MOTOR AND FUNCTIONAL DISORDERS IN PRIMARY SCHOOL-AGED CHILDREN WITH LEGG–CALVÉ–PERTHES DISEASE
DOI:
https://doi.org/10.31891/pcs.2026.2.6Keywords:
Legg–Calvé–Perthes disease, primary school-aged children, motor disorders, hip joint mobility, functional state, physical therapy, quality of lifeAbstract
Legg–Calvé–Perthes (LCP) disease is one of the most common orthopedic disorders in childhood, characterized by impaired blood supply to the femoral head and the development of avascular necrosis. The disease leads to structural changes in the hip joint, decreased joint mobility, and limitations in physical activity, which may significantly affect the functional state and quality of life of children.
The aim of the study was to determine the characteristics of motor and functional disorders in primary school-aged children with LCP disease. The study involved 30 children aged 6–12 years with a confirmed diagnosis of LCP disease. The functional condition of the musculoskeletal system was assessed using goniometry and manual muscle testing. Pain intensity was evaluated using the Visual Analogue Scale (VAS). The functional state of the cardiovascular system was assessed by measuring heart rate, arterial blood pressure, and calculating the Robinson index. The quality of life of the children was evaluated using the Pediatric Quality of Life Inventory (PedsQL). Statistical analysis included descriptive statistics methods.
The results showed the presence of moderate pain syndrome, with the mean VAS score of 5,3 ± 0,4 points. A significant decrease in the range of motion of the affected hip joint was found, particularly in hip abduction and internal rotation compared with the unaffected limb (p < 0,01). Manual muscle testing revealed reduced strength of the lower limb muscles, especially the hip abductors. The Robinson index was 96,1 ± 3,4 units, indicating a tendency toward decreased functional reserves of the cardiovascular system compared with reference values of healthy children. The overall quality of life score according to the PedsQL questionnaire was 67,4 ± 2,7 points, which was lower than normative indicators for healthy children.
The obtained results indicate that LCP disease is associated with a complex of motor and functional impairments, including pain syndrome, limitation of hip joint mobility, reduced muscle strength, decreased functional reserves, and lower quality of life. These findings should be taken into account when developing comprehensive physical therapy programs for children with this pathology.
References
Herring J. A. Legg–Calvé–Perthes disease. Journal of Pediatric Orthopaedics. 2020. Vol. 40. Suppl. 1. P. S4–S10. https://doi.org/10.1097/BPO.0000000000001505
Joseph B., Varghese G., Mulpuri K., Narasimhaiah M. Natural evolution of Perthes disease. Indian Journal of Orthopaedics. 2019. Vol. 53. No. 1. P. 10–18. https://doi.org/10.4103/ortho.IJOrtho_577_17
Novais E. N., Millis M. B. Perthes disease: pathophysiology and treatment. Journal of the American Academy of Orthopaedic Surgeons. 2018. Vol. 26. No. 7. P. 237–247. https://doi.org/10.5435/JAAOS-D-15-00646
Wiig O., Terjesen T., Svenningsen S. Prognostic factors and outcome in patients with Perthes disease. Clinical Orthopaedics and Related Research. 2020. Vol. 478. No. 5. P. 1113–1123. https://doi.org/10.1097/CORR.0000000000001103
Perry D. C., Bruce C. E., Pope D., Dangerfield P. Legg–Calvé–Perthes disease in children. The Lancet Child & Adolescent Health. 2018. Vol. 2. No. 10. P. 742–751. https://doi.org/10.1016/S2352-4642(18)30232
Laponin I. V., Korolkov O. I. Mistse miakotkanynnoi dekompresii u likuvanni uskladnenoho perebihu khvoroby Legga–Kalve–Pertesa u ditei. Zbirnyk naukovykh prats XV zizdu ortopediv-travmatolohiv Ukrainy. 2015. P. 476. [in Ukrainian].
Kim H. K. W. Legg–Calvé–Perthes disease. Journal of the American Academy of Orthopaedic Surgeons. 2010. Vol. 18. No. 11. P. 676–686. https://doi.org/10.5435/00124635-201011000-00005
Loder R. T., Skopelja E. N. The epidemiology and demographics of Legg–Calvé–Perthes disease. ISRN Orthopedics. 2011. Article ID 504393. https://doi.org/10.5402/2011/504393
Upasani V. V., Chambers R. C., Mubarak S. J. Evaluation and management of Legg–Calvé–Perthes disease. Orthopedic Clinics of North America. 2016. Vol. 47. No. 3. P. 545–553. https://doi.org/10.1016/j.ocl.2016.03.006
Havronska A. A., Korytko Z. I. Osoblyvosti fizychnoi terapii ditei z khvoroboiu Legga–Kalve–Pertesa. Ukrainskyi zhurnal laboratornoi medytsyny. 2024. Vol. 2. No. 1. P. 57–62. https://doi.org/10.62151/2786-9288.2.1.2024.07 [in Ukrainian].
Weinstein S. L., Flynn J. M. Lovell and Winter’s Pediatric Orthopaedics. 7th ed. Philadelphia : Wolters Kluwer Health, 2014.
Schoenecker J. G., Dobbs M. B., Luhmann S. J. Legg–Calvé–Perthes disease: current concepts. Journal of the American Academy of Orthopaedic Surgeons. 2012. Vol. 20. No. 9. P. 533–542.
Stulberg S. D., Cooperman D. R., Wallensten R. The natural history of Legg–Calvé–Perthes disease. Journal of Bone and Joint Surgery. 1981. Vol. 63. No. 7. P. 1095–1108.
Gavronska A. A., Korytko Z. I. Biomechanical and clinical-functional criteria for assessment of children with Legg–Calvé–Perthes disease in physical therapist practice. Science, Technology and Culture: Challenges and Perspectives. Proceedings of the International Scientific and Practical Conference (Paris, November 17–19, 2025). Paris, 2025. P. 215–223. URL: https://naukainfo.com/conference?id=73
Honiometriia. URL: https://rehabprime.com/goniometry/
Manualno-miazove testuvannia. URL: https://rehabprime.com/mmt/
Shkala boliu. URL: https://doctorthinking.org/2021/01/pain-scale/
Korytko Z. I. Medyko-biolohichni osnovy rukhovoi aktyvnosti. Lviv : LDUFK im. Ivana Boberskoho, 2020. 223 p. URL: http://repository.ldufk.edu.ua/handle/34606048/27946 [in Ukrainian].
Paediatric Quality of Life (PedsQL). URL: https://www.corc.uk.net/outcome-experience-measures/paediatric-quality-of-life-pedsql/
Guyton A. C., Hall J. E. Textbook of medical physiology. 13th ed. Philadelphia : Elsevier Saunders, 2016. 1176 p.
Filippovych Yu. B., Sorokina I. O. Fiziolohiia liudyny. Kyiv : Medytsyna, 2018. 456 p. [in Ukrainian].
Flynn J. T., Kaelber D. C., Baker-Smith C. M. et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017. Vol. 140. No. 3. e20171904. https://doi.org/10.1542/peds.2017-1904
Korytko Z. I. Do pytannia pro mekhanizmy adaptatsii sertsevo-sudynnoi systemy do tsyklichnykh navantazhen. Dosiahnennia biolohii ta medytsyny. 2010. No. 2. P. 70–74. URL: http://dspace.nbuv.gov.ua/bitstream/handle/123456789/47467/19-Korytko.PDF [in Ukrainian].
Plowman S. A., Smith D. L. Exercise physiology for health, fitness, and performance. 4th ed. Philadelphia : Wolters Kluwer, 2014. 720 p.
Cairney J., Hay J., Veldhuizen S., Missiuna C., Faught B. Developmental coordination disorder, physical activity, and fitness: a population-based study. Pediatrics. 2012. Vol. 129. No. 5. P. e1094–e1101. https://doi.org/10.1542/peds.2011-2007
Varni J. W., Seid M., Kurtin P. S. PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Medical Care. 2001. Vol. 39. No. 8. P. 800–812. https://doi.org/10.1097/00005650-200108000-00006
Joseph B., Varghese G., Mulpuri K. Perthes disease: current concepts. Indian Journal of Orthopaedics. 2016. Vol. 50. No. 4. P. 345–352. https://doi.org/10.4103/0019-5413.185596
Herring J. A. Tachdjian's Pediatric Orthopaedics. 6th ed. Philadelphia : Elsevier, 2020.
Korytko Z. I. Medyko-biolohichni osnovy fizychnoho vykhovannia. Lviv : LDUFK, 2002. 51 p. [in Ukrainian].
Klatchoian D. A., Len C. A., Terreri M. T. R. A., Silva M., Itamoto C., Ciconelli R. M., Varni J. W. Quality of life of children and adolescents from São Paulo: reliability and validity of the Brazilian version of the Pediatric Quality of Life Inventory version 4.0 Generic Core Scales. Journal of Pediatrics. 2008. Vol. 84. No. 4. P. 308–315. https://doi.org/10.2223/JPED.1788
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Адріяна ГАВРОНСЬКА, Зоряна КОРИТКО, Оксана ГУЗІЙ
This work is licensed under a Creative Commons Attribution 4.0 International License.
