Gait changes in skeletal dysplasia

Abstract

Skeletal dysplasias form a group of conditions that affect the musculoskeletal system resulting in gait changes. These conditions share some common gait patterns, such as short stride length, low gait velocity, and increased forward pelvic tilt. Increased pelvic rotation is also a common mechanism, used to increase the step length. However, specific gait deviations are found in each condition. Knee axis deviations in the coronal plane are well-described clinical features in these conditions. While bilateral knee varus is common in achondroplasia, bilateral knee valgus is a shared finding between diastrophic dysplasia and Morquio syndrome. Sagittal kinematic deviations in stance show normal knee flexion in achondroplasia and increased knee flexion values in diastrophic dysplasia and Morquio syndrome. Due to the different, multilevel gait deviations that follow the multilevel deformity found in skeletal dysplasia, instrumented, three-dimensional, gait analysis becomes a helpful tool to evaluate the individual aspects of the deformity and to approach the patient with an accordingly customized management plan.