Purpose

In acromegaly, skeletal complications resulted to be associated with low quality of life (QoL) and high risk of falls. The aim of the present study was to perform a quantitative assessment of movement through gait analysis technique in patients with acromegaly.

Study population

Thirty-three acromegalic patients [9 with active disease (AD), 14 with controlled disease (CD) and 10 with disease remission (RD)] and 20 healthy subjects were enrolled for the study.

Measurements

Kinetic and kinematic data were collected with 3D-gait analysis. Kinematic data were processed to compute the Gait Profile Score (GPS), a parameter that summarizes the overall deviation of kinematic gait data relative to unaffected population.

Results

The acromegalic group showed longer stance phase duration (p < 0.0001) compared to controls. The GPS and several gait variable scores resulted to be statistically higher in the acromegalic group compared to healthy controls. GPS values were significantly higher in AD compared to CD (p < 0.05) and RD groups (p = 0.001). The AD group presented significantly higher values in terms of hip rotation and ankle dorsiflexion compared to CD and RD groups and with regard to the foot progression compared to RD. Interestingly, patients with RD exhibited a more physiological gait pattern.

Conclusion

Acromegalic patients showed quantitative alterations of gait pattern, suggesting instability and increased risk of falls. Arthropathy, along with its associated abnormal joint loading, proprioceptive impairment and hyperkyphosis could be contributing factors. Disease control and remission appear to improve postural balance. A better knowledge on walking performance in acromegaly would help to develop specific rehabilitation programmes to reduce falls’ risk and improve QoL.

中文翻译：

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ACROMORFO 研究：肢端肥大症患者队列的步态分析

目的

在肢端肥大症中，骨骼并发症与低生活质量（QoL）和高跌倒风险有关。本研究的目的是通过步态分析技术对肢端肥大症患者的运动进行定量评估。

研究人群

33 名肢端肥大症患者 [9 名疾病活动期 (AD)、14 名疾病受控 (CD) 和 10 名疾病缓解 (RD)] 和 20 名健康受试者参加了这项研究。

测量

通过 3D 步态分析收集动力学和运动学数据。处理运动学数据以计算步态轮廓评分 (GPS)，该参数总结了运动学步态数据相对于未受影响人群的总体偏差。

结果

 与对照组相比，肢端肥大症组的站立相持续时间更长（p < 0.0001）。与健康对照组相比，肢端肥大症组的 GPS 和一些步态变量得分在统计上更高。与 CD 组 ( p  < 0.05) 和 RD 组 ( p  = 0.001)相比，AD 组的 GPS 值显着更高。与 CD 和 RD 组相比，AD 组在髋部旋转和踝关节背屈方面表现出显着更高的值，并且与 RD 组相比，在足部进展方面表现出显着更高的值。有趣的是，RD 患者表现出更符合生理学的步态模式。

结论

肢端肥大症患者的步态模式发生了定量改变，表明步态不稳定和跌倒风险增加。关节病及其相关的异常关节负荷、本体感觉障碍和后凸畸形可能是促成因素。疾病控制和缓解似乎可以改善姿势平衡。更好地了解肢端肥大症患者的步行表现将有助于制定具体的康复计划，以降低跌倒风险并提高生活质量。