Walking Difficulties With Dravet May Signal Limited Mobility
Study into functional mobility, motor impairments of children and teenagers
Children and adolescents with Dravet syndrome with walking difficulties commonly experience impairments in functional mobility and greater restrictions in daily life activities, a study suggests.
Its researchers recommend that physiotherapy be given patients to improve their gait, potentially allowing for better mobility in daily life.
The study, “The relation between gait abnormalities and daily functional mobility in developmental epileptic encephalopathies: The case of Dravet syndrome,” was published in the journal Gait & Posture.
Dravet syndrome, a rare and severe type of epilepsy that usually appears during the first year of life, is characterized by impaired cognitive and motor development. Patients often show walking problems which, according to caregivers, affect their and their family’s quality of life.
Motor impairments more severe in younger children with Dravet
Researchers in Belgium investigated whether walking difficulties in Dravet children correlate with limitations in functional mobility — the ability to move freely — in daily life.
They analyzed data from 40 children and teenagers (19 girls and 21 boys; mean age, 12.3 years) with Dravet. The children’s walking ability was evaluated annually using instrumented 3D gait analysis. The gait profile score (GPS) was used to assess their overall walking ability and how much it deviated from normal.
Functional mobility during daily life was assessed by the functional mobility scale (FMS) and the 28-item version of the mobility questionnaire (MobQues28).
FMS describes the level of a child’s functional mobility taking into account the use of assistive devices in everyday life. Used by a clinician, it is scored over three distances — 5 meters, 50 meters, and 500 meters — which mark the typical distances covered by children at home, in school, and the wider community. For each distance, the type of assistance required is rated on an ordinal scale from one (wheelchair use) to six (independent walking without an assistive device on all surfaces).
In the MobQues28, scores range from zero to 100, and lower scores indicate more mobility limitations.
Findings were divided according to three age groups: younger than 8 years (15 patients), between 8–18 years (21 patients), and older than 18 (11 patients).
The analysis revealed that patients — particularly children younger than age 8 years, and those older than 18 years — showed mobility limitations, especially for longer distances (500 meters).
The median MobQues28 scores were the lowest in both groups — score of 67 — when compared to children between 8 and 18 years old whose median score was 88.
Functional mobility showed a moderate correlation with walking abilities, with patients with better walking skills showing better functional mobility and fewer restrictions in activities of daily living.
Overall, these findings suggest that “physiotherapy addressing the gait [walking] pattern, can thus be of importance to improve functional mobility,” the researchers concluded.