Dynamic Gait Index As a Functional Gait Assessment Measure in Children with JIA

Recruiting

• Conditions: Juvenile Idiopathic Arthritis; Childhood Rheumatic Disease

• Registration Number: NCT06870045
• Lead Sponsor: Istanbul University - Cerrahpasa

Brief Summary

Juvenile idiopathic arthritis (JIA) is one of the most common chronic rheumatic diseases seen in childhood. Pain, joint swelling and loss of function caused by inflammation significantly reduce the patients' quality of life and lead to muscle weakness, limited range of motion and gait disorders. Although there are various clinical assessment methods, there is no functional test in the current literature that evaluates walking in children with JIA.

The Dynamic Gait Index (DGI) is a functional walking scale that evaluates walking on level ground, walking while changing speed, walking with sideways head turns, walking with vertical head turns, walking with pivot turns, walking by jumping over obstacles, going around obstacles and climbing stairs. While the DGA is widely used in the clinical assessment of walking in older adults and other pediatric patient groups, it has not yet been investigated for the assessment of walking difficulties in children with JIA. This study aimed to determine whether the DYI is a usable tool for assessing walking in children with JIA.

Detailed Description

Not available

Study Timeline

• Status Verified: 2025-02
• Study Start: 2025-02-01
• Study First Submitted: 2025-03-05
• Study First Submitted QC: 2025-03-05
• Last Update Submitted: 2025-03-05
• Study First Posted: 2025-03-11
• Last Update Posted: 2025-03-11
• Primary Completion: 2025-08
• Study Completion: 2025-09

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 52

Inclusion Criteria

• Study Group;

• Having a JIA diagnosis according to ILAR criteria between the ages of 8-16,

• Having unilateral knee joint involvement that will affect walking

• Being compatible, volunteer and cooperative in the study Control Group;

  1. Not having any neurological or orthopedic diagnosis
  2. Being between the ages of 8-16
  3. Being at a mental level that can understand the commands of the person performing the evaluation

Exclusion Criteria

• Study Group;
• Having an additional neurological or orthopedic diagnosis accompanying JIA and affecting treatment results,
• Having lower extremity asymmetry or active lower extremity involvement other than the knee joint that will affect walking.

Control Group;

-Having any health problem that may affect the study

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Dynamic Gait Index	Baseline and after 2 weeks from the baseline evaluation	The DGI consists of 8 items: walking on level ground, walking with changing speed, walking with sideways head turns, walking with vertical head turns, walking with pivot turns, walking over obstacles, going around obstacles, and climbing stairs. Performance on each item is rated on a 4-point scale ranging from 0 (severe impairment) to 3 (normal ability to walk without a walking aid). The total score is 24. Scores below 19 indicate a risk of falling, while scores above 22 describe safe ambulation.
Walking speed	Baseline	For the walking speed assessment, participants will be asked to walk along a 10-meter walkway at their preferred speed. Before the test, participants will be asked to walk 5 laps on the walkway and will be allowed to get used to the environment. During the walk, a video recording will be made in order to calculate the walking speed. For each participant, a video recording will be made with a camera fixed on a tripod placed laterally. During the walk, the participant's walking speed will be evaluated with the Kinovea 2D motion analysis program (Kinovea 0.8.15., GPLv2 license, 2019). Participants will be asked to walk 7 laps along the walkway, and the average data of these laps and the time taken to walk the 10-meter walkway in each lap will be recorded.
Timed Up and Go Test	Baseline	The TUG test measures the time it takes for a person to get up from an arm-supported chair, walk 3 m, walk back to the chair, and sit down. The person walks at the preferred speed in their usual shoes with or without a walking aid. The tester remains with the participants at all times to ensure safety. Before starting the movement, the movement is demonstrated and explained to the child. The time it takes to get up from the chair and sit back in it is recorded. The test is repeated twice and the fastest score is recorded. Times less than 10 seconds are considered normal, while times greater than 14 seconds are recorded as a high risk of falling.
Wong-Baker FACES Pain Scale	Baseline	The Wong-Baker FACES Pain Scale is a pain rating scale used to show children their pain intensity levels. On this scale, a person who feels happy indicates that they feel no pain (no pain), while a person who feels sad indicates that they feel a little or a lot of pain, Face 0 is very happy because they feel no pain. Face 10 visually represents severe pain that leads to crying. Participants will be asked to choose the face that best describes their pain from the scale before and after taping to assess pain.
Pediatric Balance Scale	Baseline	To detect balance loss in children, the Pediatric Balance Scale, which is a modified version of the Berg balance scale and is used to assess functional balance skills in school-aged children, will be applied. The scale consists of 14 items, scored from 0 (lowest function) to 4 (highest function), with a maximum score of 56. The Pediatric Balance Scale is designed for use in school-aged children with mild to moderate motor impairments. Pilot testing was conducted on children aged 5 to 15 years.

Secondary Outcome Measures

Name	Time	Method
Childhood Health Assessment Questionnarie	Baseline	The questionnaire consists of two different sections, the disability index and the discomfort index. The disability index consists of 8 parameters including dressing and personal care, standing up, eating, walking, hygiene, reaching out, holding and activities. All of these areas were assessed in 3 components. 1) How much difficulty they had in performing which daily functions 2) Whether they used special devices for daily functions 3) Whether they needed help from someone else in these activities were asked from each patient. There are 4 different possibilities for answers: 0 = no difficulty, 1 = with some difficulty, 2 = with great difficulty, 3 = unable. Discomfort was assessed by measuring pain with a 15 cm visual analog scale. The parents of the patients were asked to rate how much pain their child had in the past week and to give a score between 0 and 100. Similarly, they are asked to score between 0 and 100 on how much they have been affected by the disease since its onset

Trial Locations

Locations (1)

Istanbul University-Cerrahpasa; 🇹🇷 Istanbul, Turkey