Asymmetrical gait in adolescents with idiopathic scoliosis

Abstract

Purpose This study investigated side-to-side gait asymmetry in subjects with adolescent idiopathic scoliosis. Methods There were 20 adolescents with idiopathic scoliosis and 20 age-matched control subjects, who participated in the study. To minimize confounding effects, we recruited patients with similar spinal curvature for the scoliosis group, and all participants are right hand dominant. The participants were instructed to ambulate on a 10 m walkway while barefoot. There were two force plates in the middle of the walkway. The ground reaction force (GRF) and angular displacements of six segments (foot, shank, thigh, pelvis, trunk, and head) were measured during one gait cycle based on the right and left lower extremities. To remove the positional information in the kinematic data, the derivative of angular displacement in each segment was calculated. To evaluate the side-to-side gait symmetry, we calculated the cross-correlation of each bilateral gait parameter. Results In the kinematics, the scoliosis group demonstrated asymmetrical gait in the frontal and transverse planes compared to the control group. In the GRF data, the scoliosis group demonstrated asymmetrical gait in the medial-lateral (M/L) direction compared to the control group.Conclusions These results indicated that the scoliosis group produced an asymmetrical rotation pattern of the segments bilaterally in the frontal and transverse planes, resulting in asymmetrical GRF patterns in the M/L direction. This asymmetrical gait may be produced by changes in global postural control during gait and not simply by changes in control of only one or two specific segments.

Dynamic balance assessment during gait in spinal pathologies – A literature review

“…AIS subjects have about 7% shorter step length but authors do not agree on the decrease of gait velocity [10,17,19,21,22]. Opposite results are reported regarding the influence of the severity of the deformity on time-distance parameters [19,21].…”

“…AIS subjects do not show side-to-side 3D kinematic trunk asymmetry except for in the transverse plane [17,19,22]. Lower limb kinematics showed a reduction in ROM of the pelvis, hips, and shoulders in the frontal plane; a transverse plane reduction of hip ROM; and a sagittal plane reduction of knee ROM [19,21].…”

“…Considering the dissimilar results from transverse plane kinematics, two studies suggested that AIS subjects have similar ROM amplitude compared to normal subjects, with no precision about frontal balance [19,22]. Trunk rotation is considered to be essential for the assertion of the horizontal line of pelvis and head progression, which are symmetrically oriented in normal subjects.…”

“…Kinetics are relevant and reliable to assess gait compensatory mechanisms [10,14,15,20,22]. Tri-dimensional GRF are asymmetrical and higher impulses on the concave side is reported as a control mechanism [10,11,13].…”

“…Among the comparatives studies, there were no significant differences in ages for 20 studies. Minors were tested exclusively in articles related to adolescents with idiopathic scoliosis [10][11][12][13][14][15][16][17][18][19][20][21][22].…”