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Diurnal variation of gait in patients with rheumatoid arthritis : the DIVIGN study
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Backhouse, Michael, Pickles, David A., Mathieson, Hannah R., Edgson, Lucy, Emery, Paul, Helliwell, Philip S. and Redmond, Anthony C. (2014) Diurnal variation of gait in patients with rheumatoid arthritis : the DIVIGN study. Clinical Biomechanics, 29 (7). pp. 811-814. doi:10.1016/j.clinbiomech.2014.05.009 ISSN 0268-0033.
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Official URL: http://dx.doi.org/10.1016/j.clinbiomech.2014.05.00...
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.
Item Type: | Journal Article | ||||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Clinical Biomechanics | ||||||||
Publisher: | Elsevier | ||||||||
ISSN: | 0268-0033 | ||||||||
Official Date: | August 2014 | ||||||||
Dates: |
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Volume: | 29 | ||||||||
Number: | 7 | ||||||||
Page Range: | pp. 811-814 | ||||||||
DOI: | 10.1016/j.clinbiomech.2014.05.009 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) |
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