Department of Orhopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8560, Japan.
Department of Orhopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8560, Japan.
Gait Posture. 2024 Jun;111:22-29. doi: 10.1016/j.gaitpost.2024.04.013. Epub 2024 Apr 13.
Pelvic incidence (PI)-lumbar lordosis (LL) mismatch has a significant destabilizing effect on the center of gravity sway in the static standing position. However, the association between spinopelvic alignment and balance during gait in healthy volunteers is poorly understood.
The degree of PI-LL mismatch and trunk anterior tilt in the static standing posture influences dynamic balance during gait.
In this study, 131 healthy volunteers were divided into two groups: harmonious group (PI - LL ≤ 10°; n = 91) and unharmonious group (PI - LL > 10°; n = 40). A two-point accelerometer system was used for gait analysis; accelerometers were attached to the pelvis and upper trunk to measure acceleration in the forward-backward, right-left, and vertical directions so that sagittal (front-back) deviation width, coronal (right-left) width, and vertical width and their ratios were calculated. Measurements were compared between the two groups, and correlations between alignment and accelerometer data were examined.
The harmonious group showed a negative correlation between pelvic sagittal width and PI - LL, pelvic tilt (PT), and sagittal vertical axis (SVA) (correlation coefficient ρ = -0.42, -0.38, and -0.4, respectively), and a positive correlation between sagittal ratio and PI - LL (ρ = 0.35). The unharmonious group showed a positive correlation between pelvic sagittal width and PI and PT (ρ = 0.43 and 0.33, respectively) and between sagittal ratio and SVA (ρ = 0.32). The unharmonious group showed a positive correlation between upper trunk sagittal width and PI - LL and PT (ρ = 0.38 and 0.36, respectively).
The association between spinal alignment and gait parameters differs depending on the presence or absence of PI-LL mismatch. The degree of pelvic compensation and trunk anterior tilt during static standing were associated with unstable gait balance.
骨盆入射角（PI）-腰椎前凸（LL）不匹配对静态站立位重心摆动有显著的不稳定影响。然而，健康志愿者的脊柱骨盆排列与步态平衡之间的关系尚未被充分了解。
静态站立位时 PI-LL 不匹配程度和躯干前倾角度会影响步态中的动态平衡。
本研究将 131 名健康志愿者分为两组：和谐组（PI-LL≤10°；n=91）和不和谐组（PI-LL>10°；n=40）。使用两点加速度计系统进行步态分析；将加速度计附着在骨盆和上躯干上，以测量前-后、右-左和垂直方向的加速度，从而计算矢状面（前后）偏差宽度、冠状面（左右）宽度和垂直宽度及其比值。比较两组之间的测量值，并检查排列与加速度计数据之间的相关性。
和谐组中骨盆矢状面宽度与 PI-LL、骨盆倾斜度（PT）和矢状垂直轴（SVA）呈负相关（相关系数 ρ=-0.42、-0.38 和-0.4），而与矢状比呈正相关（ρ=0.35）。不和谐组中骨盆矢状面宽度与 PI 和 PT 呈正相关（ρ=0.43 和 0.33），与矢状比和 SVA 呈正相关（ρ=0.32）。不和谐组中上躯干矢状面宽度与 PI-LL 和 PT 呈正相关（ρ=0.38 和 0.36）。
脊柱排列与步态参数之间的关系因 PI-LL 不匹配的存在与否而异。静态站立时骨盆代偿程度和躯干前倾角度与不稳定的步态平衡有关。
