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The Creative Commons Public Domain Dedication waiver (http:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,3,2]],"date-time":"2020-03-02T00:00:00Z","timestamp":1583107200000},"content-version":"vor","delay-in-days":61,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Journal of Foot and Ankle Research"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Weakness is the primary impairment in paediatric neuromuscular diseases, impacting gait and gait\u2010related functional activities in ambulant children affected by these rare and often degenerative diseases. Gait speed is an indicator of health and disability, yet gait is a complex, multi\u2010faceted activity. Using the International Classification of Function, Health and Disability (ICF) model, assessment of gait and functional ambulation should consider the impairments, activity limitations and participation restrictions due to disease, and factors related to the environment and the individual person.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This narrative review involved a literature search of databases including Medline, Embase and Pubmed from 1946 to October 2019. Inclusion criteria included assessments of gait, endurance and ambulatory function in paediatric (0\u201318\u2009years) neuromuscular diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two papers were identified reporting assessments of gait speed, timed function, endurance and ambulatory capacity, gait\u2010related balance and qualitative descriptive assessments of gait function and effect of disease on gait and gait\u2010related activities. Gait speed is an indicator of disability and children with neuromuscular disease walk slower than typically developing peers. Increasing disease severity and age were associated with slower walking in children with Duchenne muscular dystrophy and Charcot\u2010Marie\u2010Tooth disease. The six\u2010minute walk test is used widely as a test of endurance and ambulatory capacity; six\u2010minute walk distance was substantially reduced across all paediatric neuromuscular diseases. Endurance and ambulatory capacity was more limited in children with spinal muscular atrophy type 3, congenital muscular dystrophy and older boys with Duchenne muscular dystrophy. Only a few papers considered normalisation of gait parameters accounting for the effect on gait of height in heterogeneous groups of children and linear growth in longitudinal studies. Balance related to gait was considered in five papers, mainly in children with Charcot\u2010Marie\u2010Tooth disease. There was limited investigation of factors including distance requirements and terrain in children's typical environments and personal factors related to self\u2010perception of disease effect on gait and gait\u2010related function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Assessments of gait and functional ambulation are important considerations in documenting disease progression and treatment efficacy in the clinical setting; and in clinical trials of disease\u2010modifying agents and physiotherapeutic interventions in paediatric neuromuscular diseases. There is a need for expert consensus on core gait and functional ambulation assessments for use in clinical and research settings.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13047-020-0378-2","type":"journal-article","created":{"date-parts":[[2020,3,2]],"date-time":"2020-03-02T20:02:58Z","timestamp":1583179378000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Walking and weakness in children: a narrative review of gait and functional ambulation in paediatric neuromuscular disease"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1805-6937","authenticated-orcid":false,"given":"Rachel A.","family":"Kennedy","sequence":"first","affiliation":[{"name":"Department of Physiotherapy The University of Melbourne Parkville Vic Australia"},{"name":"Department of Neurology The Royal Children's Hospital Parkville Vic Australia"},{"name":"Murdoch Children's Research Institute Parkville Vic Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy The University of Melbourne Parkville Vic Australia"},{"name":"Department of Neurology The Royal Children's Hospital Parkville Vic Australia"},{"name":"Murdoch Children's Research Institute Parkville Vic Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"McGinley","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy The University of Melbourne Parkville Vic Australia"},{"name":"Murdoch Children's Research Institute Parkville Vic Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kade L.","family":"Paterson","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy The University of Melbourne Parkville Vic Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,2]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejhg.2011.134"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000474"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2014.03.008"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1519\/00139143\u2010200932020\u201000002"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1123\/japa.2013\u20100236"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3102134"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild\u20102018\u2010314890"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2010.06.003"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21917"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0199657"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2018.03.029"},{"key":"e_1_2_13_13_1","unstructured":"International Classification of Functioning Disability and Health (ICF).World Health Organisation2018 Available from: https:\/\/www.who.int\/classifications\/icf\/en\/"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26500"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0209628"},{"key":"e_1_2_13_16_1","doi-asserted-by":"crossref","unstructured":"BaptistaCRD Nascimento\u2010EliasAH GarciaB TestaA DominguesPC MartinezEZ et al. 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