The relationship between spinal alignment and activity of paravertebral muscle during gait in patients with adult spinal deformity: a retrospective study
Abstract Background Spinal alignment in patients with adult spinal deformity (ASD) changes between rest and during gait. However, it remains unclear at which point the compensated walking posture breaks down and how muscles respond. This study used time-synchronized electromyography (EMG) to investi...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-01-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-022-06121-y |
| _version_ | 1797958796360810496 |
|---|---|
| author | Tomoyuki Asada Kousei Miura Hideki Kadone Kotaro Sakashita Toru Funayama Hiroshi Takahashi Hiroshi Noguchi Kosuke Sato Fumihiko Eto Hisanori Gamada Kento Inomata Masao Koda Masashi Yamazaki |
| author_facet | Tomoyuki Asada Kousei Miura Hideki Kadone Kotaro Sakashita Toru Funayama Hiroshi Takahashi Hiroshi Noguchi Kosuke Sato Fumihiko Eto Hisanori Gamada Kento Inomata Masao Koda Masashi Yamazaki |
| author_sort | Tomoyuki Asada |
| collection | DOAJ |
| description | Abstract Background Spinal alignment in patients with adult spinal deformity (ASD) changes between rest and during gait. However, it remains unclear at which point the compensated walking posture breaks down and how muscles respond. This study used time-synchronized electromyography (EMG) to investigate the relationship between dynamic spinal alignment and muscle activity during maximum walking duration to reveal compensation mechanisms. Methods This study collected preoperative three-dimensional gait analysis data from patients who were candidates for corrective surgery for ASD from April 2015 to May 2019. We preoperatively obtained dynamic spinal alignment parameters from initiation to cessation of gait using a motion capture system with time-synchronized surface integrated EMG (iEMG). We compared chronological changes in dynamic spinal alignment parameters and iEMG values 1) immediately after gait initiation (first trial), 2) half of the distance walked (half trial), and 3) immediately before cessation (last trial). Results This study included 26 patients (22 women, four men) with ASD. Spinal sagittal vertical axis distance during gait (SpSVA) increased over time (first vs. half vs. last, 172.4 ± 74.8 mm vs. 179.9 ± 76.8 mm vs. 201.6 ± 83.1 mm; P < 0.001). Cervical paravertebral muscle (PVM) and gluteus maximus activity significantly increased (P < 0.01), but thoracic and lumbar PVM activity did not change. Dynamic spinal alignment showed significant correlation with all muscle activity (cervical PVM, r = 0.41–0.54; thoracic PVM, r = 0.49–0.66; gluteus maximus, r = 0.54–0.69; quadriceps, r = 0.46–0.55) except lumbar PVM activity. Conclusion Spinal balance exacerbation occurred continuously in patients with ASD over maximum walking distance and not at specific points. To maintain horizontal gaze, cervical PVM and gluteus maximus were activated to compensate for a dynamic spinal alignment change. All muscle activities, except lumbar PVM, increased to compensate for the spinal malalignment over time. |
| first_indexed | 2024-04-11T00:24:53Z |
| format | Article |
| id | doaj.art-417806c9264045649004e442f5e83b69 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-11T00:24:53Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-417806c9264045649004e442f5e83b692023-01-08T12:03:06ZengBMCBMC Musculoskeletal Disorders1471-24742023-01-0124111010.1186/s12891-022-06121-yThe relationship between spinal alignment and activity of paravertebral muscle during gait in patients with adult spinal deformity: a retrospective studyTomoyuki Asada0Kousei Miura1Hideki Kadone2Kotaro Sakashita3Toru Funayama4Hiroshi Takahashi5Hiroshi Noguchi6Kosuke Sato7Fumihiko Eto8Hisanori Gamada9Kento Inomata10Masao Koda11Masashi Yamazaki12Department of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaCenter for Innovative Medicine and Engineering, University of Tsukuba HospitalDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaAbstract Background Spinal alignment in patients with adult spinal deformity (ASD) changes between rest and during gait. However, it remains unclear at which point the compensated walking posture breaks down and how muscles respond. This study used time-synchronized electromyography (EMG) to investigate the relationship between dynamic spinal alignment and muscle activity during maximum walking duration to reveal compensation mechanisms. Methods This study collected preoperative three-dimensional gait analysis data from patients who were candidates for corrective surgery for ASD from April 2015 to May 2019. We preoperatively obtained dynamic spinal alignment parameters from initiation to cessation of gait using a motion capture system with time-synchronized surface integrated EMG (iEMG). We compared chronological changes in dynamic spinal alignment parameters and iEMG values 1) immediately after gait initiation (first trial), 2) half of the distance walked (half trial), and 3) immediately before cessation (last trial). Results This study included 26 patients (22 women, four men) with ASD. Spinal sagittal vertical axis distance during gait (SpSVA) increased over time (first vs. half vs. last, 172.4 ± 74.8 mm vs. 179.9 ± 76.8 mm vs. 201.6 ± 83.1 mm; P < 0.001). Cervical paravertebral muscle (PVM) and gluteus maximus activity significantly increased (P < 0.01), but thoracic and lumbar PVM activity did not change. Dynamic spinal alignment showed significant correlation with all muscle activity (cervical PVM, r = 0.41–0.54; thoracic PVM, r = 0.49–0.66; gluteus maximus, r = 0.54–0.69; quadriceps, r = 0.46–0.55) except lumbar PVM activity. Conclusion Spinal balance exacerbation occurred continuously in patients with ASD over maximum walking distance and not at specific points. To maintain horizontal gaze, cervical PVM and gluteus maximus were activated to compensate for a dynamic spinal alignment change. All muscle activities, except lumbar PVM, increased to compensate for the spinal malalignment over time.https://doi.org/10.1186/s12891-022-06121-yGait analysisAdult spinal deformityParavertebral muscleIntegrated EMGDynamic spinal parameters |
| spellingShingle | Tomoyuki Asada Kousei Miura Hideki Kadone Kotaro Sakashita Toru Funayama Hiroshi Takahashi Hiroshi Noguchi Kosuke Sato Fumihiko Eto Hisanori Gamada Kento Inomata Masao Koda Masashi Yamazaki The relationship between spinal alignment and activity of paravertebral muscle during gait in patients with adult spinal deformity: a retrospective study BMC Musculoskeletal Disorders Gait analysis Adult spinal deformity Paravertebral muscle Integrated EMG Dynamic spinal parameters |
| title | The relationship between spinal alignment and activity of paravertebral muscle during gait in patients with adult spinal deformity: a retrospective study |
| title_full | The relationship between spinal alignment and activity of paravertebral muscle during gait in patients with adult spinal deformity: a retrospective study |
| title_fullStr | The relationship between spinal alignment and activity of paravertebral muscle during gait in patients with adult spinal deformity: a retrospective study |
| title_full_unstemmed | The relationship between spinal alignment and activity of paravertebral muscle during gait in patients with adult spinal deformity: a retrospective study |
| title_short | The relationship between spinal alignment and activity of paravertebral muscle during gait in patients with adult spinal deformity: a retrospective study |
| title_sort | relationship between spinal alignment and activity of paravertebral muscle during gait in patients with adult spinal deformity a retrospective study |
| topic | Gait analysis Adult spinal deformity Paravertebral muscle Integrated EMG Dynamic spinal parameters |
| url | https://doi.org/10.1186/s12891-022-06121-y |
| work_keys_str_mv | AT tomoyukiasada therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT kouseimiura therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT hidekikadone therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT kotarosakashita therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT torufunayama therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT hiroshitakahashi therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT hiroshinoguchi therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT kosukesato therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT fumihikoeto therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT hisanorigamada therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT kentoinomata therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT masaokoda therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT masashiyamazaki therelationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT tomoyukiasada relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT kouseimiura relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT hidekikadone relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT kotarosakashita relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT torufunayama relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT hiroshitakahashi relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT hiroshinoguchi relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT kosukesato relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT fumihikoeto relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT hisanorigamada relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT kentoinomata relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT masaokoda relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy AT masashiyamazaki relationshipbetweenspinalalignmentandactivityofparavertebralmuscleduringgaitinpatientswithadultspinaldeformityaretrospectivestudy |