Issue: 2, 433 - 440, 31.05.2024
Numan Bulut
,
İpek Gürbüz
,
Öznur Tunca Yılmaz
Abstract
Purpose: The aims of this study were to compare the lumbar lordosis measured with flexible ruler between healthy peers and children with Duchenne Muscular Dystrophy (DMD) and to investigate the relationship between lumbar lordosis and functional performance in children with DMD.
Material and Methods: This study included 20 children with DMD (median age: 8.29 years) and 10 healthy peers (median age: 7.96 years). Lumbar lordosis and postural alignment were assessed with flexible ruler and New York Posture Rating (NYPR), succesively. Functional performance was evaluated with Motor Function Measure and timed performance tests.
Results: Demographic characteristics of children with DMD and healthy peers were similar (p>0.05). Children with DMD (median angle: 46.58 degrees) had a higher degree of lumbar lordosis than their healthy peers (median angle: 36.10 degrees) (p<0.001). Besides, children with DMD had greater disturbance according to NYPR (p=0.002). Both the degree of lumbar lordosis and NYPR scores were moderately to strongly related to the functional performance (p<0.005, rs:0.5 - 0.8 and -0.5 - -0.8).
Conclusion: Assessment of lumbar lordosis using a flexible ruler in DMD may be an alternative method for both in differentiating between healthy and pathological status of postural change, and to predict disease prognosis.
Ethical Statement
Approval for the study was obtained from the Hacettepe University Non-Interventional Clinical Studies Ethics Board (GO 22/1020). Written informed consent was obtained from children and their families, and the study was conducted in accordance with the Declaration of Helsinki
Supporting Institution
None
Project Number
GO 22/1020
Thanks
We would like to thank the children and their families who agreed to participate in the study.
References
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- Kinali M, Main M, Mercuri E, Muntoni F. Evolution of abnormal postures in Duchenne muscular dystrophy. Ann Indian Acad Neurol 2007;10(5):44-54.
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- Case LE, Apkon SD, Eagle M, et al. Rehabilitation management of the patient with Duchenne muscular dystrophy. Pediatrics 2018;142(Supplement_2):17-33.
- Govoni A, Magri F, Brajkovic S, et al. Ongoing therapeutic trials and outcome measures for Duchenne muscular dystrophy. Cell Mol Life Sci 2013;70:4585-602.
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- Youdas JW, Garrett TR, Harmsen S, Suman VJ, Carey JR. Lumbar lordosis and pelvic inclination of asymptomatic adults. Phys Ther 1996;76 10):1066-1081.
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- Choi Y-A, Chun S-M, Kim Y, Shin H-I. Lower extremity joint contracture according to ambulatory status in children with Duchenne muscular dystrophy. BMC Musculoskelet Disord 2018;19(1):1-6.
- Hsu JD, Furumasu J. Gait and posture changes in the Duchenne muscular dystrophy child. Clin Orthop Relat Res 1993;288:122-125.
- Vuillerot C, Girardot F, Payan C, et al. Monitoring changes and predicting loss of ambulation in Duchenne muscular dystrophy with the Motor Function Measure. Dev Med Child Neurol 2010;52(1):60-5.
- Alkan H, Mutlu A, Fırat T, Bulut N, Karaduman AA, Yılmaz ÖT. Effects of functional level on balance in children with Duchenne Muscular Dystrophy. Eur J Paediatr Neurol 2017;21(4):635-8.
- Fowler EG, Staudt LA, Heberer KR, et al. Longitudinal community walking activity in Duchenne muscular dystrophy. Muscle Nerve 2018;57(3):401-6.
- Silva ECd, Machado DL, Resende MB, Silva RF, Zanoteli E, Reed UC. Motor function measure scale, steroid therapy and patients with Duchenne muscular dystrophy. Arq Neuro-Psiquiatr 2012;70(3):191-195.
- Beenakker EA, Maurits NM, Fock JM, Brouwer OF, van der Hoeven JH. Functional ability and muscle force in healthy children and ambulant Duchenne muscular dystrophy patients. Eur J Paediatr Neurol. 2005;9(6):387-93.
- Nunes MF, Hukuda ME, Favero FM, Oliveira AB, Voos MC, Caromano FA. Relationship between muscle strength and motor function in Duchenne muscular dystrophy. Arq Neuro-Psiquiatr 2016;74:530-5.
- Aydın Yağcıoğlu G, Yılmaz Ö, Alemdaroğlu Gürbüz İ, et al. Examination of the relationship between foot-body posture and balance and gait in Duchenne muscular dystrophy. Ir J Med Sci 2023;192(4):1883-1888.
The Association Between Lumbar Lordosis and Functional Performance in Children with Duchenne Muscular Dystrophy
Year 2024,
Volume: 8 Issue: 2, 433 - 440, 31.05.2024
Numan Bulut
,
İpek Gürbüz
,
Öznur Tunca Yılmaz
Project Number
GO 22/1020
References
- C Crisafulli S, Sultana J, Fontana A, Salvo F, Messina S, Trifirò G. Global epidemiology of Duchenne muscular dystrophy: an updated systematic review and meta-analysis. Orphanet J Rare Dis 2020;15(1):1-20.
- Hainsey T, Senapati S, Kuhn D, Rafael J. Cardiomyopathic features associated with muscular dystrophy are independent of dystrophin absence in cardiovasculature. Neuromuscul Disord 2003;13(4):294-302.
- Baptista CR, Costa AA, Pizzato TM, Souza FB, Mattiello-Sverzut AC. Postural alignment in children with Duchenne muscular dystrophy and its relationship with balance. Braz J Phys Ther 2014;18(2):119-126.
- Sá CdSCd, Fagundes IK, Araújo TB, Oliveira ASB, Fávero FM. The relevance of trunk evaluation in Duchenne muscular dystrophy: the segmental assessment of trunk control. Arq Neuro-Psiquiatr 2016;74 (10):791-795.
- Mazzone E, Vasco G, Sormani M, et al. Functional changes in Duchenne muscular dystrophy: a 12-month longitudinal cohort study. Neurology 2011;77(3):250-256.
- MCDonald CM, Henricson EK, Han JJ, et al. The 6‐minute walk test in Duchenne/Becker muscular dystrophy: longitudinal observations. Muscle Nerve 2010;42(6):966-974.
- P Parreira SLS, Resende MBD, Zanoteli E, Carvalho MS, Marie SK, Reed UC. Comparison of motor strength and function in patients with Duchenne muscular dystrophy with or without steroid therapy. Arq Neuro-Psiquiatr 2010;68(5):683-688.
- Birnkrant DJ, Bushby K, Bann CM, et al. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management. Lancet Neurol 2018;17(3):251-267.
- Birnkrant DJ, Bushby K, Bann CM, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management. Lancet Neurol 2018;17(4):347-361.
- Kiefer M, Bonarrigo K, Quatman-Yates C, Fowler A, Horn PS, Wong BL. Progression of ankle plantarflexion contractures and functional decline in Duchenne muscular dystrophy: implications for physical therapy management. Pediatr Phys Ther 2019;31(1):61-66.
- Kinali M, Main M, Mercuri E, Muntoni F. Evolution of abnormal postures in Duchenne muscular dystrophy. Ann Indian Acad Neurol 2007;10(5):44-54.
- Filiz MB, Toraman NF, Kutluk MG, et al. Effects of lumbar lordosis increment on gait deteriorations in ambulant boys with Duchenne Muscular Dystrophy: A cross-sectional study. Braz J Phys Ther 2021;25:749-755.
- Case LE, Apkon SD, Eagle M, et al. Rehabilitation management of the patient with Duchenne muscular dystrophy. Pediatrics 2018;142(Supplement_2):17-33.
- Govoni A, Magri F, Brajkovic S, et al. Ongoing therapeutic trials and outcome measures for Duchenne muscular dystrophy. Cell Mol Life Sci 2013;70:4585-602.
- Jung I-Y, Chae JH, Park SK, et al. The correlation analysis of functional factors and age with duchenne muscular dystrophy. Ann Rehabil Med 2012;36(1):22-32.
- Florence JM, Pandya S, King WM, et al. Clinical trials in Duchenne dystrophy: standardization and reliability of evaluation procedures. Phys Ther 1984;64(1):41-45. https://doi.org/10.1093/ptj/64.1.41.
- Lovell FW, Rothstein JM, Personius WJ. Reliability of clinical measurements of lumbar lordosis taken with a flexible rule. Phys Ther 1989;69(2):96-102.
- Reshma, Sirajudeen MS, Chinnakalai T, Suhail M, al-Hussinan NM, Pillai SP. Reliability of the flexible ruler in measuring lumbar lordosis among children. J Clin Diagnostic Res 2020;14:01-04.
- Youdas JW, Garrett TR, Harmsen S, Suman VJ, Carey JR. Lumbar lordosis and pelvic inclination of asymptomatic adults. Phys Ther 1996;76 10):1066-1081.
- Howley ET, Franks BD. Health/Fitness Instructor's Handbook. ERIC, 1986.
- McRoberts LB, Cloud RM, Black CM. Evaluation of the New York Posture Rating Chart for assessing changes in postural alignment in a garment study. Cloth Text Res J 2013;31(2):81-96.
- Arora H, Willcocks RJ, Lott DJ, et al. Longitudinal timed function tests in Duchenne muscular dystrophy: ImagingDMD cohort natural history. Muscle Nerve 2018;58:631-638.
- Bérard C, Payan C, Hodgkinson I, Fermanian J, Group MCS. A motor function measure scale for neuromuscular diseases. Construction and validation study. Neuromuscul Disord 2005;15:463-470.
- İnal HS, Tarakci E, Tarakci D, et al. Turkish version of the Motor Function Measure Scale (MFM-32) forneuromuscular diseases: a cross-cultural adaptation, reliability, and validity study. Turk J Med Sci 2017;47:1826-1833.
- Akoglu H. User's guide to correlation coefficients. Turk J Emerg Med 2018;18(3):91-93.
- Choi Y-A, Chun S-M, Kim Y, Shin H-I. Lower extremity joint contracture according to ambulatory status in children with Duchenne muscular dystrophy. BMC Musculoskelet Disord 2018;19(1):1-6.
- Hsu JD, Furumasu J. Gait and posture changes in the Duchenne muscular dystrophy child. Clin Orthop Relat Res 1993;288:122-125.
- Vuillerot C, Girardot F, Payan C, et al. Monitoring changes and predicting loss of ambulation in Duchenne muscular dystrophy with the Motor Function Measure. Dev Med Child Neurol 2010;52(1):60-5.
- Alkan H, Mutlu A, Fırat T, Bulut N, Karaduman AA, Yılmaz ÖT. Effects of functional level on balance in children with Duchenne Muscular Dystrophy. Eur J Paediatr Neurol 2017;21(4):635-8.
- Fowler EG, Staudt LA, Heberer KR, et al. Longitudinal community walking activity in Duchenne muscular dystrophy. Muscle Nerve 2018;57(3):401-6.
- Silva ECd, Machado DL, Resende MB, Silva RF, Zanoteli E, Reed UC. Motor function measure scale, steroid therapy and patients with Duchenne muscular dystrophy. Arq Neuro-Psiquiatr 2012;70(3):191-195.
- Beenakker EA, Maurits NM, Fock JM, Brouwer OF, van der Hoeven JH. Functional ability and muscle force in healthy children and ambulant Duchenne muscular dystrophy patients. Eur J Paediatr Neurol. 2005;9(6):387-93.
- Nunes MF, Hukuda ME, Favero FM, Oliveira AB, Voos MC, Caromano FA. Relationship between muscle strength and motor function in Duchenne muscular dystrophy. Arq Neuro-Psiquiatr 2016;74:530-5.
- Aydın Yağcıoğlu G, Yılmaz Ö, Alemdaroğlu Gürbüz İ, et al. Examination of the relationship between foot-body posture and balance and gait in Duchenne muscular dystrophy. Ir J Med Sci 2023;192(4):1883-1888.