Backhouse, MR, Pickles, DA, Mathieson, HR et al. (4 more authors) (2014) Diurnal variation of gait in patients with rheumatoid arthritis: The DIVIGN study. Clinical Biomechanics, 29 (7). 811 - 814. ISSN 0268-0033
Abstract
Background: Circadian variation of joint stiffness (morning stiffness) and its impact on functional ability are widely recognised in rheumatoid arthritis. Subsequent within-day variation of walking ability is important due to the increased availability of instrumented gait analysis. This study aimed to quantify diurnal variation of gait in patients with rheumatoid arthritis, and explore associations with disease characteristics. Methods: Thirty one inpatients with rheumatoid arthritis walked at a self-selected speed along a GAITRite instrumented walkway 5 times during a single day. Findings: Participants showed marked diurnal variation in gait, leading to a systematic variation throughout the day (F=19.56, P=<0.001). Gait velocity and stride length both increased, whereas the proportion of each gait cycle spent in stance phase or double support decreased, consistent with improving function throughout the day. Although absolute gait velocity correlated with disease characteristics, the magnitude of diurnal variation appeared to be independent of disease activity (rho=0.26, P=0.15), disease duration (rho=-0.19, P=0.324), and underlying functional ability (rho=0.09, P=0.65). Interpretation: Although morning stiffness is well recognised in rheumatoid arthritis, this is the first time that its effect on gait has been quantified. Patients with rheumatoid arthritis exhibited a systematic change in walking ability throughout the day, which was independent of disease characteristics. These findings have important implications for the interpretation of existing data and the design of future studies. Repeat measures should be conducted at the same time of day to exclude the effects of diurnal variation.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/) |
Keywords: | Diurnal variation; Gait analysis; Rheumatoid arthritis; Activities of Daily Living; Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid; Circadian Rhythm; Female; Gait; Humans; Male; Middle Aged; Walking |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Nursing Adult (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Clinical Biomechanic & Physical Med (LIRMM) (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Clinical Musculoskeletal Medicine (LIRMM) (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 30 Jul 2015 14:13 |
Last Modified: | 01 Mar 2019 12:35 |
Published Version: | http://dx.doi.org/10.1016/j.clinbiomech.2014.05.00... |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.clinbiomech.2014.05.009 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:86534 |