Dynamic Gait Index as a Functional Gait Assessment Measure in Children With JIA

Official title

Investigation of Validity and Reliability of Dynamic Walking Index in Childhood Rheumatic Diseases

Overview

Juvenile idiopathic arthritis (JIA) is one of the most common chronic rheumatic diseases seen in childhood. Pain, joint swelling and loss of function caused by inflammation significantly reduce the patients' quality of life and lead to muscle weakness, limited range of motion and gait disorders. Although there are various clinical assessment methods, there is no functional test in the current literature that evaluates walking in children with JIA. The Dynamic Gait Index (DGI) is a functional walking scale that evaluates walking on level ground, walking while changing speed, walking with sideways head turns, walking with vertical head turns, walking with pivot turns, walking by jumping over obstacles, going around obstacles and climbing stairs. While the DGA is widely used in the clinical assessment of walking in older adults and other pediatric patient groups, it has not yet been investigated for the assessment of walking difficulties in children with JIA. This study aimed to determine whether the DYI is a usable tool for assessing walking in children with JIA.

Interventions

• Other Physical examination
  The physical examination will included Timed Up and Go Test (TUG), Walking speed, Wong-Baker FACES Pain Scale, Pediatric balance scale and CHAQ (Childhood Health Assessment Questionnaire).
• Other Dynamic Gait Index
  The DGI, whose validity and reliability will be investigated, consists of 8 items: walking on level ground, walking with changing speed, walking with sideways head turns, walking with vertical head turns, walking with pivot turns, walking over obstacles, going around obstacles, and climbing stairs. Performance on each item is rated on a 4-point scale ranging from 0 (severe impairment) to 3 (normal walking ability without a walking aid). The total score is 24. Scores below 19 indicate a risk of f

Primary outcome measures

• Dynamic Gait Index [Time frame: Baseline and after 2 weeks from the baseline evaluation]
• Walking speed [Time frame: Baseline]
• Timed Up and Go Test [Time frame: Baseline]
• Wong-Baker FACES Pain Scale [Time frame: Baseline]
• Pediatric Balance Scale [Time frame: Baseline]

Secondary outcome measures (1)

• Childhood Health Assessment Questionnarie [Time frame: Baseline]

Eligibility criteria

Inclusion criteria

• Study Group;
• Having a JIA diagnosis according to ILAR criteria between the ages of 8-16,
• Having unilateral knee joint involvement that will affect walking
• Being compatible, volunteer and cooperative in the study Control Group;

• Not having any neurological or orthopedic diagnosis
• Being between the ages of 8-16
• Being at a mental level that can understand the commands of the person performing the evaluation

Exclusion criteria

• Study Group;
• Having an additional neurological or orthopedic diagnosis accompanying JIA and affecting treatment results,
• Having lower extremity asymmetry or active lower extremity involvement other than the knee joint that will affect walking.

Control Group;

-Having any health problem that may affect the study

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Observational model

Cohort

Study locations

Turkey (Türkiye) · 1 center

• Istanbul University-Cerrahpasa — Istanbul

Publications

• Ozdogan H, Ruperto N, Kasapcopur O, Bakkaloglu A, Arisoy N, Ozen S, Ugurlu U, Unsal E, Melikoglu M; Paediatric Rheumatology International Trials Organisation. The Turkish version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ). Clin Exp Rheumatol. 2001 Jul-Aug;19(4 Suppl 23):S158-62. PMID 11510322
• Franjoine MR, Gunther JS, Taylor MJ. Pediatric balance scale: a modified version of the berg balance scale for the school-age child with mild to moderate motor impairment. Pediatr Phys Ther. 2003 Summer;15(2):114-28. doi: 10.1097/01.PEP.0000068117.48023.18. PMID 17057441
• Balsalobre-Fernandez C, Tejero-Gonzalez CM, del Campo-Vecino J, Bavaresco N. The concurrent validity and reliability of a low-cost, high-speed camera-based method for measuring the flight time of vertical jumps. J Strength Cond Res. 2014 Feb;28(2):528-33. doi: 10.1519/JSC.0b013e318299a52e. PMID 23689339
• Garra G, Singer AJ, Taira BR, Chohan J, Cardoz H, Chisena E, Thode HC Jr. Validation of the Wong-Baker FACES Pain Rating Scale in pediatric emergency department patients. Acad Emerg Med. 2010 Jan;17(1):50-4. doi: 10.1111/j.1553-2712.2009.00620.x. Epub 2009 Dec 9. PMID 20003121
• Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed 'up & go' test in children. Dev Med Child Neurol. 2005 Aug;47(8):518-24. doi: 10.1017/s0012162205001027. PMID 16108451
• Lubetzky-Vilnai A, Jirikowic TL, McCoy SW. Investigation of the Dynamic Gait Index in children: a pilot study. Pediatr Phys Ther. 2011 Fall;23(3):268-73. doi: 10.1097/PEP.0b013e318227cd82. PMID 21829122
• Shumway-Cook A, Baldwin M, Polissar NL, Gruber W. Predicting the probability for falls in community-dwelling older adults. Phys Ther. 1997 Aug;77(8):812-9. doi: 10.1093/ptj/77.8.812. PMID 9256869
• Jonsdottir J, Cattaneo D. Reliability and validity of the dynamic gait index in persons with chronic stroke. Arch Phys Med Rehabil. 2007 Nov;88(11):1410-5. doi: 10.1016/j.apmr.2007.08.109. PMID 17964880

Identifiers

NCT: NCT06870045 · dyi_jia

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗