Effects of muscular deficiency on postural and gait capacities in patients with Charcot-Marie-Tooth disease.

Abstract

OBJECTIVE: The aim of this study was to examine the relationships between lower limb muscular deficiencies and postural and gait capacities. DESIGN: Observational study. SUBJECTS: A total of 26 patients with Charcot-Marie-Tooth disease and 19 health-matched healthy subjects. METHODS: Barefoot gait and postural control were analysed using a walking mat and a force platform, respectively. Muscular strength of the plantar and dorsal ankle flexors were assessed using the Medical Research Council scale. RESULTS: Gait parameters correlated with both dorsal- and plantar-flexors strength, whereas postural parameters correlated only with plantar-flexors strength. More particularly, patients with a weak deficit of the plantar-flexor muscles were characterized by normal postural control except along the antero-posterior axis. For gait control, the overall pattern defined from the gait cycle division was preserved, whereas other spatio-temporal parameters were impaired, and more so in patients with a high level of deficit of the plantar-flexor muscles. CONCLUSION: These data highlight behaviour differences in standardized tasks, such as standing still upright or gait. Improved knowledge of postural and gait capacities may constitute a basis to emphasize the corrections that should be enabled by rehabilitation exercises or orthotic devices.