Influence of spino-pelvic and postural alignment parameters on gait kinematics

Otayek, Joeffroy; Bizdikian, Aren Joe; Yared, Fares; Saad, Eddy; Bakouny, Ziad; Massaad, Abir; Ghanimeh, Joe; Labaki, Chris; Skalli, Wafa; Ghanem, Ismat; Kreichati, Gaby; Assi, Ayman

doi:10.1016/j.gaitpost.2019.12.029

Cited by 22 publications

(24 citation statements)

References 45 publications

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“…In multiple regression analysis using gait parameters as the dependent variables, FTF was related to step length and gait speed, and LTF was related to step length in women only. A study on healthy subjects reported that vertical axis tilt and posterior pelvic tilt in the sagittal plane affected gait speed and step length [30]. In contrast, a study of PD patients with > 5° of forward exion, lateral exion, and neck exion concluded that trunk forward exion was associated only with the degree of lateral exion, and posture did not explain de cits in activities of daily living, motor impairment, falls or back pain [31].…”

Section: Discussionmentioning

confidence: 99%

“…A study on healthy subjects reported that vertical axis tilt and posterior pelvic tilt in the sagittal plane affected gait speed and step length [30]. In contrast, a study of PD patients with > 5° of forward exion, lateral exion, and neck exion concluded that trunk forward exion was associated only with the degree of lateral exion, and posture did not explain de cits in activities of daily living, motor impairment, falls or back pain [31]. Another study of PD patients with severe postural abnormalities reported similar results; gait function was not impaired even with severe LTF [19].…”

Section: Discussionmentioning

confidence: 99%

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Sex differences in posture and vertical perception of gait function in patients with Parkinson's disease

Mikami¹,

Kamo²,

Ichinoseki‐Sekine

2022

Preprint

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Sex differences in the effect of posture and subjective vertical position (SPV) on gait function have not been clarified in Parkinson's disease (PD) patients. Therefore, this study aimed to determine the involvement of posture and vertical perception in the gait function of PD patients according to sex. The study included 59 adult patients with PD (31 men and 28 women) who visited the Rehabilitation Department of Neurology Clinic as outpatients. Relationships between four postural evaluations [forward trunk flexion (FTF), lateral trunk flexion (LTF), SPV], and eight gait assessments [walking time, step length, gait speed, number of steps, step time, coefficient of variation of step time (step CV), cadence, and mean gait acceleration (acceleration)] were analyzed according to sex. None of the postural evaluations showed an association with gait parameters in men. By contrast, in women, relationships were seen between walking time and SPV in the sagittal plane, stride length and FTF angle, the number of steps and FTF and LTF, and step CV and SPV in the coronal plane, indicating that posture was related to gait function. Our results could aid rehabilitative therapies to improve PD patients' gait function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sex differences in posture and vertical perception of gait function in patients with Parkinson's disease

Mikami¹,

Kamo²,

Ichinoseki‐Sekine

2022

Preprint

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“…PO ranges were reported in some studies but not as normative values. In 2020, Otayek et al reported that the mean PO angle in asymptomatic patients is -0.1 ± 1.6 [11]. For scoliosis patients, Banno et al defined significant PO as > 3°, but did not have anatomical references for the ranges they used [2,20].…”

Section: Introductionmentioning

confidence: 99%

Slight pelvic obliquity is normal in a healthy population: a cross‐sectional study

et al. 2023

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Purpose Pelvic obliquity (PO) has not been extensively investigated, and there is no gold standard for measurement. The PO is essential for surgeons in planning hip arthroplasty, which includes the restoration of leg length discrepancy (LLD). We aimed to establish a normative range of PO angles by measuring healthy individuals without musculoskeletal disorders. Methods Our study included 134 consecutive cases (70 females) referred to our institution between April 2020 and September 2021 for non-orthopedic problems. Patients were screened for normal gait and posture using the visual observation method (VOM) and the Modified Gait Abnormality Rating Scale (GARS-M). In standing standard radiographs, the PO angle was measured as the angle between the horizontal plane and the inter-teardrop line. Results Patients' mean age and Body Mass Index (BMI) were 39.7 ± 16.8 and 22.3 ± 3.1, respectively. PO angles did not follow a normal distribution, with a median (IQR) of 2.0° (0.9°—3.1°). According to the Wilcoxon one-sample test, the median PO angle differed significantly from zero (P < 0.001). The PO angle did not differ significantly between males and females (2° vs. 2°, P = 0.46), nor did it correlate significantly with age (P = 0.24). Considering the 95% percentile of PO angles was 5.6°, this range (0°—5.6°) was regarded as a normative value. Conclusion Normative values for PO in the normal healthy population range from 0° to 5.6°, with a median value of 2.0°. The PO angle was independent of age and sex and differed significantly from 0°. Slight pelvic obliquity may be normal, and physicians should not always assume that it is caused by pain, scoliosis, or weakness of the abductors. Level of evidence III.

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“…6 When hip flexion is restored with total hip arthroplasty (THA), these compensatory changes can be reversed. 7 Ageing has been linked to many alterations of physiological and anatomical structures within the human body, [7][8][9][10] with most literature reporting that LL and hip flexion decrease during ageing. 3 Younger individuals have the capacity to better regulate their spinopelvic alignment, 8 while older individuals demonstrate inadequate compensation mechanisms at the spinopelvic junction due to restriction in range of motion at this level.…”

Section: Introductionmentioning

confidence: 99%

The effect of ethnicity on the age-related changes of spinopelvic characteristics: a systematic review

et al. 2023

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AimsSpinopelvic characteristics influence the hip’s biomechanical behaviour. However, to date there is little knowledge defining what ‘normal’ spinopelvic characteristics are. This study aims to determine how static spinopelvic characteristics change with age and ethnicity among asymptomatic, healthy individuals.MethodsThis systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines to identify English studies, including ≥ 18-year-old participants, without evidence of hip or spine pathology or a history of previous surgery or interventional treatment, documenting lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI). From a total of 2,543 articles retrieved after the initial database search, 61 articles were eventually selected for data extraction.ResultsWhen all ethnicities were combined the mean values for LL, SS, PT, and PI were: 47.4° (SD 11.0°), 35.8° (SD 7.8°), 14.0° (SD 7.2°), and 48.8° (SD 10°), respectively. LL, SS, and PT had statistically significant (p < 0.001) changes per decade at: −1.5° (SD 0.3°), −1.3° (SD 0.3°), and 1.4° (SD 0.1°). Asian populations had the largest age-dependent change in LL, SS, and PT compared to any other ethnicity per decade at: −1.3° (SD 0.3°) to −0.5° (SD 1.3°), –1.2° (SD 0.2°) to −0.3° (SD 0.3°), and 1.7° (SD 0.2°) versus 1.1° (SD 0.1°), respectively.ConclusionAgeing alters the orientation between the spine and pelvis, causing LL, SS, and PT to modify their orientations in a compensatory mechanism to maintain sagittal alignment for balance when standing. Asian populations have the largest degree of age-dependent change to their spinopelvic parameters compared to any other ethnicity, likely due to their lower PI.Cite this article: Bone Joint Res 2023;12(4):231–244.

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Influence of spino-pelvic and postural alignment parameters on gait kinematics

Cited by 22 publications

References 45 publications

Sex differences in posture and vertical perception of gait function in patients with Parkinson's disease

Sex differences in posture and vertical perception of gait function in patients with Parkinson's disease

Slight pelvic obliquity is normal in a healthy population: a cross‐sectional study

The effect of ethnicity on the age-related changes of spinopelvic characteristics: a systematic review

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