Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers, Paris, France.
Spine Deform. 2024 Mar;12(2):423-431. doi: 10.1007/s43390-023-00799-3. Epub 2024 Jan 10.
To investigate kinematic adaptations from self-selected to fast speed walking in ASD patients.
115 primary ASD and 66 controls underwent biplanar radiographic X-rays and 3D gait analysis to calculate trunk, segmental spine and lower limb kinematics during self-selected and fast speed walking. Kinematic adaptation was calculated as the difference (Δ) between fast and self-selected speed walking. ASD with 7 or more limited kinematic adaptation parameters were classified as ASD-limited-KA, while those with less than 7 limited kinematic adaptation parameters were classified as ASD-mild-KA.
25 patients were classified as ASD-limited-KA and 90 as ASD-mild-KA. ASD-limited-KA patients walked with a lesser increase of pelvic rotation (Δ = 1.7 vs 5.5°), sagittal hip movement (Δ = 3.1 vs 7.4°) and shoulder-pelvis axial rotation (Δ = 3.4 vs 6.4°) compared to controls (all p < 0.05). ASD-limited-KA had an increased SVA (60.6 vs - 5.7 mm), PT (23.7 vs 11.9°), PI-LL (9.7 vs - 11.7°), knee flexion (9.2 vs - 0.4°) and a decreased LL (44.0 vs 61.4°) compared to controls (all p < 0.05). Kinematic and radiographic alterations were less pronounced in ASD-mild-KA. The limited increase of walking speed was correlated to the deteriorated physical component summary score of SF-36 (r = 0.37).
Kinematic limitations during adaptation from self-selected to fast speed walking highlight an alteration of a daily life activity in ASD patients. ASD with limited kinematic adaptations showed more severe sagittal malalignment with an increased SVA, PT, PI-LL, and knee flexion, a decreased LL and the most deteriorated quality of life. This highlights the importance of 3D movement analysis in the evaluation of ASD.
研究 ASD 患者从自选自走到快走的运动学适应性。
115 名 ASD 患者和 66 名对照组进行双平面放射 X 线和 3D 步态分析，以计算自选自走和快走时躯干、节段脊柱和下肢的运动学。运动学适应性通过快和自选自走速度之间的差异（Δ）计算。具有 7 个或更多受限运动学适应性参数的 ASD 患者被归类为 ASD-受限-KA，而具有少于 7 个受限运动学适应性参数的 ASD 患者被归类为 ASD-轻度-KA。
25 名患者被归类为 ASD-受限-KA，90 名患者被归类为 ASD-轻度-KA。与对照组相比，ASD-受限-KA 患者骨盆旋转（Δ=1.7 对 5.5°）、矢状面髋关节运动（Δ=3.1 对 7.4°）和肩骨盆轴向旋转（Δ=3.4 对 6.4°）的增加幅度较小（均 P<0.05）。与对照组相比，ASD-受限-KA 患者的 SVA（60.6 对-5.7 毫米）、PT（23.7 对 11.9°）、PI-LL（9.7 对-11.7°）、膝关节屈曲（9.2 对-0.4°）和 LL 减小（44.0 对 61.4°）更大（均 P<0.05）。ASD-轻度-KA 的运动学和影像学改变不那么明显。行走速度的有限增加与 SF-36 的身体成分综合评分恶化相关（r=0.37）。
从自选自走到快走的运动学适应性受限突出了 ASD 患者日常生活活动的改变。具有受限运动学适应性的 ASD 患者表现出更严重的矢状面对线不良，SVA、PT、PI-LL 增加，膝关节屈曲增加，LL 减小，生活质量下降最严重。这强调了 3D 运动分析在 ASD 评估中的重要性。
