The use of gait analysis in the assessment of patients afflicted with spinal disorders
- 303 Downloads
Use gait analysis to establish and detail the clinically relevant components of normal human gait, analyze the gait characteristics for those afflicted with spinal pathology, and identify those aspects of human gait that correlate with pre- and postoperative patient function and outcomes.
Twenty patients with adult degenerative scoliosis (ADS), 20 patients with cervical spondylotic myelopathy (CSM), and 15 healthy volunteers performed over-ground gait trials with a comfortable self-selected speed using video cameras to measure patient motion, surface electromyography (EMG) to record muscle activity, and force plates to record ground reaction force (GRF). Gait distance and temporal parameters, ankle, knee, hip, pelvic, and trunk range of motion (ROM), duration of lower extremity EMG activity and peak vertical GRF were measured.
Patients with ADS and CSM exhibited a significantly slower gait speed, decrease in step length, cadence, longer stride time, stance time, double support time, and an increase in step width compared to those in the control group. These patients also exhibited a significantly different ankle, knee, pelvic, and trunk ROM. Moreover, spinal disorder patients exhibited a significantly longer duration of rectus femoris, semitendinosus, tibialis anterior and medial gastrocnemius muscle activity along with an altered vertical GRF pattern.
Gait analysis provides an objective measure of functional gait in healthy controls as well as those with ADS and CSM. This study established and detailed some of the important kinematic and kinetic variables of gait in patients with spinal disorders. We recommend that spine care providers use gait analysis as part of their clinical evaluation to provide an objective measure of function.
KeywordsGait analysis Electromyography Ground reaction force Adult degenerative scoliosis Cervical spondylotic myelopathy
Compliance with ethical standards
Conflict of interest
None of the authors has any potential conflict of interest.
The study was approved by the Western Institutional Review Board for the Protection of Human Subjects (IRB#: 20152881).
- 2.Oatis CA (2004) Kinesiology—the mechanics and pathomechanics of human movement. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
- 6.Yagi M, Ohne H, Konomi T, Fujiyoshi K, Kaneko S, Takemitsu M, Machida M, Yato Y, Asazuma T (2017) Walking balance and compensatory gait mechanisms in surgically treated patients with adult spinal deformity. Spine J 17:409–417. https://doi.org/10.1016/j.spinee.2016.10.014 CrossRefPubMedGoogle Scholar
- 7.Baskwill AJ, Belli P, Kelleher L (2017) Evaluation of a gait assessment module using 3D motion capture technology. Int J Ther Massage Bodyw 10:3–9Google Scholar
- 13.Siasios ID, Spanos SL, Kanellopoulos AK, Fotiadou A, Pollina J, Schneider D, Becker A, Dimopoulos VG, Fountas KN (2017) The role of gait analysis in the evaluation of patients with cervical myelopathy: a literature review study. World Neurosurg 101:275–282. https://doi.org/10.1016/j.wneu.2017.01.122 CrossRefPubMedGoogle Scholar
- 20.Ko SU, Ling SM, Schreiber C, Nesbitt M, Ferrucci L (2011) Gait patterns during different walking conditions in older adults with and without knee osteoarthritis–results from the Baltimore longitudinal study of aging. Gait Posture 33:205–210. https://doi.org/10.1016/j.gaitpost.2010.11.006 CrossRefPubMedGoogle Scholar
- 29.Renaud A, Fuentes A, Hagemeister N, Lavigne M, Vendittoli PA (2016) Clinical and biomechanical evaluations of staged bilateral total knee arthroplasty patients with two different implant designs. Open Orthop J 10:155–165. https://doi.org/10.2174/1874325001610010155 CrossRefPubMedPubMedCentralGoogle Scholar
- 31.Sacco IC, Akashi PM, Hennig EM (2010) A comparison of lower limb EMG and ground reaction forces between barefoot and shod gait in participants with diabetic neuropathic and healthy controls. BMC Musculoskelet Disord 11:24. https://doi.org/10.1186/1471-2474-11-24 CrossRefPubMedPubMedCentralGoogle Scholar
- 33.Vaughan CL, Davis BL, O’Conner JC (1999) Dynamics of human gait. Kiboho Publishers, Cape TownGoogle Scholar
- 34.Robertson GE, Caldwell GE, Hamill J, Kamen G, Whittlesey SN (2013) Research methods in biomechanics. Human Kinetics, ChampaignGoogle Scholar