The use of orthoses and gait analysis in children with AMC

PURPOSE: Arthrogryposis multiplex congenita (AMC) can be described as a complex condition characterized by deformed joints with an intact sensory system. Consequences of muscle weakness and joint contractures in the lower limbs influence walking ability. With orthoses most children achieve functional ambulation. Based on four studies, the aim of this article was to describe gait pattern wearing habitual orthoses, to quantify quiet standing, to test and describe a new orthosis and compare gait differences with regular orthoses, in children with AMC. METHODS: In total 83 children, of which 35 with AMC took part in the studies. All children had underwent clinical examination. Based on joint range of motion and muscle strength they had been prescribed various orthosis types, ranging from insoles to knee–ankle–foot orthoses with locked knee joints. 3D gait and motion analysis was performed during standing and walking with 34 reflective markers aligned with anatomical landmarks. RESULTS: The findings are presented with respect to each of the included studies. CONCLUSIONS: According to the positive subjective impressions from parents and children, the clinical experiences of our research group, and the objective results from the gait assessments, continuously wearing of orthoses in persons with AMC is recommended.