Gait alterations in patients with adult spinal deformity
ABSTRACT: Background: Adult spinal deformity patients (ASD) experience altered spinal alignment affecting spatiotemporal parameters and joint kinematics. Differences in spinal deformity between patients with symptomatic idiopathic scoliosis (ID-ASD) and patients with “de novo” scoliosis (DN-ASD) ma...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | North American Spine Society Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666548423001087 |
| _version_ | 1827312345264685056 |
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| author | Stephanie M.D. Huysmans Rachel Senden Eva Jacobs Paul J.B. Willems Rik G.J. Marcellis Mark van den Boogaart Kenneth Meijer Paul C. Willems |
| author_facet | Stephanie M.D. Huysmans Rachel Senden Eva Jacobs Paul J.B. Willems Rik G.J. Marcellis Mark van den Boogaart Kenneth Meijer Paul C. Willems |
| author_sort | Stephanie M.D. Huysmans |
| collection | DOAJ |
| description | ABSTRACT: Background: Adult spinal deformity patients (ASD) experience altered spinal alignment affecting spatiotemporal parameters and joint kinematics. Differences in spinal deformity between patients with symptomatic idiopathic scoliosis (ID-ASD) and patients with “de novo” scoliosis (DN-ASD) may affect gait characteristics differently. This study aims to compare gait characteristics between ID-ASD, DN-ASD, and asymptomatic healthy matched controls. Methods: In this observational case-control study, ID-ASD (n = 24) and DN-ASD (n = 26) patients visiting the out-patient spine clinic and scheduled for long-segment spinal fusion were included. Patients were matched, based on age, gender, leg length and BMI, with asymptomatic healthy controls. Gait was measured at comfortable walking speed on an instrumented treadmill with 3D motion capture system. Trunk, pelvic and lower extremities range of motion (ROM) and spatiotemporal parameters (SPT) are presented as median (first and thirds quartile). Independent t-test or Mann–Whitney U test was used to compare ID-ASD, DN-ASD and controls. Statistical Parametric Mapping (independent t-test) was used to compare 3D joint kinematics. Results: DN-ASD patients walk with increased anterior trunk tilt during the whole gait cycle compared with ID-ASD patients and controls. ID-ASD walk with decreased trunk lateroflexion compared with DN-ASD and controls. DN-ASD showed decreased pelvic obliquity and -rotation, increased knee flexion, and decreased ankle plantar flexion. ID-ASD and DN-ASD displayed decreased trunk, pelvic and lower extremity ROM compared with controls, but increased pelvic tilt ROM. ID-ASD patients walked with comparable SPT to controls, whereas DN-ASD patients walked significantly slower with corresponding changes in SPT and wider steps. Conclusions: DN-ASD patients exhibit distinct alterations in SPT and kinematic gait characteristics compared with ID-ASD and controls. These alterations seem to be predominantly influenced by sagittal spinal malalignment and kinematic findings in ASD patients should not be generalized as such, but always be interpreted with consideration for the nature of the ASD. |
| first_indexed | 2024-03-08T14:25:30Z |
| format | Article |
| id | doaj.art-b9e4b937a9b54434933886a988a2eeb0 |
| institution | Directory Open Access Journal |
| issn | 2666-5484 |
| language | English |
| last_indexed | 2024-04-24T21:41:52Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | North American Spine Society Journal |
| spelling | doaj.art-b9e4b937a9b54434933886a988a2eeb02024-03-21T05:37:49ZengElsevierNorth American Spine Society Journal2666-54842024-03-0117100306Gait alterations in patients with adult spinal deformityStephanie M.D. Huysmans0Rachel Senden1Eva Jacobs2Paul J.B. Willems3Rik G.J. Marcellis4Mark van den Boogaart5Kenneth Meijer6Paul C. Willems7Department of Orthopedic Surgery and Research School CAPHRI (Care and Public Health Research Institute), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands; Corresponding author. Department of Orthopedic Surgery, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, DEB25, 6229 HX PO Box 5800 Maastricht, The Netherlands. Tel.: +31642199057.Department of Physiotherapy, Maastricht University Medical Center+ (MUMC+), Maastricht, the NetherlandsDepartment of Orthopedic Surgery and Research School CAPHRI (Care and Public Health Research Institute), Maastricht University Medical Center+ (MUMC+), Maastricht, the NetherlandsDepartment of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism (MUMC+), the NetherlandsDepartment of Physiotherapy, Maastricht University Medical Center+ (MUMC+), Maastricht, the NetherlandsDepartment of Orthopedic Surgery and Research School CAPHRI (Care and Public Health Research Institute), Maastricht University Medical Center+ (MUMC+), Maastricht, the NetherlandsDepartment of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism (MUMC+), the NetherlandsDepartment of Orthopedic Surgery and Research School CAPHRI (Care and Public Health Research Institute), Maastricht University Medical Center+ (MUMC+), Maastricht, the NetherlandsABSTRACT: Background: Adult spinal deformity patients (ASD) experience altered spinal alignment affecting spatiotemporal parameters and joint kinematics. Differences in spinal deformity between patients with symptomatic idiopathic scoliosis (ID-ASD) and patients with “de novo” scoliosis (DN-ASD) may affect gait characteristics differently. This study aims to compare gait characteristics between ID-ASD, DN-ASD, and asymptomatic healthy matched controls. Methods: In this observational case-control study, ID-ASD (n = 24) and DN-ASD (n = 26) patients visiting the out-patient spine clinic and scheduled for long-segment spinal fusion were included. Patients were matched, based on age, gender, leg length and BMI, with asymptomatic healthy controls. Gait was measured at comfortable walking speed on an instrumented treadmill with 3D motion capture system. Trunk, pelvic and lower extremities range of motion (ROM) and spatiotemporal parameters (SPT) are presented as median (first and thirds quartile). Independent t-test or Mann–Whitney U test was used to compare ID-ASD, DN-ASD and controls. Statistical Parametric Mapping (independent t-test) was used to compare 3D joint kinematics. Results: DN-ASD patients walk with increased anterior trunk tilt during the whole gait cycle compared with ID-ASD patients and controls. ID-ASD walk with decreased trunk lateroflexion compared with DN-ASD and controls. DN-ASD showed decreased pelvic obliquity and -rotation, increased knee flexion, and decreased ankle plantar flexion. ID-ASD and DN-ASD displayed decreased trunk, pelvic and lower extremity ROM compared with controls, but increased pelvic tilt ROM. ID-ASD patients walked with comparable SPT to controls, whereas DN-ASD patients walked significantly slower with corresponding changes in SPT and wider steps. Conclusions: DN-ASD patients exhibit distinct alterations in SPT and kinematic gait characteristics compared with ID-ASD and controls. These alterations seem to be predominantly influenced by sagittal spinal malalignment and kinematic findings in ASD patients should not be generalized as such, but always be interpreted with consideration for the nature of the ASD.http://www.sciencedirect.com/science/article/pii/S2666548423001087Adult spinal deformity3D gait analysisSagittal alignmentSpineTrunk tiltGait characteristics |
| spellingShingle | Stephanie M.D. Huysmans Rachel Senden Eva Jacobs Paul J.B. Willems Rik G.J. Marcellis Mark van den Boogaart Kenneth Meijer Paul C. Willems Gait alterations in patients with adult spinal deformity North American Spine Society Journal Adult spinal deformity 3D gait analysis Sagittal alignment Spine Trunk tilt Gait characteristics |
| title | Gait alterations in patients with adult spinal deformity |
| title_full | Gait alterations in patients with adult spinal deformity |
| title_fullStr | Gait alterations in patients with adult spinal deformity |
| title_full_unstemmed | Gait alterations in patients with adult spinal deformity |
| title_short | Gait alterations in patients with adult spinal deformity |
| title_sort | gait alterations in patients with adult spinal deformity |
| topic | Adult spinal deformity 3D gait analysis Sagittal alignment Spine Trunk tilt Gait characteristics |
| url | http://www.sciencedirect.com/science/article/pii/S2666548423001087 |
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