Yang Jae Hyuk, Suh Seung-Woo, Sung Paul S, Park Woo-Hyung
Department of Orthopedics, Scoliosis Research Institute, Korea University Medical College, Guro Hospital 97, Guro Dong, Guro Gu, Seoul, 152-703, Korea.
Eur Spine J. 2013 Nov;22(11):2407-13. doi: 10.1007/s00586-013-2845-y. Epub 2013 Jun 4.
This study investigated side-to-side gait asymmetry in subjects with adolescent idiopathic scoliosis.
There were 20 adolescents with idiopathic scoliosis and 20 age-matched control subjects, who participated in the study. To minimize confounding effects, we recruited patients with similar spinal curvature for the scoliosis group, and all participants are right hand dominant. The participants were instructed to ambulate on a 10 m walkway while barefoot. There were two force plates in the middle of the walkway. The ground reaction force (GRF) and angular displacements of six segments (foot, shank, thigh, pelvis, trunk, and head) were measured during one gait cycle based on the right and left lower extremities. To remove the positional information in the kinematic data, the derivative of angular displacement in each segment was calculated. To evaluate the side-to-side gait symmetry, we calculated the cross-correlation of each bilateral gait parameter.
In the kinematics, the scoliosis group demonstrated asymmetrical gait in the frontal and transverse planes compared to the control group. In the GRF data, the scoliosis group demonstrated asymmetrical gait in the medial-lateral (M/L) direction compared to the control group.
These results indicated that the scoliosis group produced an asymmetrical rotation pattern of the segments bilaterally in the frontal and transverse planes, resulting in asymmetrical GRF patterns in the M/L direction. This asymmetrical gait may be produced by changes in global postural control during gait and not simply by changes in control of only one or two specific segments.
本研究调查青少年特发性脊柱侧凸患者的左右侧步态不对称情况。
20名青少年特发性脊柱侧凸患者和20名年龄匹配的对照受试者参与了本研究。为尽量减少混杂效应,我们为脊柱侧凸组招募了脊柱弯曲度相似的患者,且所有参与者均为右利手。参与者被要求赤足在10米长的通道上行走。通道中间有两个测力台。在一个步态周期内,基于左右下肢测量地面反作用力(GRF)以及六个节段(足、小腿、大腿、骨盆、躯干和头部)的角位移。为去除运动学数据中的位置信息,计算每个节段角位移的导数。为评估左右侧步态对称性,我们计算了每个双侧步态参数的互相关。
在运动学方面,与对照组相比,脊柱侧凸组在额面和横面表现出不对称步态。在GRF数据中,与对照组相比,脊柱侧凸组在内外侧(M/L)方向表现出不对称步态。
这些结果表明,脊柱侧凸组在额面和横面双侧节段产生不对称旋转模式,导致在M/L方向出现不对称GRF模式。这种不对称步态可能是由步态期间整体姿势控制的变化引起的,而不仅仅是由一两个特定节段控制的变化引起的。