Pelvis–shoulder coordination during level walking in patients with ankylosing spondylitis

Mangone, Massimiliano; Scettri, Paola; Paoloni, Marco; Procaccianti, Rita; Spadaro, Antonio; Santilli, Valter

doi:10.1016/j.gaitpost.2011.02.002

Cited by 35 publications

(44 citation statements)

References 22 publications

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“…These results were found in agreement with the consequences of AS reported in the literature which affecting the axial joints, determines a diffuse stiffness and produces a rigid spine from the occiput to the sacrum [3]. Finally it can be hypothesized that these results could be related to the Pelvis–shoulder coordination alterations found by Mangone et al in AS subjects [36], even though their findings were related to walking conditions.…”

Section: Discussionsupporting

confidence: 90%

Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis

Sawacha

Carraro

Din

et al. 2012

J NeuroEngineering Rehabil

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BackgroundAnkylosing spondylitis is a major chronic rheumatic disease that predominantly affects axial joints, determining a rigid spine from the occiput to the sacrum. The dorsal hyperkyphosis may induce the patients to stand in a stooped position with consequent restriction in patients’ daily living activities. The aim of this study was to develop a method for quantitatively and objectively assessing both balance and posture and their mutual relationship in ankylosing spondylitis subjects.MethodsThe data of 12 healthy and 12 ankylosing spondylitis subjects (treated with anti-TNF-α stabilized), with a mean age of 51.42 and 49.42 years; mean BMI of 23.08 and 25.44 kg/m2 were collected. Subjects underwent a morphological examination of the spinal mobility by means of a pocket compass needle goniometer, together with an evaluation of both spinal and hip mobility (Bath Ankylosing Spondylitis Metrology Index), and disease activity (Bath Ankylosing Spondylitis Disease Activity Index). Quantitative evaluation of kinematics and balance were performed through a six cameras stereophotogrammetric system and a force plate. Kinematic models together with a test for evaluating balance in different eye level conditions were developed. Head protrusion, trunk flexion-extension, pelvic tilt, hip-knee-ankle flexion-extension were evaluated during Romberg Test, together with centre of pressure parameters.ResultsEach subject was able to accomplish the required task. Subjects’ were comparable for demographic parameters. A significant increment was observed in ankylosing spondylitis subjects for knee joint angle with the target placed at each eye level on both sides (p < 0.042). When considering the pelvic tilt angle a statistically significant reduction was found with the target placed respectively at 10° (p = 0.034) and at 30° (p = 0.019) less than eye level. Furthermore in ankylosing spondylitis subjects both hip (p = 0.048) and ankle (p = 0.029) joints angles differs significantly. When considering the posturographic parameters significant differences were observed for ellipse, center of pressure path and mean velocity (p < 0.04). Goniometric evaluation revealed significant increment of thoracic kyphosis reduction of cervical and lumbar range of motion compared to healthy subjects.ConclusionsOur findings confirm the need to investigate both balance and posture in ankylosing spondylitis subjects. This methodology could help clinicians to plan rehabilitation treatments.

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Section: Discussionsupporting

confidence: 90%

Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis

Sawacha

Carraro

Din

et al. 2012

J NeuroEngineering Rehabil

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“…1 ). Thirty-one studies evaluated gait parameters in RA [ 7 , 8 , 11 , 13 – 18 , 34 – 55 ], three in AS [ 10 , 56 , 57 ] one in PsA [ 21 ] and one in gout [ 12 ]. Twenty-four studies examined spatiotemporal gait parameters, with 19 in RA, two in AS, one PsA and gout (Additional file 3 : Table S3).…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen RA [ 7 , 14 – 18 , 37 , 39 , 40 , 44 , 45 , 51 – 54 ], one PsA [ 21 ] and one gout study [ 12 ] reported significant decreases in walking velocity. No significant differences in walking velocity were reported for AS [ 10 , 56 ]. Overall pooled data (SMD, 95 % CI) (Fig.…”

Section: Resultsmentioning

confidence: 99%

Gait characteristics associated with the foot and ankle in inflammatory arthritis: a systematic review and meta-analysis

Carroll

Parmar

Dalbeth

et al. 2015

BMC Musculoskelet Disord

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BackgroundGait analysis is increasingly being used to characterise dysfunction of the lower limb and foot in people with inflammatory arthritis (IA). The aim of the systematic review was to evaluate the spatiotemporal, foot and ankle kinematic, kinetic, peak plantar pressure and muscle activity parameters between patients with inflammatory arthritis and healthy controls.MethodsAn electronic literature search was performed on Medline, CINAHL, SportsDiscus and The Cochrane Library. Methodological quality was assessed using a modified Quality Index. Effect sizes with 95 % confidence intervals (CI) were calculated as the standardised mean difference (SMD). Meta-analysis was conducted if studies were homogenous.ResultsThirty six studies with quality ranging from high to low met the inclusion criteria. The majority of studies reported gait parameters in Rheumatoid arthritis (RA). The gait pattern in RA was characterised by decreased walking speed (SMD 95 % CI −1.57, −2.25 to −0.89), decreased cadence (SMD −0.97, −1.49 to −0.45), decreased stride length (SMD −1.66, −1.84 to −1.49), decreased ankle power (SMD −1.36, −1.70 to −1.02), increased double limb support time (SMD 1.03, 0.84 to 1.22), and peak plantar pressures at the forefoot (SMD 1.11, 0.76 to 1.45). Walking velocity was reduced in psoriatic arthritis and gout with no differences in ankylosing spondylitis. No studies have been conducted in polymyalgia rheumatica, systemic sclerosis or systemic lupus erythematosus.ConclusionsThe review identified the majority of studies reporting gait adaptations in RA, but limited evidence relating to other IA conditions. Poor data reporting, small sample sizes and heterogeneity across IA conditions limit the interpretation of the findings. Future studies may consider a standardised analytical approach to gait analysis that will provide clinicians and researchers with objective evidence of foot function in people with IA.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-015-0596-0) contains supplementary material, which is available to authorized users.

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“…The phase shifts between the pelvic and thorax rotations were calculated using the continuous relative phase method using a technique described by van Emmerik and Wagenaar (1996). This method has been widely used for quantifying the coordination between different oscillating body segments, including pelvisthorax coordination (Mangone et al, 2011;Seay et al, 2011). It can be defined as the difference between the respective phase angle of each segment (Lamoth et al, 2002a).…”

Section: Assessment Of Phase Shiftsmentioning

confidence: 99%

Is the Pelvis-Thorax Coordination a Valuable Outcome Instrument to Assess Patients With Hip Osteoarthritis?

Moissenet

Naaïm

Ornetti

et al. 2020

Front. Bioeng. Biotechnol.

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The evaluation of the disease severity in hip osteoarthritis (OA) patients being currently based on subjective instruments. It would be of interest to develop more objective instruments, for example based on gait analysis. The aims of this study were to explore if pelvis-thorax coordination parameters could be valuable instrument outcomes to achieve this evaluation by assessing their reliability, discriminant capacity and responsiveness. Methods: Three groups of subjects; healthy, hip OA patients with severe disease (defined as indication to surgery), hip OA patients with less severe disease (no indication to surgery) were included. Hip OA patients with severe disease were evaluated before and 6 months after surgery. Subjects had to perform a gait analysis at comfortable speed, and pelvis-thorax coordination was evaluated. The correlations with clinical and structural parameters, as well as reliability, discriminant capacities and responsiveness, were assessed. Results: The pelvis-thorax coordination in the coronal plane during walking was correlated to clinical and to structural severity in hip OA patients (R 2 = 0.13). The coronal plane coordination allowed to discriminate healthy subjects from all hip OA patients (sensibility = 0.86; specificity = 0.59). Moreover, when comparing OA patients only, coronal plane coordination allows to discriminate patients with indication of surgery from those with no indication of surgery (sensibility = 0.72; specificity = 0.72). Moreover, the pelvis-thorax coordination demonstrated an excellent reliability and a good responsiveness. Moissenet et al. Pelvis-Shoulder Coordination With Hip Osteoarthritis Conclusion: Changes in the pelvis-thorax coordination might refer to different mechanisms, from analgesia to motor control plasticity, and might be a possible explanation for the weak correlation between structure and symptoms in hip OA patients. Moreover, such parameter might be used as an objective outcome in hip OA clinical trials.

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Pelvis–shoulder coordination during level walking in patients with ankylosing spondylitis

Cited by 35 publications

References 22 publications

Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis

Biomechanical assessment of balance and posture in subjects with ankylosing spondylitis

Gait characteristics associated with the foot and ankle in inflammatory arthritis: a systematic review and meta-analysis

Is the Pelvis-Thorax Coordination a Valuable Outcome Instrument to Assess Patients With Hip Osteoarthritis?

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