Change in Gait Deviation Index after anti-tumour necrosis factor-α treatment in individuals with rheumatoid arthritis: a pilot study

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Broström, E WKarolinska Institutet (author)

Change in Gait Deviation Index after anti-tumour necrosis factor-α treatment in individuals with rheumatoid arthritis : a pilot study

Article/chapterEnglish2013

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2013-04-14
Informa Healthcare,2013
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LIBRIS-ID:oai:DiVA.org:oru-55788
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-55788URI
https://doi.org/10.3109/03009742.2013.776102DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:127385208URI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Funding Agencies:Research foundations Promobilia Karolinska Institutet FoundationsDevelopmental foundation of the footwear industry
OBJECTIVES: Anti-tumour necrosis factor-alpha (TNF-α) inhibitors provide fast, effective resolution of rheumatoid arthritis (RA) inflammation. In this study we aimed to quantify the impact of TNF-α treatment on gait dynamics.METHOD: The sample comprised 16 subjects [11 female, median age 56 (range 48-66) years, median disease duration 9.5 (range 4.6-20.6) years] with RA who met the American College of Rheumatology (ACR) criteria, had lower extremity involvement, did not use walking aids, and had started TNF-α treatment within 1 week of baseline gait analysis. Gait analysis focused on three-dimensional (3D) lower extremity joint kinematics, kinetics, time and distance parameters. The Gait Deviation Index (GDI) and GDI-Kinetic were calculated. Data on gait, disease activity, and physical disability were collected at baseline and at 3.5 months.RESULTS: Following treatment with TNF-α, statistically significant improvements were found in disease activity [using the 28-joint Disease Activity Score based on C-reactive protein (DAS28-CRP); median difference (m(d)) = 2.3, p < 0.01], physical disability [Health Assessment Questionnaire (HAQ) m(d) = 0.4, p < 0.01], and pain during walking [visual analogue scale (VAS) m(d) = 11.0, p < 0.05]. Reductions in gait deviations were noted (GDI m(d) = 3.7, p = 0.04; GDI-Kinetic m(d) = 4.1, p = 0.05) along with reductions in dimensionless time and distance parameters. A moderate to good negative correlation existed between baseline GDI and GDI change scores (r(s) = -0.7, p < 0.01).CONCLUSIONS: Treatment with TNF-α improved gait dynamics in adults with RA. Significant gait deviations were, however, still present after treatment. In this study, GDI and GDI-Kinetic scores appeared to be useful outcome measures to quantify changes in gait deviations after this intervention.

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Esbjörnsson, A-CKarolinska Institutet (author)
von Heideken, JKarolinska Institutet (author)
Larsson, PKarolinska Institutet (author)
Wretenberg, Per,1963-Karolinska Institutet,Region Örebro län,Department of Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden(Swepub:oru)pewg (author)
Iversen, MKarolinska Institutet (author)
Region Örebro länKarolinska Institutet (creator_code:org_t)

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In:Scandinavian Journal of Rheumatology: Informa Healthcare42:5, s. 356-3610300-97421502-7732

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By the author/editor: Broström, E W; Esbjörnsson, A-C; von Heideken, J; Larsson, P; Wretenberg, Per, ...; Iversen, M

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Rheumatology and ...

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By the university: Örebro University; Karolinska Institutet

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