Effect of joint injections in children with juvenile idiopathic arthritis: evaluation by 3D-gait analysis.

Abstract

AIM:

To investigate how gait patterns change after intra-articular corticosteroid injections (ICIs) in the lower extremities.

METHODS:

Eighteen children, aged 5-16 y, with juvenile idiopathic arthritis (JIA) and lower extremity involvement participated in the study. Sixty-four joints in the lower extremities were treated with ICIs. The Visual Analogue Scale (VAS, 0-100 mm) was used to assess pain. A 3D motion analysis system and two force plates were used to measure gait parameters, kinematics and kinetics. The first gait analysis was performed before treatment with ICIs, and a second one was done 8-17 d after treatment.

RESULTS:

The participants' average rating of pain decreased from 26 mm on the VAS before ICI to 11 mm (p = 0.001) after treatment. The self-chosen walking velocity was significantly faster (p = 0.02) after treatment. The range of knee and ankle joint angles during gait increased significantly (p = 0.03 and 0.04) after treatment. At loading response, the hip extension moment increased (p = 0.01) as did knee flexion moment, and plantar flexion moment at pre-swing increased significantly (p = 0.02 and 0.002) after treatment. The ankle also generated more power (p = 0.005) after treatment.

CONCLUSION:

The study shows positive effects of treatment with ICIs in the lower extremities--especially regarding pain, walking velocity and joint moments. The data indicate that ICI treatment influences the gait pattern also in joints that have not been injected.

• Authors: E Broström, S Hagelberg, Y Haglund-Akerlind
• Journal: Acta paediatrica (Oslo, Norway : 1992) (Acta Paediatr) Vol. 93 Issue 7 Pg. 906-10 (Jul 2004) ISSN: 0803-5253 [Print] Norway
• PMID: 15303805 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Methylprednisolone

Topics

• Adolescent
• Ankle (physiopathology)
• Anti-Inflammatory Agents (administration & dosage, therapeutic use)
• Arthritis, Juvenile (drug therapy)
• Biomechanical Phenomena
• Child
• Child, Preschool
• Female
• Gait (drug effects, physiology)
• Humans
• Injections
• Joints (drug effects, physiopathology)
• Knee (physiopathology)
• Male
• Methylprednisolone (administration & dosage, therapeutic use)
• Pain (drug therapy)
• Treatment Outcome