PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
摘要：
■成人脊柱畸形（ASD）患者的脊柱排列改变会影响时空参数和关节运动学。有症状的特发性脊柱侧凸（ID-ASD）患者和“从头”脊柱侧凸（DN-ASD）患者之间的脊柱畸形差异可能会对步态特征产生不同的影响。本研究旨在比较ID-ASD之间的步态特征，DN-ASD,和无症状健康匹配的对照。
■在这项观察性病例对照研究中，包括ID-ASD（n=24）和DN-ASD（n=26）到门诊脊柱诊所并计划进行长节段脊柱融合的患者。患者匹配，根据年龄,性别,腿长和BMI，无症状健康对照。在带有3D运动捕获系统的仪表跑步机上以舒适的步行速度测量步态。行李箱,骨盆和下肢活动范围（ROM）和时空参数（SPT）表示为中位数（第一和第三四分位数）。使用独立t检验或Mann-WhitneyU检验比较ID-ASD，DN-ASD和控制。使用统计参数映射(独立t检验)来比较3D关节运动学。
■DN-ASD患者与ID-ASD患者和对照组相比，在整个步态周期中行走前躯干倾斜增加。与DN-ASD和对照组相比，ID-ASD步行的躯干延迟弯曲减少。DN-ASD显示骨盆倾角和旋转减少，膝关节屈曲增加，踝关节足底屈曲减少。ID-ASD和DN-ASD显示减少的中继，与对照组相比，骨盆和下肢ROM，但增加骨盆倾斜ROM。ID-ASD患者的SPT与对照组相当，而DN-ASD患者的步行速度明显较慢，SPT有相应的变化，步数较宽。
■与ID-ASD和对照组相比，DN-ASD患者在SPT和运动学步态特征方面表现出明显的改变。这些改变似乎主要受到矢状脊柱排列不良的影响，ASD患者的运动学发现不应如此广泛。但总是要考虑ASD的性质来解释。
■在这项观察性病例对照研究中，包括ID-ASD（n=24）和DN-ASD（n=26）到门诊脊柱诊所并计划进行长节段脊柱融合的患者。患者匹配，根据年龄,性别,腿长和BMI，无症状健康对照。在带有3D运动捕获系统的仪表跑步机上以舒适的步行速度测量步态。行李箱,骨盆和下肢活动范围（ROM）和时空参数（SPT）表示为中位数（第一和第三四分位数）。使用独立t检验或Mann-WhitneyU检验比较ID-ASD，DN-ASD和控制。使用统计参数映射(独立t检验)来比较3D关节运动学。
■DN-ASD患者与ID-ASD患者和对照组相比，在整个步态周期中行走前躯干倾斜增加。与DN-ASD和对照组相比，ID-ASD步行的躯干延迟弯曲减少。DN-ASD显示骨盆倾角和旋转减少，膝关节屈曲增加，踝关节足底屈曲减少。ID-ASD和DN-ASD显示减少的中继，与对照组相比，骨盆和下肢ROM，但增加骨盆倾斜ROM。ID-ASD患者的SPT与对照组相当，而DN-ASD患者的步行速度明显较慢，SPT有相应的变化，步数较宽。
■与ID-ASD和对照组相比，DN-ASD患者在SPT和运动学步态特征方面表现出明显的改变。这些改变似乎主要受到矢状脊柱排列不良的影响，ASD患者的运动学发现不应如此广泛。但总是要考虑ASD的性质来解释。
