Cheng Hao, Jiang Zi-Ang, Chen Liang, Wang Guo-Dong, Liu Xiao-Yang, Sun Jian-Min, Tsai Tsung-Yuan
Department of Spine Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China.
Front Bioeng Biotechnol. 2023 May 25;11:1192647. doi: 10.3389/fbioe.2023.1192647. eCollection 2023.
Thoracolumbar kyphosis (TLK) is a common feature in patients with spinal deformities. However, due to limited studies, the impacts of TLK on gait have not been reported. The objective of the study was to quantify and evaluate the impacts of gait biomechanics of patients with TLK secondary to Scheuermann's disease. Twenty cases of Scheuermann's disease patients with TLK and twenty cases of asymptomatic participants were recruited into this study. And the gait motion analysis was conducted. The stride length was shorter in the TLK group compared to control group (1.24 ± 0.11 m vs. 1.36 ± 0.21 m, = 0.04). Compared to control group, the stride time and step time were more prolonged in the TLK group (1.18 ± 0.11s vs. 1.11 ± 0.08 s, = 0.03; 0.59 ± 0.06 s vs. 0.56 ± 0.04 s, = 0.04). The gait speed of the TLK group was significantly slower than it of control group (1.05 ± 0.12 m/s vs. 1.17 ± 0.14 m/s, = 0.01); In the sagittal plane, the range of motion (ROM) of the hip in the TLK group was significantly smaller than that of the control group (37.71 ± 4.35° vs. 40.05 ± 3.71°, = 0.00). In the transverse plane, the adduction/abduction ROMs of the knee and ankle, as well as the internal and external rotation of the knee, were smaller in TLK group than ROMs in the control group (4.66 ± 2.21° vs. 5.61 ± 1.82°, = 0.00; 11.48 ± 3.97° vs. 13.16 ± 5.6°, = 0.02; 9.00 ± 5.14° vs. 12.95 ± 5.78°, = 0.00). The main finding of this study was that measurements of gait patterns and joint movement of the TLK group were significantly lower than those of the control group. And these impacts have the potential to exacerbate degenerative progress of joints in the lower extremities. These abnormal features of gait can also serve as a guideline for physicians to focus on TLK in these patients.
胸腰段后凸（TLK）是脊柱畸形患者的常见特征。然而，由于研究有限，TLK对步态的影响尚未见报道。本研究的目的是量化和评估休门氏病继发TLK患者的步态生物力学影响。本研究招募了20例患有TLK的休门氏病患者和20例无症状参与者。并进行了步态运动分析。与对照组相比，TLK组的步长较短（1.24±0.11米对1.36±0.21米，P = 0.04）。与对照组相比，TLK组的步幅时间和单步时间更长（1.18±0.11秒对1.11±0.08秒，P = 0.03；0.59±0.06秒对0.56±0.04秒，P = 0.04）。TLK组的步态速度明显慢于对照组（1.05±0.12米/秒对1.17±0.14米/秒，P = 0.01）；在矢状面，TLK组髋关节的活动范围（ROM）明显小于对照组（37.71±4.35°对40.05±3.71°，P = 0.00）。在横断面，TLK组膝关节和踝关节的内收/外展ROM以及膝关节的内旋和外旋均小于对照组的ROM（4.66±2.21°对5.61±1.82°，P = 0.00；11.48±3.97°对13.16±5.6°，P = 0.02；9.00±5.14°对12.95±5.78°，P = 0.00）。本研究的主要发现是，TLK组的步态模式和关节运动测量值明显低于对照组。并且这些影响有可能加剧下肢关节的退变进程。这些异常的步态特征也可为医生关注这些患者中的TLK提供指导。
