Skip to main content

Advertisement

SpringerLink
Log in

Gait strategy and body composition in patients with Prader–Willi syndrome

  • Original Article
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

Individuals with Prader–Willi syndrome (PWS) exhibit reduced lean body mass and increased fat–lean mass ratio when compared with individuals of normal weight and obese ones. Thus, research on the association of functional limitations during gait and body composition may be of great importance from a rehabilitative viewpoint. In particular, the aim of this study was to compare the gait profile of persons with PWS to that of unaffected individuals and to see if a relationship exists between gait profile and body composition in individuals with PWS.

Methods

Eighteen individuals with PWS and 20 unaffected individuals (Healthy Group: HG) were assessed. Their gait pattern was quantified with 3D-Gait Analysis (3D-GA). Overall body weight, lean and fat masses were measured by dual-energy X-ray absorptiometry.

Results

Individuals with PWS were found to be characterized by a significantly different (p < 0.05) gait pattern with respect to healthy controls in terms of both kinematic and kinetic parameters. No correlations were found between kinematic parameters and overall mass and lean/fat mass, while some parameters associated with ground reaction force were found to be significantly correlated with overall mass, lean mass and fat mass. Significant regression models were obtained, including impact and propulsive force and loading rate.

Conclusion

Our data suggest that in individuals with PWS, gait is influenced by the overall and lean body mass. Thus, therapeutic strategies should target both weight reduction and lean mass increase to optimize gait, minimize articular stress, and reduce the risk of repetitive strain on the lower limbs.

Level of evidence

Level III: Case–control analytic study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Cassidy SB, Schwartz S, Miller JL, Driscoll DJ (2012) Prader–Willi syndrome. Genet Med 14:10–26

    Article  CAS  Google Scholar 

  2. Angulo MA, Butler MG, Cataletto ME (2015) Prader–Willi syndrome: a review of clinical, genetic, and endocrine findings. J Endocrinol Investig 38:1249–1263. https://doi.org/10.1007/s40618-015-0312-9

    Article  CAS  Google Scholar 

  3. Theodoro MF, Talebizadeh Z, Butler MG (2006) Body composition and fatness patterns in Prader–Willi syndrome: comparison with simple obesity. Obesity 14:1685–1690

    Article  Google Scholar 

  4. Tanaka Y, Abe Y, Oto Y, Itabashi H, Shiraishi M, Yoshino A, Obata K, Murakami N, Nagai T (2012) Characterization of fat distribution in Prader-Willi syndrome: relationships with adipocytokines and influence of growth hormone treatment. Am J Med Genet Part A 161:27–33. https://doi.org/10.1002/ajmg.a.35653

    Article  CAS  Google Scholar 

  5. Bedogni G, Grugni G, Tringali G, Agosti F, Bedogni G, Grugni G, Tringali G, Agosti F, Bedogni G, Grugni G, Tringali G, Agosti F, Sartorio A (2015) Assessment of fat-free mass from bioelectrical impedance analysis in obese women with Prader–Willi syndrome assessment of fat-free mass from bioelectrical impedance analysis in obese women with Prader–Willi syndrome. Ann Hum Biol. https://doi.org/10.3109/03014460.2014.990922

    Article  PubMed  Google Scholar 

  6. Backholer K, Wong E, Freak-Poli R, Walls HL, Peeters A (2012) Increasing body weight and risk of limitations in activities of daily living: a systematic review and meta-analysis. Obes Rev 13:456–468. https://doi.org/10.1111/j.1467-789X.2011.00970.x

    Article  CAS  PubMed  Google Scholar 

  7. Richmond SA, Kang J, Emery CA (2013) Is body mass index a risk factor for sport injury in adolescents? J Sci Med Sport 16:401–405. https://doi.org/10.1016/j.jsams.2012.11.898

    Article  PubMed  Google Scholar 

  8. Cimolin V, Galli M, Grugni G, Vismara L, Albertini G, Rigoldi C, Capodaglio P (2010) Gait patterns in Prader–Willi and Down syndrome patients. J NeuroEng Rehabil. https://doi.org/10.1186/1743-0003-7-28

    Article  PubMed  PubMed Central  Google Scholar 

  9. Vismara L, Romei M, Galli M, Montesano A, Baccalaro G, Crivellini M, Grugni G (2007) Clinical implications of gait analysis in the rehabilitation of adult patients with “Prader–Willi” syndrome: a cross-sectional comparative study (“Prader–Willi” syndrome vs matched obese patients and healthy subjects). J NeuroEng Rehabil 4:1–7. https://doi.org/10.1186/1743-0003-4-14

    Article  Google Scholar 

  10. Cimolin V, Cau N, Galli M, Santovito C, Grugni G, Capodaglio P (2017) Gait initiation and termination strategies in patients with Prader–Willi syndrome. J NeuroEng Rehabil. https://doi.org/10.1186/s12984-017-0257-7

    Article  PubMed  PubMed Central  Google Scholar 

  11. Capodaglio P, Menegoni F, Vismara L, Cimolin V, Grugni G, Galli M (2011) Characterisation of balance capacity in Prader–Willi patients. Res Dev Disabil. https://doi.org/10.1016/j.ridd.2010.09.002

    Article  PubMed  Google Scholar 

  12. Menegoni F, Galli M, Tacchini E, Vismara L, Cavigioli M, Capodaglio P (2009) Gender-specific effect of obesity on balance. Obesity 17:1951–1956. https://doi.org/10.1038/oby.2009.82

    Article  PubMed  Google Scholar 

  13. Galli M, Crivellini M, Sibella F, Montesano A, Bertocco PPC (2000) Sit-to-stand movement analysis in obese subjects. Int J Obes 24:1488–1492

    Article  CAS  Google Scholar 

  14. Reus L, Pillen S, Pelzer BJ, van Alfen-van der Velden JAAEM, Hokken-Koelega ACS, Zwarts M, Otten BJ, Nijhuis-van der Sanden MWG (2014) Growth hormone therapy, muscle thickness, and motor development in Prader–Willi syndrome: an RCT. Pediatrics 134:e1619–e1627. https://doi.org/10.1542/peds.2013-3607

    Article  PubMed  Google Scholar 

  15. Reus L, Zwarts M, Van Vlimmeren LA, Willemsen MA, Otten BJ, Der Sanden MWGN (2011) Neuroscience and biobehavioral reviews motor problems in Prader–Willi syndrome: a systematic review on body composition and neuromuscular functioning. Neurosci Biobehav Rev 35:956–969. https://doi.org/10.1016/j.neubiorev.2010.10.015

    Article  CAS  PubMed  Google Scholar 

  16. Baker R, McGinley JL, Schwartz MH, Beynon S, Rozumalski A, Graham HK, Tirosh O (2009) The gait profile score and movement analysis profile. Gait Posture 30:265–269. https://doi.org/10.1016/j.gaitpost.2009.05.020

    Article  PubMed  Google Scholar 

  17. Celletti C, Galli M, Cimolin V, Castori M, Tenore N, Albertini G, Camerota F (2013) Research in developmental disabilities use of the Gait Profile Score for the evaluation of patients with joint hypermobility syndrome/Ehlers–Danlos syndrome hypermobility type. Res Dev Disabil 34:4280–4285. https://doi.org/10.1016/j.ridd.2013.09.019

    Article  PubMed  Google Scholar 

  18. McMulkin ML, MacWilliams BA (2008) Intersite variations of the Gillette Gait Index. Gait Posture 28:483–487. https://doi.org/10.1016/j.gaitpost.2008.03.002

    Article  PubMed  Google Scholar 

  19. Pau M, Corona F, Pili R, Casula C, Sors F, Bien M, Kleiner A, Pau M (2016) Effects of physical rehabilitation integrated with rhythmic auditory stimulation on spatio-temporal and kinematic parameters of gait in Parkinson’s disease. Front Neurol 7:1–12. https://doi.org/10.3389/fneur.2016.00126

    Article  Google Scholar 

  20. Galli M, Cimolin V, De Pandis MF, Le Pera D, Sova I, Albertini G, Stocchi F, Franceschini M (2016) Robot-assisted gait training versus treadmill training in patients with Parkinson’s disease: a kinematic evaluation with gait profile score. Funct Neurol 31:1. https://doi.org/10.11138/FNeur/2016.31.3.163

    Article  Google Scholar 

  21. Coghe G, Pau M, Mamusa E, Pisano C, Pilloni G, Porta M, Marrosu G, Frau J, Lorefice L, Fenu G, Giovanna M, Cocco E, Coghe G, Pau M, Mamusa E, Pisano C, Corona F, Pilloni G, Porta M, Marrosu G, Vannelli A, Frau J, Lorefice L, Fenu G, Marrosu MG, Cocco E (2018) Quantifying gait impairment in individuals affected by Charcot–Marie–Tooth disease: the usefulness of gait profile score and gait variable score. Disabil Rehabil. https://doi.org/10.1080/09638288.2018.1506946

    Article  PubMed  Google Scholar 

  22. Sims DT, Burden A, Payton C, Morse CI (2019) A quantitative description of self-selected walking in adults with Achondroplasia using the gait profile score. Gait Posture 68:150–154. https://doi.org/10.1016/j.gaitpost.2018.11.019

    Article  CAS  PubMed  Google Scholar 

  23. Galli M, Cimolin V, Rigoldi C, Kleiner A, Condoluci C, Albertini G (2015) Use of the gait profile score for the quantification of gait pattern in down syndrome. J Dev Phys Disabil. https://doi.org/10.1007/s10882-015-9438-0

    Article  Google Scholar 

  24. Pau M, Coghe G, Atzeni C, Corona F, Pilloni G, Marrosu MG, Cocco E, Galli M (2014) Novel characterization of gait impairments in people with multiple sclerosis by means of the gait profile score. J Neurol Sci 345:159–163. https://doi.org/10.1016/j.jns.2014.07.032

    Article  PubMed  Google Scholar 

  25. Schreiber C, Armand S, Moissenet F (2018) Influence of normative data’ s walking speed on the computation of conventional gait indices. J Biomech 76:68–73. https://doi.org/10.1016/j.jbiomech.2018.05.022

    Article  PubMed  Google Scholar 

  26. Beynon S, Mcginley JL, Dobson F, Baker R (2010) Correlations of the gait profile score and the movement analysis profile relative to clinical judgments. Gait Posture 32:129–132. https://doi.org/10.1016/j.gaitpost.2010.01.010

    Article  PubMed  Google Scholar 

  27. Ferreira LAB, Cimolin V, Costici PF, Albertini G, Oliveira CS, Galli M (2014) Effects of gastrocnemius fascia lengthening on gait pattern in children with cerebral palsy using the gait profile score. Res Dev Disabil. https://doi.org/10.1016/j.ridd.2014.02.001

    Article  PubMed  Google Scholar 

  28. Kark L, Vickers D, McIntosh A, Simmons A (2012) Use of gait summary measures with lower limb amputees. Gait Posture 35:238–243. https://doi.org/10.1016/j.gaitpost.2011.09.013

    Article  PubMed  Google Scholar 

  29. Pamukoff DN, Lewek MD, Blackburn JT (2016) Clinical biomechanics greater vertical loading rate in obese compared to normal weight young adults. JCLB 33:61–65. https://doi.org/10.1016/j.clinbiomech.2016.02.007

    Article  Google Scholar 

  30. Villarrasa-sapiña I, Serra-añó P, Pardo-ibáñez A, Gonzalez L, García-massó X (2017) Clinical biomechanics relationship between body composition and vertical ground reaction forces in obese children when walking. Clin Biomech 41:77–81. https://doi.org/10.1016/j.clinbiomech.2016.12.008

    Article  Google Scholar 

  31. Mündermann A, Dyrby CO, Andriacchi TP (2005) Secondary gait changes in patients with medial compartment knee osteoarthritis: increased load at the ankle, knee, and hip during walking. Arthritis Rheum 52:2835–2844. https://doi.org/10.1002/art.21262

    Article  PubMed  Google Scholar 

  32. Neri M, Andermacher E, Spanó A, Salvioli GCC (1992) Validation study of the italian version of the Cambridge mental disorders of the elderly examination: preliminary findings. Dementia 3:70–77

    Google Scholar 

  33. Davis RB, Ounpuu S, Tyburski D, Gage JR (1991) A gait analysis data collection and reduction technique. Hum Mov Sci 10:575–597

    Article  Google Scholar 

  34. LaRoche Dain P, Kralian RJ, Millett ED (2011) Fat mass limits lower-extremity relative strength and maximal walking performance in older women. J Electromyogr Kinesiol 21:754–761. https://doi.org/10.1016/j.jelekin.2011.07.006.Fat

    Article  PubMed  PubMed Central  Google Scholar 

  35. Lai PPK, Leung AKL, Li ANM, Zhang M (2008) Three-dimensional gait analysis of obese adults. Clin Biomech 23:2–6. https://doi.org/10.1016/j.clinbiomech.2008.02.004

    Article  Google Scholar 

  36. Vincent HK, Vincent KR, Lamb KM (2010) Obesity and mobility disability in the older adult. Diagn Obes Complic 1:568–579. https://doi.org/10.1111/j.1467-789X.2009.00703.x

    Article  Google Scholar 

  37. Rolland Y, Lauwers-Cances V, Cristini C, Abellan van Kan G, Janssen I, Morley JEVB (2009) Difficulties with physical function associated with obesity, sarcopenia, and sarcopenic-obesity in community-dwelling elderly women: the EPIDOS (EPIDemiologie de l’ OSteoporose) Study 1–3. Am J Clin Nutr. https://doi.org/10.3945/ajcn.2008.26950.INTRODUCTION

    Article  PubMed  Google Scholar 

  38. Visser M, Goodpaster BH, Kritchevsky SB, Newman AB, Nevitt M, Rubin SM, Simonsick EM, Harris TB (2005) Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol Ser A Biol Sci Med Sci 60:324–333

    Article  Google Scholar 

  39. Visser M, Kritchevsky SB, Goodpaster BH, Newman AB, Nevitt M, Stamm E, Harris TB (2002) Leg muscle mass and composition in relation to lower extremity performance in men and women aged 70 to 79: the health, aging and body composition study. J Am Geriatr Soc 50:897–904

    Article  Google Scholar 

  40. Beavers KM, Beavers DP, Houston DK, Harris TB, Hue TF, Koster A, Newman AB, Simonsick EM, Studenski SA, Nicklas BJ, Kritchevsky SB (2013) Associations between body composition and gait-speed decline: results from the health, aging, and body composition study. Am J Clin Nutr 1–4:552–560. https://doi.org/10.3945/ajcn.112.047860.INTRODUCTION

    Article  Google Scholar 

  41. Verghese J, Holtzer R, Oh-park M, Derby CA, Lipton RB, Wang C (2011) Inflammatory markers and gait speed decline in older adults. J Gerontol Ser A Biomed Sci Med Sci. https://doi.org/10.1093/gerona/glr099

    Article  Google Scholar 

  42. Lafortuna CL, Minocci A, Capodaglio P, Gondoni LA, Sartorio A, Vismara L, Rizzo G, Grugni G, Molecolare F (2014) Skeletal muscle characteristics and motor performance after 2-year growth hormone treatment in adults with Prader–Willi syndrome. J Gerontol Ser A Biomed Sci Med Sci 99:1816–1824

    CAS  Google Scholar 

  43. Murakami N, Obata K, Abe Y, Oto Y, Kido Y, Itabashi H, Tsuchiya T, Tanaka Y, Yoshino A, Nagai T (2012) Scoliosis in Prader–Willi syndrome: effect of growth hormone therapy and value of paravertebral muscle volume by CT in predicting scoliosis progression. Am J Med Genet Part A. https://doi.org/10.1002/ajmg.a.35429

    Article  PubMed  Google Scholar 

  44. Festen DAM, Van Wijngaarden RDL, Van Eekelen M, Otten BJ, Wit JM, Duivenvoorden HJ, Hokken-koelega ACS (2008) Randomized controlled GH trial: effects on anthropometry, body composition and body proportions in a large group of children with Prader–Willi syndrome. Clin Endocrinol. https://doi.org/10.1111/j.1365-2265.2008.03228.x

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to acknowledge Eng. Maria Gina Mastroianni for her valuable contribution.

Funding

Not applicable.

Author information

Authors and Affiliations

  1. Department of Electronics, Information and Bioengineering, Politecnico di Milano, p.zza Leonardo Da Vinci 32, 20133, Milan, Italy

    Veronica Cimolin & Manuela Galli

  2. Orthopaedic Rehabilitation Unit and Clinical Lab for Gait Analysis and Posture, Ospedale San Giuseppe, Istituto Auxologico Italiano, IRCCS, Piancavallo, Verbania, Italy

    Nicola Cau, Cinzia Parisio & Paolo Capodaglio

  3. Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy

    Massimiliano Pau

  4. Unit of Auxology, Ospedale San Giuseppe, Istituto Auxologico Italiano, IRCCS, Piancavallo, VB, Italy

    Antonella Saezza & Graziano Grugni

Authors
  1. Veronica Cimolin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicola Cau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manuela Galli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Massimiliano Pau
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cinzia Parisio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Antonella Saezza
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Graziano Grugni
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Paolo Capodaglio
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Veronica Cimolin.

Ethics declarations

Conflict of interest

There were no potential conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committees of the Istituto Auxologico Italiano, Ospedale San Giuseppe, Piancavallo (VB), Italy.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cimolin, V., Cau, N., Galli, M. et al. Gait strategy and body composition in patients with Prader–Willi syndrome. Eat Weight Disord 26, 115–124 (2021). https://doi.org/10.1007/s40519-019-00825-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40519-019-00825-2

Keywords

Search

Navigation