Format

Send to

Choose Destination
Gait Posture. 2017 Jun;55:37-42. doi: 10.1016/j.gaitpost.2017.03.036. Epub 2017 Apr 5.

Assessment of stability during gait in patients with spinal deformity-A preliminary analysis using the dynamic stability margin.

Author information

1
Motion Analysis Laboratory, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Biomechanics Laboratory, Ecole Nationale Supérieure des Arts et Métiers-Paris Tech, 151 Bd de l'Hôpital, 75013 Paris, France.
2
Motion Analysis Laboratory, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Whitaker International Program, Department of Physical Therapy, Chiang Mai University, 110 Intawaroroj Rd, Sripoom, Chiang Mai 50200, Thailand.
3
Motion Analysis Laboratory, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
4
Pediatric Orthopaedics Department, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
5
Motion Analysis Laboratory, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: kaufman.kenton@mayo.edu.

Abstract

Daily living activities are dynamic, requiring spinal motion through space. Current assessment of spinal deformities is based on static measurements from full-spine standing radiographs. Tools to assess dynamic stability during gait might be useful to enhance the standard evaluation. The aim of this study was to evaluate gait dynamic imbalance in patients with spinal deformity using the dynamic stability margin (DSM). Twelve normal subjects and 17 patients with spinal deformity were prospectively recruited. A kinematic 3D gait analysis was performed for the control group (CG) and the spinal deformity group (SDG). The DSM (distance between the extrapolated center of mass and the base of support) and time-distance parameters were calculated for the right and left side during gait. The relationship between DSM and step length was assessed using three variables: gait stability, symmetry, and consistency. Variables' accuracy was validated by a discriminant analysis. Patients with spinal deformity exhibited gait instability according to the DSM (0.25m versus 0.31m) with decreased velocity (1.1ms-1 versus 1.3ms-1) and decreased step length (0.32m versus 0.38m). According to the discriminant analysis, gait stability was the more accurate variable (area under the curve AUC=0.98) followed by gait symmetry and consistency. However, gait consistency showed 100% of specificity, sensitivity, and accuracy of precision. The DSM showed that patients with spinal malalignment exhibit decreased gait stability, symmetry, and consistency besides gait time-distance parameter changes. Additional work is required to determine how to apply the DSM for preoperative and postoperative spinal deformity management.

KEYWORDS:

Base of support; Dynamic stability margin; Extrapolated center of mass; Gait stability; Spinal deformity

PMID:
28411443
DOI:
10.1016/j.gaitpost.2017.03.036
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center