Are Gait Kinematics of Adults with Achondroplasia and Congenital Pituitary Insufficiency Different from Healthy Adults?

Background Short stature resulting from skeletal dysplasia or pituitary insufficiency can significantly alter gait biomechanics. However, gait characteristics of adults with these conditions remain poorly described. Research question Do adults with short stature due to achondroplasia or congenital pituitary insufficiency demonstrate different gait kinematics and spatiotemporal parameters compared to healthy adults? Methods This cross-sectional study included 10 adults with short stature (6 with achondroplasia, 4 with pituitary insufficiency) and 20 age- and sex-matched healthy controls. Gait was assessed using wearable inertial measurement unit (IMU) sensors and a pressure-sensitive walkway. Kinematic data (joint range of motion in the pelvis, spine, and lower extremities) and spatiotemporal parameters were collected and normalized to leg length. Group comparisons were conducted using appropriate statistical tests (p < 0.05). Results The short stature group showed significantly higher normalized cadence (p < 0.001) and shorter stride length (p < 0.001), with no difference in normalized gait speed. Kinematic analysis revealed increased hip flexion, hip abduction, ankle dorsiflexion, anterior pelvic tilt, and lumbar axial rotation. Reduced knee flexion, reduced hip external rotation during swing and increased pelvic obliquity were observed. Greater trunk and pelvic mobility were observed in the short stature group. Significance Adults with short stature adopt distinct compensatory strategies to improve gait efficiency. These include increased cadence, hip flexion, ankle dorsiflexion and enhanced mobility in the pelvis and trunk to optimize foot clearance and balance. Rehabilitation programs should address segmental disproportions and emphasize proximal control to reduce effort and musculoskeletal strain.