Gait in children with juvenile chronic arthritis - Timing and force parameters

Objectives: To examine gait in children with juvenile chronic arthritis (JCA) with reference to velocity, ground reaction forces and temporal parameters. Methods: Fifteen children with JCA were assigned into two groups (uni- and bilateral involvement and classified as pauci- or polyarticular arthritis). Fourteen healthy children participated in the control group. Light-beams were used to determine walking velocity and the children with JCA rated their pain on a visual analogue scale. Two force plates registered the ground reaction forces and foot-switches were used to obtain temporal parameters. Results: The mean velocity for the children with JCA was significantly less than for the healthy controls. Velocity normalized to height showed a tendency for the children with JCA to walk slower than controls. Differences between JCA children and healthy controls were observed for peak vertical forces during heel contact and push-off. No temporal differences were observed between the groups. Conclusions: Such kinetic and temporal information may provide the clinician with a sensitive tool for pre- and post assessment of intra-articular steroid injections and/or physical therapy

Is Achilles tendon blood flow related to foot pronation?

In the etiology of Achilles tendinopathy (AT), it is frequently suggested that excessive pronation causes a vascular constriction of the Achilles tendon, described as the "whipping phenomenon" (Clement et al., 1984). Although previous studies focused on the association between pronation and AT, it is striking that the underlying association between foot pronation and blood flow has not been studied yet. Therefore, the aim of this study was to investigate whether the amount of pronation during running influences the Achilles tendon blood flow. Twenty-five experienced runners, aged 34.5±10.2 years, participated in this study. 2D-lower limb kinematics during barefoot and shod running in both frontal and sagittal plane were assessed. Blood flow of the Achilles tendon was measured before and after barefoot and shod running, using the oxygen-to-see device. The results of this study showed a significant effect of eversion excursion on the increase in Achilles tendon blood flow after shod running. More specifically, the more the eversion excursion observed, the lower the increase in blood flow (P=.013). We therefore suggest, in individuals with increased inversion at touchdown and increased eversion around midstance during shod running, that antipronation measures could be useful in both preventing and managing Achilles tendinopathy