Chockalingam Nachiappan, Dangerfield Peter H, Rahmatalla Aziz, Ahmed El-Nasri, Cochrane Tom
School of Health, Staffordshire University, Leek Road, Stoke on Trent, ST4 2DF, UK.
Eur Spine J. 2004 Dec;13(8):750-4. doi: 10.1007/s00586-004-0762-9. Epub 2004 Jun 22.
Although the causes and progression of adolescent idiopathic scoliosis (AIS) are still unclear, a recent extensive review has indicated a number of possible aetiological factors. Previous investigations, employing gait measurements, have indicated asymmetries in the ground reaction forces and suggest a relationship between these asymmetries, neurological dysfunction and spinal deformity. Using a strain-gauge force platform, the present study has examined the time-domain parameters of various components of the ground reaction force together with impulse. Symmetry indices (SI) between left and right sides have also been estimated. The results show that the patients with a left compensatory curve had a greater SI for a left-side impulse, whilst subjects with little or no compensation had a greater right-side impulse. This indicates that a possible gait compensation is occurring, so that the subjects compensate on the opposite pelvis/lower limb to that of the curve. While indicating the asymmetries between left and right, the results also serve to highlight the value of using kinetic parameters in developing the understanding of the pathogenesis and aetiology of scoliosis.
尽管青少年特发性脊柱侧凸(AIS)的病因和进展仍不明确,但最近一项广泛的综述指出了一些可能的病因因素。以往采用步态测量的研究表明,地面反作用力存在不对称性,并提示这些不对称性、神经功能障碍与脊柱畸形之间存在关联。本研究使用应变片测力平台,研究了地面反作用力各分量的时域参数以及冲量。还估算了左右两侧的对称指数(SI)。结果显示,左侧代偿性侧弯患者左侧冲量的SI更大,而代偿很少或无代偿的受试者右侧冲量更大。这表明可能存在步态代偿,即受试者在与侧弯相反的骨盆/下肢进行代偿。这些结果在表明左右不对称的同时,也凸显了利用动力学参数来加深对脊柱侧凸发病机制和病因理解的价值。