Use of a Triaxial Accelerometer to Measure Changes in Gait Sway and Related Motor Function after Corrective Spinal Fusion Surgery for Adult Spinal Deformity
<b>Background</b>: Adult spinal deformity is a complex condition that causes lower back pain, causing spinal imbalance and discomfort in activities of daily life. After corrective spinal surgery, patients’ gait and balance abilities might not revert to normalcy and they might be at incre...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/7/1923 |
| _version_ | 1797212431949234176 |
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| author | Tomoyoshi Sakaguchi Naveen Sake Masato Tanaka Yoshihiro Fujiwara Shinya Arataki Takuya Taoka Yuya Kodama Kazuhiko Takamatsu Yosuke Yasuda Masami Nakagawa Kayo Utsunomiya Hiroki Tomiyama |
| author_facet | Tomoyoshi Sakaguchi Naveen Sake Masato Tanaka Yoshihiro Fujiwara Shinya Arataki Takuya Taoka Yuya Kodama Kazuhiko Takamatsu Yosuke Yasuda Masami Nakagawa Kayo Utsunomiya Hiroki Tomiyama |
| author_sort | Tomoyoshi Sakaguchi |
| collection | DOAJ |
| description | <b>Background</b>: Adult spinal deformity is a complex condition that causes lower back pain, causing spinal imbalance and discomfort in activities of daily life. After corrective spinal surgery, patients’ gait and balance abilities might not revert to normalcy and they might be at increased risk of falling. Therefore, early evaluation of such a risk is imperative to prevent further complications such as a fall, or even worse, fractures in post-surgery ASD patients. However, there has been no report of an investigation of such early changes in gait sway before and after ASD surgery. This is a prospective to investigate changes in gait sway before and following ASD surgery, using accelerometers, and also to examine motor function related to postoperative gait sway. <b>Methods</b>: Twenty patients were included who underwent corrective surgery as treatment for ASD, from October 2019 to January 2023. Measurement parameters included a 10 m walking test and the timed up-and-go test (TUG), gait sway was evaluated using accelerometers (root mean square; RMS), and hip flexion and knee extension muscle strength were tested. RMS included RMS vertical: RMS<sub>V</sub>; RMS anterior posterior: RMS<sub>AP</sub>; RMS medial lateral: RMS<sub>ML.</sub> The radiographic spinopelvic parameters were also evaluated preoperatively and postoperatively. <i>p</i> < 0.05 was noted as remarkably significant. <b>Results</b>: Preoperative and postoperative RMS<sub>V</sub> were 1.07 ± 0.6 and 1.31 ± 0.8, respectively (<i>p</i> < 0.05). RMS<sub>ML</sub> significantly decreased from 0.33 ± 0.2 to 0.19 ± 0.1 postoperatively (<i>p</i> < 0.01). However, RMS<sub>AP</sub> did not change postoperatively (0.20 ± 0.2 vs. 0.14 ± 0.1, <i>p</i> > 0.05). Patients’ one-month postoperative hip flexor muscle strength became significantly weaker (0.16 ± 0.04 vs. 0.10 ± 0.03 kgf/kg, <i>p</i> = 0.002), but TUG was maintained (11.6 ± 4.2 vs. 11.7 s, <i>p</i> = 0.305). RMS<sub>V</sub> was negatively correlated with quadriceps muscle strength and positively with TUG. RMS<sub>AP</sub> was negatively correlated with quadriceps muscle strength. All spinopelvic parameters became normal range after surgery. <b>Conclusions</b>: After corrective spinal fusion for ASD patients, the gait pattern improved significantly. Iliopsoas (hip flexor) and quadriceps femoris (knee extensor) muscles may play important roles for gait anterolateral and vertical swing, respectively. |
| first_indexed | 2024-04-24T10:42:17Z |
| format | Article |
| id | doaj.art-62f2a7ade2284f97a88fac8e43ca0995 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-24T10:42:17Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-62f2a7ade2284f97a88fac8e43ca09952024-04-12T13:21:02ZengMDPI AGJournal of Clinical Medicine2077-03832024-03-01137192310.3390/jcm13071923Use of a Triaxial Accelerometer to Measure Changes in Gait Sway and Related Motor Function after Corrective Spinal Fusion Surgery for Adult Spinal DeformityTomoyoshi Sakaguchi0Naveen Sake1Masato Tanaka2Yoshihiro Fujiwara3Shinya Arataki4Takuya Taoka5Yuya Kodama6Kazuhiko Takamatsu7Yosuke Yasuda8Masami Nakagawa9Kayo Utsunomiya10Hiroki Tomiyama11Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanHashimoto Artificial Limb Manufacture Co., Ltd., 32-13 Urayasunishimachi, Minami Ward, Okayama 702-8025, Japan<b>Background</b>: Adult spinal deformity is a complex condition that causes lower back pain, causing spinal imbalance and discomfort in activities of daily life. After corrective spinal surgery, patients’ gait and balance abilities might not revert to normalcy and they might be at increased risk of falling. Therefore, early evaluation of such a risk is imperative to prevent further complications such as a fall, or even worse, fractures in post-surgery ASD patients. However, there has been no report of an investigation of such early changes in gait sway before and after ASD surgery. This is a prospective to investigate changes in gait sway before and following ASD surgery, using accelerometers, and also to examine motor function related to postoperative gait sway. <b>Methods</b>: Twenty patients were included who underwent corrective surgery as treatment for ASD, from October 2019 to January 2023. Measurement parameters included a 10 m walking test and the timed up-and-go test (TUG), gait sway was evaluated using accelerometers (root mean square; RMS), and hip flexion and knee extension muscle strength were tested. RMS included RMS vertical: RMS<sub>V</sub>; RMS anterior posterior: RMS<sub>AP</sub>; RMS medial lateral: RMS<sub>ML.</sub> The radiographic spinopelvic parameters were also evaluated preoperatively and postoperatively. <i>p</i> < 0.05 was noted as remarkably significant. <b>Results</b>: Preoperative and postoperative RMS<sub>V</sub> were 1.07 ± 0.6 and 1.31 ± 0.8, respectively (<i>p</i> < 0.05). RMS<sub>ML</sub> significantly decreased from 0.33 ± 0.2 to 0.19 ± 0.1 postoperatively (<i>p</i> < 0.01). However, RMS<sub>AP</sub> did not change postoperatively (0.20 ± 0.2 vs. 0.14 ± 0.1, <i>p</i> > 0.05). Patients’ one-month postoperative hip flexor muscle strength became significantly weaker (0.16 ± 0.04 vs. 0.10 ± 0.03 kgf/kg, <i>p</i> = 0.002), but TUG was maintained (11.6 ± 4.2 vs. 11.7 s, <i>p</i> = 0.305). RMS<sub>V</sub> was negatively correlated with quadriceps muscle strength and positively with TUG. RMS<sub>AP</sub> was negatively correlated with quadriceps muscle strength. All spinopelvic parameters became normal range after surgery. <b>Conclusions</b>: After corrective spinal fusion for ASD patients, the gait pattern improved significantly. Iliopsoas (hip flexor) and quadriceps femoris (knee extensor) muscles may play important roles for gait anterolateral and vertical swing, respectively.https://www.mdpi.com/2077-0383/13/7/1923adult spinal deformitysurgeryrehabilitationspinal balancegait sway |
| spellingShingle | Tomoyoshi Sakaguchi Naveen Sake Masato Tanaka Yoshihiro Fujiwara Shinya Arataki Takuya Taoka Yuya Kodama Kazuhiko Takamatsu Yosuke Yasuda Masami Nakagawa Kayo Utsunomiya Hiroki Tomiyama Use of a Triaxial Accelerometer to Measure Changes in Gait Sway and Related Motor Function after Corrective Spinal Fusion Surgery for Adult Spinal Deformity Journal of Clinical Medicine adult spinal deformity surgery rehabilitation spinal balance gait sway |
| title | Use of a Triaxial Accelerometer to Measure Changes in Gait Sway and Related Motor Function after Corrective Spinal Fusion Surgery for Adult Spinal Deformity |
| title_full | Use of a Triaxial Accelerometer to Measure Changes in Gait Sway and Related Motor Function after Corrective Spinal Fusion Surgery for Adult Spinal Deformity |
| title_fullStr | Use of a Triaxial Accelerometer to Measure Changes in Gait Sway and Related Motor Function after Corrective Spinal Fusion Surgery for Adult Spinal Deformity |
| title_full_unstemmed | Use of a Triaxial Accelerometer to Measure Changes in Gait Sway and Related Motor Function after Corrective Spinal Fusion Surgery for Adult Spinal Deformity |
| title_short | Use of a Triaxial Accelerometer to Measure Changes in Gait Sway and Related Motor Function after Corrective Spinal Fusion Surgery for Adult Spinal Deformity |
| title_sort | use of a triaxial accelerometer to measure changes in gait sway and related motor function after corrective spinal fusion surgery for adult spinal deformity |
| topic | adult spinal deformity surgery rehabilitation spinal balance gait sway |
| url | https://www.mdpi.com/2077-0383/13/7/1923 |
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