Impact of Scoliosis on Gait

Reference work entry

Abstract

Scoliosis is one of the most common orthopedic disorders in children and adolescents. The idiopathic classification has been studied at length in hopes of identifying factors contributing to the origin and progression of the disease. Gait analysis is frequently employed to analyze the balance and movement abnormalities associated with the disorder. While the majority of gait studies in scoliosis note some deviations from normal gait, specific conclusions are often based on weak or inconsistent evidence. The most widely reported findings include restricted motion of the pelvis and hip and an asymmetrical rotation of the trunk as well as general asymmetry between limbs. Additionally, energy cost and muscle activation are higher during scoliotic gait than in normal walking. These differences seem to improve with both orthotic and surgical treatment, although postoperative adolescents with idiopathic scoliosis still maintain a higher-energy cost of walking than their typically developing peers. Ultimately, the relationship between gait abnormalities and the origin or progression of the scoliotic curve remains unclear. The idea of a neurological dysfunction that contributes to both the spinal deformity and the gait deviation is predominantly rooted in theory. Still, future research into motor control and somatosensory function during gait may provide more insight into a neurological influence in the scoliosis population.

Keywords

Gait Idiopathic scoliosis Spinal deformity Scoliotic gait Kinematics Asymmetry Kinetics Dynamic balance Proprioception Muscle activity Curve severity Bracing Spinal fusion Energy cost 

References

  1. Ascani E et al (1986) Natural history of untreated idiopathic scoliosis after skeletal maturity. Spine 11(8):784–789CrossRefGoogle Scholar
  2. Asher MA, Burton DC (2006) Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis [Online] 1. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1475645/. Accessed 12 Feb 2015
  3. Barrack RL et al (1984) Proprioception in idiopathic scoliosis. Spine (Phila Pa 1976) 9(7):681–685CrossRefGoogle Scholar
  4. Chen P-Q et al (1998) The postural stability control and gait pattern of idiopathic scoliosis adolescents. Clin Biomech 13(1):S52–S58MathSciNetCrossRefGoogle Scholar
  5. Danielsson AJ, Romberg K, Nachemson AL (2006) Spinal range of motion, muscle endurance, and back pain and function at least 20 years after fusion or brace treatment for adolescent idiopathic scoliosis: a case-control study. Spine (Phila Pa 1976) 31(3):275–283CrossRefGoogle Scholar
  6. Engsberg JR et al (2003) Prospective comparison of gait and trunk range of motion in adolescents with idiopathic thoracic scoliosis undergoing anterior or posterior spinal fusion. Spine (Phila Pa 1976) 28(17):1993–2000CrossRefGoogle Scholar
  7. Giakas G et al (1996) Comparison of gait patterns between healthy and scoliotic patients using time and frequency domain analysis of ground reaction forces. Spine (Phila Pa 1976) 21(19):2235–2242CrossRefGoogle Scholar
  8. Grivas TB et al (2010) Brace technology thematic series: the dynamic derotation brace. Scoliosis [Online] 1. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20858270. Accessed 18 Feb 2015
  9. Gum JL et al (2007) Transverse plane pelvic rotation in adolescent idiopathic scoliosis: primary or compensatory? Eur Spine J 16(10):1579–1586CrossRefGoogle Scholar
  10. Herzog W et al (1989) Asymmetries in ground reaction force patterns in normal human gait. Med Sci Sports Exerc 21(1):110–114CrossRefGoogle Scholar
  11. Konieczny MR, Senyurt H, Krauspe R (2013) Epidemiology of adolescent idiopathic scoliosis. J Child Orthop 7:3–9CrossRefGoogle Scholar
  12. Kramers-de Quervain IA et al (2004) Gait analysis in patients with idiopathic scoliosis. Eur Spine J 13(5):449–456CrossRefGoogle Scholar
  13. Lehman RA et al (2015) Return to sports after surgery to correct adolescent idiopathic scoliosis: a survey of the Spinal Deformity Study Group. Spine J 15(5):951–958CrossRefGoogle Scholar
  14. Mahaudens P, Thonnard JL, Detrembleur C (2005) Influence of structural pelvic disorders during standing and walking in adolescents with idiopathic scoliosis. Spine J 5(4):427–433CrossRefGoogle Scholar
  15. Mahaudens P et al (2009) Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis. Eur Spine J 18(4):512–521CrossRefGoogle Scholar
  16. Mahaudens P et al (2010) Gait in thoracolumbar/lumbar adolescent idiopathic scoliosis: effect of surgery on gait mechanisms. Eur Spine J 19(7):1179–1188CrossRefGoogle Scholar
  17. Mahaudens P et al (2014) Effect of long-term orthotic treatment on gait biomechanics in adolescent idiopathic scoliosis. Spine J 14(8):1510–1519CrossRefGoogle Scholar
  18. Mallau S et al (2007) Locomotor skills and balance strategies in adolescents idiopathic scoliosis. Spine (Phila Pa 1976) 32(1):E14–E22CrossRefGoogle Scholar
  19. Mayo NE et al (1994) The Ste-Justine adolescent idiopathic scoliosis cohort study. Part III: back pain. Spine (Phila Pa 1976) 19(14):1573–1581CrossRefGoogle Scholar
  20. Park HJ et al (2015) Analysis of coordination between thoracic and pelvic kinematic movements during gait in adolescents with idiopathic scoliosis. Eur Spine J 25:385–393CrossRefGoogle Scholar
  21. Park YS et al (2016) Association of spinal deformity and pelvic tilt with gait asymmetry in adolescent idiopathic scoliosis patients: investigation of ground reaction force. Clin Biomech 36:52–57CrossRefGoogle Scholar
  22. Paul JC et al (2014) Gait stability improvement after fusion surgery for adolescent idiopathic scoliosis is influenced by corrective measures in coronal and sagittal planes. Gait Posture 40(4):510–515CrossRefGoogle Scholar
  23. Perry J, Burnfield JM, Cabico LM (2010) Gait analysis: normal and pathological function, 2nd edn. SLACK, ThorofareGoogle Scholar
  24. Prince F et al (2010) Comparison of locomotor pattern between idiopathic scoliosis patients and control subjects. Scoliosis [Online] 1. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938665/. Accessed 1 Mar 2015
  25. Saji M, Upadhyay S, Leong J (1995) Increased femoral neck-shaft angles in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 20(3):303–311CrossRefGoogle Scholar
  26. Schizas CG et al (1998) Gait asymmetries in patients with idiopathic scoliosis using vertical forces measurement only. Eur Spine J 7(2):95–98CrossRefGoogle Scholar
  27. Schlösser TPC et al (2014) How “idiopathic” is adolescent idiopathic scoliosis? A systematic review on associated abnormalities. PLoS One [Online] 9(5). Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4018432/. Accessed 14 Jan 2015
  28. Schwender JD, Denis F (2000) Coronal plane imbalance in adolescent idiopathic scoliosis with left lumbar curves exceeding 40 degrees: the role of the lumbosacral hemicurve. Spine (Phila Pa 1976) 25(18):2358–2363CrossRefGoogle Scholar
  29. Syczewska M et al (2012) Influence of the structural deformity of the spine on the gait pathology in scoliotic patients. Gait Posture 35(2):209–213CrossRefGoogle Scholar
  30. Weinstein SL et al (2003) Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA 289(5):559–567CrossRefGoogle Scholar
  31. Wong MS et al (2008) The effect of rigid versus flexible spinal orthosis on the gait pattern of patients with adolescent idiopathic scoliosis. Gait Posture 27(2):189–195CrossRefGoogle Scholar
  32. Yang JH, Suh SW et al (2013) Asymmetrical gait in adolescents with idiopathic scoliosis. Eur Spine J 22(11):2407–2413CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of DelawareNewarkUSA
  2. 2.Nemours A.I. duPont Hospital for ChildrenWilmingtonUSA

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