Representative dynamic ranges of spinal alignment during gait in patients with mild and severe adult spinal deformities

Hip Extensor Strength Influences Dynamic Postural Changes during Gait in Patients with Adult Spinal Deformity: A Cross-Sectional Study Using Three-Dimensional Motion Analysis

“…Lee et al [22] reported that large preoperative dynamic postural changes could negatively impact postoperative clinical outcomes. These reports emphasize the importance of dynamic postural changes in patients with ASD; however, factors related to dynamic postural changes, such as physical function, have not been examined thoroughly [13][14][15][16][17][18]22]. The current study builds on the findings of previous studies and extends the evidence for dynamic postural change in patients with ASD.…”

“…However, this technique has been reported to feature some limitations because standing necessitates effortful postural changes by the patient [11]. Therefore, 3D-MAS, which can well capture real-life situations, was used to evaluate dynamic spinal alignment [11][12][13][14][15][16][17][18]. An earlier report on dynamic spinal alignment in patients with ASD showed that trunk and pelvis anteversion increases during gait compared with standing and that trunk and hip extensor strength may be involved in the postural change [13].…”

“…The current study revealed an association between dynamic postural change and hip extensor strength in patients with ASD. The trunk and pelvis are known to contribute more to anteversion during gait than during standing [13][14][15][16][17]. The hip extensors, such as the gluteus maximus and hamstrings, originate from the pelvic girdle and attach to the posterior aspect of the femur, which undergoes pelvic retroversion and prevents excessive pelvic anteversion [23].…”

“…Some researchers have suggested that the standing radiographs used to assess spinal alignment in patients with ASD may not reflect the actual posture of the patient in real-life situations because standing requires effortful postural changes and compensatory mechanisms [11,12]. Thus, studies on spinal alignment assessment by gait analysis are increasingly being conducted using a threedimensional motion analysis system (3D-MAS); indeed, this technology has shown that the gait posture of patients with ASD demonstrates increased anteversion of the trunk and pelvis compared with the standing posture [13][14][15][16][17]. Patients with ASD have also been reported to demonstrate increased anteversion when they walk even if they no longer manifest a poor standing posture.…”

Kinematic Evaluation of the Sagittal Posture during Walking in Healthy Subjects by 3D Motion Analysis Using DB-Total Protocol

“…Traditional stereophotogrammetric models [ 7 , 8 , 9 , 10 , 11 ] were used to assess the kinematics of pelvis, hip, knee, ankle, trunk (considered as a single rigid segment that does not provide information on kinematic changes within the spine) and rarely head and upper limbs. A few studies analyzed the multi-segmental-trunk, head, lower- and upper- limbs kinematics in upright standing [ 12 , 13 , 14 ] by introducing a larger number of skin markers on the body; other ones assessed the trunk in several districts during locomotion or elementary exercises [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. In particular, [ 15 ] described spine kinematics considering lower-thoracic, lumbar and pelvic segments during walking; [ 16 ] characterized spine motion by 5-link-segment-model to upright posture, chair raising-sitting, stepping up and down, and level walking, and [ 17 ] investigated the contribution of upper-body movements to dynamic balance control during different and challenging motor tasks.…”