Background

Juvenile Idiopathic Arthritis (JIA) is a chronic inflammatory arthritis that impacts biomechanical features of gait. This systematic review describes the effects of JIA on gait motion parameters and walking performance.

Methods

Six databases were searched (PubMed/Medline, Cochrane, the EBSCOHost database SPORTDiscus, Web of Science, and Embase). Studies were restricted to children with any subtype of JIA who were assessed for gait motion features (kinematic, kinetic, temporalspatial) or walking performance (velocity or distance covered); could include intervention or treatment exposure with measures of gait and gait speed; could involve comparison of gait in JIA to healthy controls. Quality of evidence was assessed using the GRADE system. This systematic review was registered at PROSPERO (CRD42018109582)

Results

The search yielded 625 papers, 23 of which described biomechanical features of gait and/or assessed walking performance. Twenty studies measured walking velocity and walking ability using simple field tests or laboratory methods. Eleven studies measured temporalspatial parameters such as cadence, step length, stride length, step width, single and double support time. Nine studies evaluated kinetic measurements including joint power, flexion and extension and joint moments. Nine studies evaluated kinematic parameters including range of motion, pelvic tilt, center of motion and trunk sway.

Conclusions

Key features of gait in children with JIA include slower gait velocity, shortened step length, decreased range of motion at the hip, knee and ankle with trend towards flexion, decreased joint power, anteriorly tilted pelvis and trunk with shifted center of motion. There is a potential to ameliorate JIA-related gait changes with exercise and/or pharmaceutical interventions.

中文翻译：

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幼年特发性关节炎，步态特征及其与功能的关系

背景

幼年特发性关节炎（JIA）是一种慢性炎症性关节炎，会影响步态的生物力学特征。该系统评价描述了JIA对步态运动参数和步行性能的影响。

方法

搜索了六个数据库（PubMed / Medline，Cochrane，EBSCOHost数据库SPORTDiscus，Web of Science和Embase）。研究仅限于经过评估步态运动特征（运动，动力学，时空）或步行表现（速度或覆盖距离）的任何JIA亚型的儿童；可以包括步态和步态速度的干预或治疗接触；可能需要将JIA的步态与健康对照进行比较。使用GRADE系统评估证据质量。该系统评价已在PROSPERO（CRD42018109582）注册

结果

搜索产生625篇论文，其中23篇描述了步态的生物力学特征和/或评估的步行表现。二十项研究使用简单的现场测试或实验室方法测量了步行速度和步行能力。十一项研究测量了时空参数，例如节奏，步长，步幅，步长，单和双支撑时间。九项研究评估了动力学测量值，包括关节力量，屈伸和关节力矩。九项研究评估了运动学参数，包括运动范围，骨盆倾斜度，运动中心和躯干摇摆。

结论

JIA儿童步态的主要特征包括步态速度较慢，步长缩短，髋部，膝盖和脚踝的活动范围减少，有屈曲趋势，关节力量下降，骨盆前倾和运动中心移位的躯干。有可能通过运动和/或药物干预改善与JIA相关的步态变化。