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病因和畸形发病时间对脊柱侧凸患者时空、运动学、动力学和肌电图步态变量的影响:一项前瞻性、对照研究。

Influence of Etiology and Onset of Deformity on Spatiotemporal, Kinematic, Kinetic, and Electromyography Gait Variables in Patients with Scoliosis-A Prospective, Comparative Study.

机构信息

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Spine (Phila Pa 1976). 2021 Mar 15;46(6):374-382. doi: 10.1097/BRS.0000000000003796.

Abstract

STUDY DESIGN

Prospective comparative study.

OBJECTIVE

The aim of this study was to compare the spatiotemporal, kinematic, kinetic and electromyographic (EMG) gait variables in patients with adolescent idiopathic scoliosis (AIS) and congenital scoliosis and to compare these gait variables of scoliosis patients with healthy controls.

SUMMARY OF BACKGROUND DATA

Earlier studies have solely focussed on the possibility of altered gait patterns in AIS patients; not much light has been shed on the differences in gait patterns in congenital and adolescent scoliosis patients.

METHODS

Forty scoliosis patients (20 each with AIS and congenital scoliosis) and 20 healthy volunteers were prospectively recruited. After thorough clinical and radiological examination, all patients underwent gait analysis in accordance with standard protocols.The outcome measures included spatiotemporal, kinetic, kinematic and EMG activity. Composite indices for gait analysis-Gait Profile Score (GPS) and Gait Deviation Index (GDI)-were also calculated. Relevant statistical tests were applied to compare the different groups.

RESULTS

No significant difference was found between the AIS and congenital scoliosis groups with respect to baseline demographic and radiological parameters. The two subgroups of scoliosis patients (AIS and congenital) did not differ significantly with respect to any of the measured gait analysis parameters. However, when compared to the healthy age-matched control group, the scoliosis patients differed significantly with respect to gait speed, stride length, step length, GDI, GPS and peak EMG activation for erector spinae, biceps femoris, semimembranosus, rectus femoris, gastrocnemious, and tibialis anterior.

CONCLUSION

Our findings confirm the previous findings of literature regarding the alteration in gait patterns in scoliosis patients when compared to normal individuals. However, the lack of difference in gait analysis variables between AIS and congenital scoliosis patients suggests that this alteration in gait is secondary to the existence of the deformity and does not correlate with the onset or etiology of deformity.Level of Evidence: 2.

摘要

研究设计

前瞻性对比研究。

目的

本研究旨在比较青少年特发性脊柱侧凸(AIS)和先天性脊柱侧凸患者的时空、运动学、动力学和肌电图(EMG)步态变量,并将这些脊柱侧凸患者的步态变量与健康对照组进行比较。

背景资料概要

早期研究仅关注 AIS 患者步态模式改变的可能性;对于先天性和青少年脊柱侧凸患者的步态模式差异,研究结果并不多。

方法

前瞻性招募了 40 名脊柱侧凸患者(每组 20 名 AIS 和先天性脊柱侧凸患者)和 20 名健康志愿者。在彻底的临床和放射学检查后,所有患者均按照标准方案进行步态分析。测量指标包括时空、动力学、运动学和 EMG 活动。还计算了步态分析的综合指标-步态轮廓评分(GPS)和步态偏差指数(GDI)。应用相关统计检验比较不同组。

结果

在基线人口统计学和放射学参数方面,AIS 和先天性脊柱侧凸组之间没有发现显著差异。脊柱侧凸患者的两个亚组(AIS 和先天性)在任何测量的步态分析参数方面均无显著差异。然而,与年龄匹配的健康对照组相比,脊柱侧凸患者的步态速度、步长、步长、GDI、GPS 和竖脊肌、股二头肌、半膜肌、股直肌、腓肠肌和胫骨前肌的最大 EMG 激活均有显著差异。

结论

我们的研究结果证实了文献中关于脊柱侧凸患者与正常个体相比步态模式改变的发现。然而,AIS 和先天性脊柱侧凸患者之间步态分析变量的差异并不表明这种步态改变是畸形存在的结果,与畸形的发生或病因无关。证据等级:2。

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