The use of gait analysis in the assessment of patients afflicted with spinal disorders

Abstract

Purpose

Use gait analysis to establish and detail the clinically relevant components of normal human gait, analyze the gait characteristics for those afflicted with spinal pathology, and identify those aspects of human gait that correlate with pre- and postoperative patient function and outcomes.

Methods

Twenty patients with adult degenerative scoliosis (ADS), 20 patients with cervical spondylotic myelopathy (CSM), and 15 healthy volunteers performed over-ground gait trials with a comfortable self-selected speed using video cameras to measure patient motion, surface electromyography (EMG) to record muscle activity, and force plates to record ground reaction force (GRF). Gait distance and temporal parameters, ankle, knee, hip, pelvic, and trunk range of motion (ROM), duration of lower extremity EMG activity and peak vertical GRF were measured.

Results

Patients with ADS and CSM exhibited a significantly slower gait speed, decrease in step length, cadence, longer stride time, stance time, double support time, and an increase in step width compared to those in the control group. These patients also exhibited a significantly different ankle, knee, pelvic, and trunk ROM. Moreover, spinal disorder patients exhibited a significantly longer duration of rectus femoris, semitendinosus, tibialis anterior and medial gastrocnemius muscle activity along with an altered vertical GRF pattern.

Conclusions

Gait analysis provides an objective measure of functional gait in healthy controls as well as those with ADS and CSM. This study established and detailed some of the important kinematic and kinetic variables of gait in patients with spinal disorders. We recommend that spine care providers use gait analysis as part of their clinical evaluation to provide an objective measure of function.

Graphical abstract

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Notes

  1. 1.

    Low pass filter is often used to remove high frequencies from digitized kinematic data and as a digital antialiasing filter. The cutoff is selected so that low frequencies are unchanged but higher frequencies are attenuated. This is the most common filter type [34].

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Correspondence to Ram Haddas.

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None of the authors has any potential conflict of interest.

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The study was approved by the Western Institutional Review Board for the Protection of Human Subjects (IRB#: 20152881).

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Haddas, R., Ju, K.L., Belanger, T. et al. The use of gait analysis in the assessment of patients afflicted with spinal disorders. Eur Spine J 27, 1712–1723 (2018). https://doi.org/10.1007/s00586-018-5569-1

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Keywords

  • Gait analysis
  • Electromyography
  • Ground reaction force
  • Adult degenerative scoliosis
  • Cervical spondylotic myelopathy