Bruyneel Anne-Violette, Chavet Pascale, Bollini Gérard, Allard Paul, Mesure Serge
Institut des Sciences du Mouvement, UMR 6233, France.
Neurosci Lett. 2008 Dec 12;447(2-3):158-63. doi: 10.1016/j.neulet.2008.10.007. Epub 2008 Oct 7.
The idiopathic scoliosis is characterized by a three-dimensional spinal deformity involving new dynamical strategies to regulate the posture. The aim is to analyze the centre of pressure (CP) behaviour in forward stepping (FS) and lateral stepping (LS) to determine the dynamical consequences of scoliosis. Ten adolescents suffering from right thoracic scoliosis (Cobb>or=18 degrees ) and 15 healthy adolescents participated in this study. Two forceplates recorded the CP evolution in medio-lateral and antero-posterior axes resulting from FS and, LS with the dominant (D) and with the non-dominant (nD) limbs. Our results showed between groups and within groups differences respect to axis of motion. The comparison between groups in the LS showed the increase of the CP total displacement only when stepping with nD limb. Conversely no major evidence emerges from the FS analysis. Whatever the axis was, the CP total displacement of the D limb did not differ between groups. The comparison between lower limbs for healthy subjects was always different for FS whereas this comparison became non-significant for LS. For patients the same analysis showed results less systematically different. The correlation analysis, only when LS is initiated with nD limb, revealed opposite CP dynamical strategies between groups. These results may be explained by the influence of the spinal deformation on internal mass distribution and the asymmetrical neurophysiological factors previously described. Therefore, to perform LS the patients develop an asymmetry between both limbs to guarantee the balance despite scoliosis. Thus LS reveals the differences between groups and between initiation limbs.
特发性脊柱侧弯的特征是三维脊柱畸形，涉及调节姿势的新动态策略。目的是分析向前迈步（FS）和侧向迈步（LS）时的压力中心（CP）行为，以确定脊柱侧弯的动态后果。十名患有右胸段脊柱侧弯（Cobb≥18度）的青少年和十五名健康青少年参与了本研究。两个测力板记录了FS和LS过程中，优势（D）肢体和非优势（nD）肢体在内外侧和前后轴上的CP演变。我们的结果显示，在运动轴方面存在组间和组内差异。在LS中，组间比较显示仅在使用nD肢体迈步时CP总位移增加。相反，FS分析未发现主要证据。无论在哪个轴上，D肢体的CP总位移在组间均无差异。健康受试者下肢在FS时的比较始终不同，而在LS时这种比较变得不显著。对于患者，相同的分析显示结果的系统性差异较小。相关性分析仅在以nD肢体开始LS时，揭示了组间相反的CP动态策略。这些结果可能由脊柱变形对内部质量分布的影响以及先前描述的不对称神经生理因素来解释。因此，为了进行LS，患者在双下肢之间形成不对称以确保尽管存在脊柱侧弯仍能保持平衡。因此，LS揭示了组间以及起始肢体之间的差异。
