Bonab Masoud Amir Rashedi, Sener Suleyman, Colak Tugba Kuru, Amirrashedi Mahsa, Yeldan Ipek, Konya Deniz, Toktas Zafer Orkun
Physiotherapy and Rehabilitation Department, Institute of Health Sciences, Marmara University, Istanbul, Turkey.
Department of Neurosurgery, GZA Sint-Augustinus, Wilrijk, Belgium.
Neurospine. 2023 Sep;20(3):947-958. doi: 10.14245/ns.2346122.061. Epub 2023 Sep 30.
The aim of this study was to emphasize on the interaction of spatial and temporal gait parameters and analyse the gait asymmetry in the patients with lumbar disc herniation (LDH) before and after microdiscectomy.
This was a prospective, observational study conducted on 59 cases of LDH planned for lumbar microdiscectomy, and healthy control group with 54 participants for analysis was performed prior to surgery and 15 days after surgery. The spatiotemporal gait parameters were measured using a "Win-Track" gait analysis platform system. All the participants walked barefoot for 10 times with their normal walking speed in the same day. The 3 flawless walking data were recorded and the arithmetic means were computed. The gait symmetry index was used to calculate the walking asymmetry. The pain intensity of the patients was recorded shortly before performing the analysis by a visual analogue scale.
In the postoperative assessment LDH patients had significantly shorter temporal parameters, longer spatial parameters, faster walking speed, and more cadence than the preoperative assessment (p < 0.05). There were improvements in the asymmetry values of the postoperative gait parameters compared to the preoperative values, but these differences were not significant (p > 0.05). In addition, there was a significant difference in all parameters in terms of gait asymmetry between the postoperative assessment and the healthy controls (p < 0.05).
These results can guide the patient-specific evaluating and implementation of gait rehabilitation programs, and design protocols before or after surgery in the LDH patients.
本研究旨在强调空间和时间步态参数的相互作用,并分析腰椎间盘突出症(LDH)患者在显微椎间盘切除术前后的步态不对称性。
这是一项前瞻性观察性研究,对59例计划进行腰椎显微椎间盘切除术的LDH患者进行研究,并在手术前和手术后15天对54名参与者组成的健康对照组进行分析。使用“Win-Track”步态分析平台系统测量时空步态参数。所有参与者在同一天以正常步行速度赤脚行走10次。记录3次完美的步行数据并计算算术平均值。使用步态对称指数计算步行不对称性。在进行分析前不久,通过视觉模拟量表记录患者的疼痛强度。
在术后评估中,LDH患者的时间参数明显短于术前评估,空间参数更长,步行速度更快,步频更高(p < 0.05)。与术前值相比,术后步态参数的不对称值有所改善,但这些差异不显著(p > 0.05)。此外,术后评估与健康对照组在步态不对称的所有参数方面存在显著差异(p < 0.05)。
这些结果可为LDH患者手术前后步态康复计划的个体化评估和实施以及设计方案提供指导。