Abstract

Background and objectives: gait deviations refer to abnormal patterns of movement that may arise due to various physical deformities. Physical deformity on the other hand is a condition where there is an abnormality or malformation in the physical structure of a person’s body. This study categorized gait deviations and pattern of physical deformity among physically deformed tertiary students in Owerri.
Methods: the study focused on tertiary students living with gait deviation due to physical deformity in four (4) tertiary institutions of Imo state, Nigeria, with 94 participants who willing participated in the study. Using self-reported data, data was collected through physical meetings and a structured questionnaire, providing insights into the specific gait abnormalities, their potential impacts on the students’ daily activities and quality of life, the pattern of their physical deformity. SPSS was for quantitative analysis, and descriptive statistics was used to synergize and interpret the findings.
Results: the result shows53.2% of respondents are male, with 46.6% female. Dominant physical deformity is pes planus 26.6%, genu recurvatum 24.5%, pes cavus 23.4%, muscle dystrophy 13.8% and cerebral palsy 11.7%. 36.2% had acquired physical deformity, while 61.7% is congenital. 83% of the respondents experienced pain, which is mostly around the leg region, 6.4% experienced pain at the spine and at more than one body part respectively. 20.2% reported mild pain, 29.8% reported moderate pain, 30.9% reported severe pain, while 2.2% reported excruciating pain. 60% of the students affirmed changes in the leg movement while walking. Abducted hip 21.3%, adducted hip 13.8%, valgus 13.8%and varus 11.7% are some of the leg movement deviations identified among the respondents. 33% of the students experienced changes in their posture as a result of their physical deformities. The identified postural changes are lordosis 14.9%, scoliosis 10.6% and kyphosis 7.4%. 82% of the respondents experienced a change in their step length, with the majority having a step length that is below normal 61.7%, above normal and normal 10.6% respectively. limping gait 22.3%, steppage gait 20.2%, spastic gait 19.1%, waddling gait 16% and hemiplegic gait 13.8% were the identified gait deviations.
Conclusion: significant physical deformities exist among tertiary institution students in the study area, with noticeable gait deviations that could affect their daily functional and activity abilities/efficiency. There is a need to draw up policies and measures that will support them both in their rehabilitation program and daily life activities.

Keywords:Gait, deviations; Deformity; Students

Introduction

Individuals with deformities face challenges in coping with their daily life activities, in which some of them live sedentary lifestyles or depend on others to cope with physical activities. Such individuals can be assisted with ambulatory and assistive devices to be reintegrated socio-economically into society [1]. Understanding the pattern of such deformities and associated mobility/functional challenges, will help to rehabilitate and reintegrate the individual better [1,2]. Information on categorization, prevalence and impact of gait deviations among tertiary students with physical deformities in the selected region is very limited and inaccessible, attesting to the fact that such area of study remains understudied and poorly understood. The lack of comprehensive assessment and categorization of these deviations within this specific demographic presents a significant gap in our understanding of how physical deformities affect gait patterns, mobility, and overall quality of life among tertiary students in this region. Therefore, there is a pressing need to categorize, investigate and evaluate the nature, prevalence, and implications of gait deviations in these individuals to provide insights that could guide tailored interventions, enhance support systems, and improve the overall well-being of affected students in Imo State [3-5].

This study seeks to categorize the pattern of deformities and mobility challenges (gait deviations) among some tertiary institution students in Owerri, Imo State Nigeria. The study is focused on students because they can respond better to questionnaires at this level and it also appears to be the first time such individuals tend to live an independent lifestyle outside their home, so as to determine how they cope with their daily activities. Gait refers to the pattern of movement characterized by walking, running, or any other form of locomotion involving the bipedal (two-legged) motion of an individual. It’s a complex process involving a coordinated sequence of movements that allows a person to move from one point to another [6-8]. Human gaits are the various ways in which a human can move, either naturally or as a result of specialized training [4,6]. As movement is paramount in the activities of the daily life of the human being, it is, therefore, essential to identify and better understand any departure from the normal walking pattern. These deviations can be due to various factors including anatomical, biomechanical, neurological, or musculoskeletal issues [1,3,9]. These gait deviations are often adaptations made by individuals to cope with their physical deformities, and they may vary significantly based on the nature and extent of the deformity. Gait analysis in these cases can provide valuable insights into the specific challenges faced by individuals with physical deformities, helping in devising tailored interventions or treatments to improve their mobility and quality of life. Some of the common gait deviations observed in people with physical deformities include Limb length discrepancy, joint deformities, club foot, scoliosis, and cerebral palsy [1,5,10,11]. The degree of gait deviations can be seen to vary in different individuals, and such discrepancy has been narrowed down to a few causes such as age, sex, underlying conditions and other factors. The categorization of gait deviations among students with physical deformities has been traditionally used to gather information to understand control, improve performance, diagnose movement disorders, and evaluate treatment and rehabilitation programs [12,13].

In the knowledge of the categorization of gait deviations among students with physical deformities, functional tests which evaluate the student’s ability to perform various functional tasks such as stair climbing, sit-to-stand transfers, and balance tasks (walking with horizontal head turns) are one of the means of knowing their gait patterns [7,12,14]. Depending on the deformity and its severity, the gait assessment may include looking for any compensation strategies the student has developed, assessing any joint involvement, checking for muscle imbalances and monitoring the student’s center of balance while walking [14]. Several studies have investigated gait deviations among young adults, with a focus on various factors such as gender, age, and physical activity level [1,4,7,10-12]. A study conducted a while ago assessed the prevalence of gait deviations among male and female university students in Egypt and found that male students exhibited more gait abnormalities than their female counterparts, with a higher incidence of foot pronation and hip adduction [15]. Another study investigated the Effects of Physical Activity on Academic Performance in School-Aged Children and reported that students without physical deformities performed better than children with physical deformities [16].

Methods

This study surveyed four tertiary institutions in Owerri Imo State, Nigeria. Basically, a questionnaire with scalable replies and descriptive questions with in-depth answers (qualitative and quantitative technique) was used to gather data. It displays a prospective analysis of the difficulties, restrictions, social consequences, emotional well-being, and overall setbacks of students with gait deviations caused by physical deformities who live and school in any of the four known tertiary institutions in Imo state experience on a daily basis. This research design utilized a multidimensional approach to examine the various aspects and impacts of physical deformities on the student, and society. Students living with physical deformities that cause gait deviations in Imo state who are at least 17 years old to 28 years old will make up the population.

Exclusion Criteria

Students with the following characteristics were excluded from the study: neurological disorders affecting gait (e.g., Parkinson’s disease, stroke), severe musculoskeletal impairments hindering mobility and students that sit on wheelchairs, as there is no identified gait deviation.

Data Collection and Analysis

A survey study was deployed, where respondents were interviewed and responses obtained via the questionnaire. Data gotten was then categorized for easy presentation, interpretation and analysis. Statistical package for social sciences (SPSS) was used for quantitative analysis, and descriptive statistics, to synergize and interpret the findings.

Ethical Considerations

Informed Consent was gotten from the respondents and ensured that their privacy and confidentiality was preserved both during and after the study. Participants also had the liberty to opt out of the study without any consequences.

Results

Table 1 shows that 53.2% of the respondents were male students, while 46.8% are female. Table 2 shows that 7.4% of the respondents are below 18years old, while 92.6% were within the range of 19-28years old. Table 3 shows that the dominant physical deformity is pes planus 26.6%, followed by genu recurvatum the above table 4 shows that the number of students with acquired physical deformities as 36.2%, while those with congenital physical deformity is 61.7%. Table 5 shows that 83% of the respondents experienced pain, which is mostly around the leg region, 6.4% experienced pain at the spine and at more than one body part respectively. 20.2% reported mild pain, 29.8% reported moderate pain, 30.9% reported severe pain, while 2.2% reported excruciating pain. Table 6 identifies 60% of the students’ affirming changes in the leg movement while walking. Abducted hip 21.3%, adducted hip 13.8%, valgus 13.8%and varus 11.7% are some of the leg movement deviations identified among the respondents. Table 7 shows that 33% of the students experienced changes in their posture as a result of their physical deformities. The identified postural changes are lordosis 14.9%, scoliosis 10.6% and kyphosis 7.4%. Table 8 shows that an overwhelming percentage 82% of the respondents experienced a change in their step length, with the majority having a step length that is below normal 61.7%, above normal and normal 10.6% respectively. Table 9 shows that limping gait 22.3%, steppage gait 20.2%, spastic gait 19.1%, waddling gait 16% and hemiplegic gait 13.8% were the identified gait deviations.

Source: SPSS Output, 2024

Source: SPSS Output, 2024

Source: SPSS Output, 2024

Discussion

The study found that (53.2%) of the respondents were male while the remaining (46.8%) are female, which suggests that more male students live with physical deformity and deviated gait patterns than females, which agrees with the work of Abdulhadi A, et al [15]. The students’ age range was ≤18≤28. Very few of the participants were below 18 years of age, but not less than 16 years because the minimum age for university admission in Nigeria is 16 years, which confirms that the visited universities were not flaunting the rule. The participants experienced pain mostly in the legs, spine and also in more than one body part, which agrees with the work of Jangwon, 2017 which reported that the most body parts affected by physical deformities are the legs and spine [17]. The noticeable leg movements disorders associated with their physical deformities are abducted hip 21.3%, adducted hip13.8%, valgus 13.8% and varus 11.7%, which shows that the hip and knee were more affected than the ankle. Identified postural deformities are; lordosis 14.9%, scoliosis 10.6% and kyphosis 7.4%. The participants step length was categorized as; below normal 61.7%, above normal 10.6% and normal 10.6%. Noticeable gait deviations are waddling gait 16%, limping gait 22.3%, spastic gait 19.1%, steppage gait 20.2% and hemiplegic gait 13.8%.

Conclusion

Disability has significant consequences on a student and the way they live their lives. The categorization of gait deviations among students with physical deformities in Imo State, Nigeria demonstrates the multidimensional challenges faced by these students and the ignorance of living with it. It underscores the importance of addressing some discriminatory factors like employment disparities, educational barriers, healthcare access, and social bias, to improve their socio-economic outcomes. Also, there is need to create a more inclusive society and for policymakers, advocacy groups, and stakeholders to collaborate and develop/implement comprehensive strategies that will help this class of individuals. These strategies should focus on promoting equal opportunities, removing physical and attitudinal barriers, providing accessible healthcare services, enhancing educational support, and fostering social inclusion. By prioritizing inclusive policies and practices, we can empower individuals with physical disabilities to overcome socio economic challenges, enhance their quality of life, and contribute meaningfully to society.

Acknowledgement

We would like to thank the participants and the staff of some selected tertiary schools in Owerri, where most of the participants were met.

Funding/Support/

This study received no external funding or support.

Availability of data and materials

The data used to support the findings of this study are available from the corresponding author upon request.

Declaration

The authors have no conflict of interest to declare.

Subject’s consent

The aim and procedure of the study was explained to each subject, and informed consent was obtained from all consented before participating in the study.

Ethical approval and consent to participate

The study was granted ethical approval and reviewed by the ethical committee of School of Health Technology, Federal University of Technology Owerri, Imo State.

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