Balance and gait performance of scoliotic subjects: A review of the literature

Karimi, Mohammad Taghi; Kavyani, Mahsa; Kamali, Mostafa

doi:10.3233/bmr-150641

Cited by 24 publications

(22 citation statements)

References 36 publications

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“…These changes may cause postural stability deficits affecting the onset and curve progression [18]. Previous studies on changes in postural stability deficits for individuals with AIS compared to typically developed adolescents (CON) have shown inconsistent results from significant differences [19] to no differences in balance tasks [20, 21]. …”

Section: Introductionmentioning

confidence: 99%

Does postural stability differ between adolescents with idiopathic scoliosis and typically developed? A systematic literature review and meta-analysis

et al. 2018

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BackgroundPostural stability deficits have been proposed to influence the onset and progression of adolescent idiopathic scoliosis (AIS). This study aimed to systematically identify, critically evaluate and meta-analyse studies assessing postural stability during unperturbed stance with posturography in AIS compared to typically developed adolescents.MethodsStudies from four electronic databases (PubMed, Scopus, CINAHL, PEDro) were searched and case-control methodological quality assessed using a risk-of-bias assessment tool and a posturography methodological quality checklist. Pooled data regarding centre of pressure (COP) parameters such as sway area, Mediolateral (ML) and Anteroposterior (AP) position and range were compared for AIS and typically developed adolescents using Cohen’s d effect size (ES) and homogeneity estimates.ResultsEighteen studies for quality analysis and 9 of these for meta-analysis were identified from 971 records. Risk-of-bias assessment identified 6 high, 10 moderate and 2 low risk-of-bias studies. The posturography methodological quality checklist identified 4 low, 7 moderate and 7 high-quality studies. Meta-analysis was performed for sway area whereas ML and AP are presented in three different meta-analyses due to divergent measurement units used in the studies: ML position 1 (MLP1), ML position 2 (MLP2) and ML range (MLR); AP position 1 (APP1), AP position 2 (APP2) and AP range (APR). Cohen’s d showed a medium ES difference in sway area 0.65, 95% CI (0.49–0.63), whereas ML showed no (MLP1, MLP2) and large (MLR) ES differences; MLP1 0.15, 95% CI (0.08–0.22); MLP2 0.14, 95% CI (0.08–0.19); and MLR 0.94, 95% CI (0.83–1.04). Cohen’s d for AP showed small ES (APP1) and large ES difference (APP2 and APR); APP1 0.43, 95% CI (0.31–0.54); APP2 0.85, 95% CI (0.72–0.97); and APR 0.98, 95% CI (0.87–1.09). Cochran’s Q and Higgins I2 showed homogeneity between studies.ConclusionsThere is moderate quality evidence for decreased postural stability in AIS measured as COP parameters sway area, ML and AP range with a positional shift posteriorly in the sagittal plane. The findings support studying postural stability in early stage AIS and also prospectively identify cause and effect of the curvature as well as effectiveness of postural control interventions in the prevention of scoliosis progression.

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Section: Introductionmentioning

confidence: 99%

Does postural stability differ between adolescents with idiopathic scoliosis and typically developed? A systematic literature review and meta-analysis

et al. 2018

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“…Kinematic changes of the body segments associated with AIS are thought to be a compensatory mechanism for maintaining whole-body dynamic balance [18][19][20]. Asymmetrical AIS spinal deformity alters the shape, mass distribution and thus the COM position of the trunk [21], the extent of which depends on the severity of the condition. With the upper body accounting for about 60% of the body's mass, the altered trunk inertial properties may further affect the motions of the trunk itself and other body segments in order to maintain balance during activities such as gait [14,22], which are expected to increase the neuromechanical demand on the locomotor system.…”

Section: Introductionmentioning

confidence: 99%

Whole body balance control in Lenke 1 thoracic adolescent idiopathic scoliosis during level walking

Lee

et al. 2020

PLoS ONE

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Introduction Altered trunk shape and body alignment in Lenke 1 thoracic adolescent idiopathic scoliosis (AIS) may affect the body's balance control during activities. The current study aimed to identify the effects of Lenke 1 thoracic AIS on the balance control during level walking in terms of the inclination angles (IA) of the center of mass (COM) relative to the center of pressure (COP), the rate of change of IA (RCIA), and the jerk index of IA. The association between the Cobb angle, IA and RCIA was also evaluated. Materials and methods Sixteen adolescents with AIS (age: 14.0±1.8 years, height: 154.8±4.7 cm, mass: 42.0±7.5 kg) and sixteen healthy controls (age: 14.4±2.0 years, height: 158.4±6.2 cm, body mass: 48.6±8.9 kg) performed level walking in a gait laboratory. The kinematic and ground reaction force data were measured for both concave-side and convex-side limb cycles, and used to calculate the IA and RCIA, the jerk index of IA, and the temporal-spatial parameters. Correlations between the Cobb angle, IA and RCIA were quantified using Pearson's correlation coefficients (r). Results The patients showed less smooth COM-COP motion with increased jerk index of IA in the sagittal plane during single limb support (SLS) of the concave-limb (p = 0.05) and in the frontal plane during double limb support (DLS) (p < 0.05). The patients also showed significantly increased posterior RCIA on both the concave and convex side during initial (p = 0.04, p = 0.03) and terminal (p = 0.04, p = 0.03) DLS when compared to healthy controls. In the frontal plane, the patients walking on the concave-side limb showed decreased IA over SLS (p = 0.01), and at contralateral toe-off (p<0.01) and contralateral heel-strike (p = 0.02), but increased mean IA magnitude over terminal DLS (p = 0.01). The frontal IA at contralateral

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“…A successful obstacle-crossing task requires precise control of the end-point of the crossing limb while maintaining whole-body balance through highly coordinated control of the motions of the trunk and the pelvis-leg segments. With the upper body accounting for 60% of the body mass, the asymmetrical AIS spinal deformity alters the shape and mass distribution of the trunk, and thus its center of mass position [20], affecting the coordinated control of the motions of the trunk and other body segments during obstacle-crossing. Depending on which limb is leading, i.e., the limb on the convex or concave side, the control of the motions of the body segments can be different with different balance strategies, especially when AIS occurs with impaired proprioception [9].…”

Section: Introductionmentioning

confidence: 99%

Altered balance control in thoracic adolescent idiopathic scoliosis during obstructed gait

Lee

et al. 2020

PLoS ONE

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Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity during adolescence, leading to altered postural control with compromised stability. To identify the effects of AIS on whole-body balance control during obstacle-crossing, 14 adolescents with Lenke 1 thoracic AIS and 14 healthy controls were compared in terms of the inclination angle (IA) of the body's center of mass (COM) relative to the center of pressure (COP), the rate of change of IA (RCIA) and the jerk index of IA. Between-side comparisons were also performed for the AIS group. The patients showed less smooth COM-COP motion in the sagittal plane with significantly increased anterior RCIA and IA jerk index during crossing with either the concave side (p = 0.001) or the convex side (p = 0.001) leading when compared to healthy controls. In the frontal plane, the patients showed close-to-zero RCIA (p = 0.002) while crossing with the leading limb, with an increased IA magnitude (p = 0.039) only while crossing with the concave-side limb leading. The patients with Lenke 1 thoracic AIS were found to cross obstacles with altered, compromised COM-COP control in both sagittal and frontal planes when compared to healthy controls. The results suggest that the thoracic spinal deformity in Lenke 1 AIS affects the whole-body balance control during obstaclecrossing, which should be monitored for signs of increased risk of loss of balance in the management of such patient groups.

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Balance and gait performance of scoliotic subjects: A review of the literature

Abstract: There was a not sufficient robust evidence to judge about the influence of scoliosis deformity on kinetic and kinematic parameters. However, it should be emphasized that use of orthosis may influence the symmetry of gait and improve standing stability in adult with idiopathic scoliosis.

Cited by 24 publications

References 36 publications

Does postural stability differ between adolescents with idiopathic scoliosis and typically developed? A systematic literature review and meta-analysis

Does postural stability differ between adolescents with idiopathic scoliosis and typically developed? A systematic literature review and meta-analysis

Whole body balance control in Lenke 1 thoracic adolescent idiopathic scoliosis during level walking

Altered balance control in thoracic adolescent idiopathic scoliosis during obstructed gait

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