Gait analysis in patients with idiopathic scoliosis

Quervain, Inès A. Kramers-de; Müller, Roland; Stacoff, Alex; Grob, Dieter; Stüssi, Edgar

doi:10.1007/s00586-003-0588-x

Cited by 125 publications

(103 citation statements)

References 8 publications

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“…GRF differences between groups are more acute for lateral stepping. Large asymmetry of GRF gait has already been demonstrated in mediolateral component [11,18]. Giakas et al [17] have shown high GRF frequencies for SG and Schizas et al [25] have shown asymmetry of vertical GRF superior to 4% in SG.…”

Section: Discussionmentioning

confidence: 96%

Dynamical asymmetries in idiopathic scoliosis during forward and lateral initiation step

et al. 2009

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Adolescent idiopathic scoliosis (AIS) is characterized by morphological trunk modifications acting on body mass distribution. Some specific biomechanical strategies during postural regulation have been reported. Given that spinal deformity is three-dimensional, some strategy analysis resulting from different stepping directions should lead to a better understanding of the dynamic adaptation of behaviour. The aim of this study is to identify dynamic strategies of AIS patients stepping in lateral and forward directions. Ten AIS patients with a right thoracic curve and 15 controlled volunteers have been tested. Ground reaction forces (GRF) have been recorded for rightlimb stepping and for left-limb stepping associated to forward and lateral directions. Force amplitudes, corresponding occurrences, impulses of stepping phases and an asymmetry index have been computed. Asymmetry and variability increased in the AIS group, compared to the control group, whatever the stepping direction is. Asymmetry for AIS patients systematically provides an increased left initiation GRF compared to a right initiation. Nevertheless, for both groups, lateral initiation shows the largest asymmetry index reported for a forward initiation. More precisely, adaptive dynamic strategies for the AIS group have been characterized by an asymmetry between right and left limbs for lateral and forward initiation. These results can be explained by the influence of scoliosis pathology on dynamic movements due to spinal deformity. A right thoracic curve leads to an extra weight on the limb, which needs to be moved; consequently, stepping initiation with the right limb was more challenging for patients than stepping with the left limb. For the AIS group, the observed variability can also depend on the ontogenesis of adaptive strategies. Lateral step initiation has to be considered as the most relevant paradigm to study scoliosis and may also serve as a clinical basis for treatment to analyse the dynamic postural control and asymmetry strategies of the scoliosis patient.

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Section: Discussionmentioning

confidence: 96%

Dynamical asymmetries in idiopathic scoliosis during forward and lateral initiation step

et al. 2009

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“…Holden and Cavanagh [20] found that increased rearfoot pronation in during running causes significant increase in the free moment while Bleuse et al [8] found that it was related to anticipatory arm raising movements. Only, Kramers-de Quervain et al [23] reported data in adolescent idiopathic scoliosis girls. They underlined that free moment asymmetry was the single dynamic parameter related to the abnormal transverse plane acromion-pelvis alignment.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, few authors reported the use of the free moment [8,9,20,23,40]. Though the free moment measurement is useful in dynamic movement as running or walking, little attention has been paid to its measurement in standing balance.…”

Section: Discussionmentioning

confidence: 99%

“…They concluded that it contributed to the generation of slow arm movement when stabilization of the center of mass was not necessarily. To the best of our knowledge, only, Kramers-de Quervain et al [23] observed during walking the free moment in adolescent idiopathic scoliosis girls. During the stance of walking, an asymmetry of T V between left and right side was observed whereas the other force parameters (vertical, medio-lateral, antero-posterior) did not show a significant side asymmetry.…”

Section: Introductionmentioning

confidence: 91%

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Free moment contribution to quiet standing in able-bodied and scoliotic girls

et al. 2007

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Adolescent idiopathic scoliosis girls are known to display standing imbalance. In addition to a motor deficit problem, the axial torsion of the spine and trunk torsion could reflect an imbalance around the vertical axis. Unlike the excursion of the center of pressure (COP), the forces and moments were rarely addressed to characterize the quiet standing balance. Nonetheless, one dynamical parameter, called free moment (T V ), representing the vertical torque on the feet can reflect the oscillation around the vertical axis associated to the standing imbalance. The objectives of this study were to test if the free moment variability can be utilized to characterize standing balance in a group of able-bodied and non-treated scoliotic girls and to determine if it was associated with that of the COP among each group of subjects tested. Forty-six adolescent girls with half of them presenting an adolescent idiopathic scoliosis were tested during quiet standing balance.Standing balance was assessed with the subjects standing upright and bare feet on a force plate. RMS and range of COP excursions and free moment were calculated.The scoliotic group displayed higher variability in COP excursion by about 24% than the able-bodied girls. Similarly, the T V RMS (P = 0.00136) and range (P = 0.00197) were statistically higher by about 42% in the scoliotic group. The variability of T V was associated with that of the COP in both groups. In the medio-lateral direction, the significant correlations between the RMS and range of the free moment and those of the COP were about 0.7 for the able-bodied group and 0.5 for the medio-lateral COP range for the scoliotic group girls. Along the antero-posterior axis, the only statistically significant correlations were observed for the scoliotic group. The free moment variability about the COP measured during quiet standing can be suggestive of an asymmetry control of the trunk around the vertical axis during standing balance. Its variability was more pronounced in scoliotic girls and was associated with the antero-posterior COP variability reflecting both biomechanical and motor control deficits. Free moment calculation could be a supplement insight into the standing balance of scoliotic subjects. Keywords Scoliosis Á Standing balance Á Free moment Abbreviations APAntero-posterior direction COM The center of mass is a point equivalent of the total body mass resulting from the location of each body segment COP The center of pressure is the location of the net ground reaction force. ML Medio-lateral direction x where X m is the arithmetic mean of the variable X. X i is the ith value of the variable X measured at the instant i, and N is the number of X i values

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“…The specific postural strategies occurring in AIS have been previously studied during upright stance [8], stepping initiation [4], walking [10] and side-stepping initiation [4]. Scoliotic patients show an increase of the amplitude of the postural oscillations [27] associated with instability [8,25] and an increased asymmetry of the dynamics of the lower limbs [5,18,29]. The variability of the parameters analysed was greater for scoliotic patients than for control subjects [4], especially in the mediolateral (ML) and anteroposterior (AP) directions [16,30].…”

Section: Introductionmentioning

confidence: 99%

Idiopathic scoliosis: relations between the Cobb angle and the dynamical strategies when sitting on a seesaw

Bruyneel¹,

Chavet²,

Ebermeyer³

et al. 2010

Eur Spine J

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The aim of this study was to determine the influence of the severity of the spinal curve on the postural regulation when self-imposed disturbances occur in a seated position in anteroposterior (AP) and mediolateral (ML) orientations. Twelve female adolescents with a right thoracic scoliosis (Cobb = 30.4°± 9.7) were included in this study. The ground reaction forces (GRF) were studied while the subjects were maintaining their sitting on a seesaw (ML or AP destabilisation). Five conditions were tested: eyes open; with additional loads placed onto the subject's right or left shoulder; or onto the subject's right or left pelvis. We tested the correlation between the Cobb angle and the postural parameters (index of performance and GRF variability) for each condition. When the destabilisation was AP, the Cobb angle was significantly correlated with GRF variability and anterior and concavity index of performance. Two conditions showed higher correlations: stabilisation with the concavity pelvis load (GRF variability) and the open eyes (index of performance). In contrast, whatever the condition tested was, no link was found when the destabilisations were applied in ML direction. The destabilisation in a seated position highlights the influence of the curve severity on the postural organisation. In seated position, the postural control strategies specific to the scoliotic patients were always correlated by severity of curve, especially when the destabilisation is applied in AP directions. This study showed that the unstable seating position can be considered as a pertinent paradigm to help finding a postural clinical index for adolescent idiopathic scoliosis.

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Gait analysis in patients with idiopathic scoliosis

Cited by 125 publications

References 8 publications

Dynamical asymmetries in idiopathic scoliosis during forward and lateral initiation step

Dynamical asymmetries in idiopathic scoliosis during forward and lateral initiation step

Free moment contribution to quiet standing in able-bodied and scoliotic girls

Idiopathic scoliosis: relations between the Cobb angle and the dynamical strategies when sitting on a seesaw

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