The Effects of Improvement in Upper Extremity Function on Gait and Balance in Children With Upper Extremity Affected

Abstract

Background: This study aimed to investigate the effects of functional improvement in the upper extremity on gait and balance in children with upper extremity affected. Research question: What are the effects of functional improvement in the upper extremity on gait and balance in children with upper extremity affected? Methods: Eighteen children with a diagnosis of rheumatologic diseases and 15 healthy children were evaluated with Shriners Hospital Upper Extremity Assessment, Jebsen-Taylor Hand Function Test, Abilhand Rheumatoid Arthritis Scale, 10-meter walk test and Childhood Health Assessment Questionnaire. For static balance assessment, the Biodex Balance was used. Ground reaction forces (peak forces (heel strike and push-off) and minimum force (loading response), single-limb support duration, Center-of-Force displacement and walking speed were evaluated with the Sensor Medica. Arm swing was evaluated with the Kinovea 2D motion analysis. Results: Before treatment, single-limb support duration and push-off force was higher and center-of-force displacement was lower on affected side compared to unaffected side in rheumatologic group. After the 6week rehabilitation program, upper extremity function, quality of life and functional gait score improved. Single-limb support duration decreased on affected side and increased on unaffected side. On affected side, pushoff force decreased. The arm swing parameters were similar before and after treatment. Significance: Improving upper extremity function can help with gait balance by decreasing the difference in walking and balance parameters between the affected and unaffected sides and providing for more symmetrical weight transfer.