Sklenský J, Švehlík M, Urbášek K, Macková P, Repko M
Ortopedická klinika Lékařské fakulty Masarykovy univerzity Brno.
Ortopedická klinika Fakultní nemocnice Brno.
Acta Chir Orthop Traumatol Cech. 2024;91(3):137-142. doi: 10.55095/achot2024/022.
The study describes changes in gait parameters (temporal-spatial parameters, kinematic parameters represented by the global Gait Deviation Index) of individuals with Adolescent Idiopathic Scoliosis (AIS) compared to the healthy population. The hypothesis assumed a difference in the observed parameters between the two mentioned groups.
In a retrospective study, the temporal-spatial parameters and Gait Deviation Index (GDI) of a cohort of 45 AIS patients (36 girls and 9 boys with the mean age of 15.2 years, the mean Cobb angle of the thoracic curve of 47.3° and the lumbar curve of 51.8°) were compared to a typically developing population of 12 healthy individuals with no musculoskeletal pathology. The difference of followed-up parameters in patients with AIS compared to normal values was assessed by one-sample Student's T-test at the significance level of p = 0.05.
The gait analysis shows significant deviations in the gait stereotype of patients with AIS compared to the healthy population. Statistically significant differences within temporal-spatial parameters were confirmed for cadence, walking speed, step time, stride time for left leg, step length, stride length and step width. The mean GDI of the cohort reached the value of 91.07 that indicates a slight alteration of gait, however, even this change is statistically significant.
In our cohort of patients with AIS, we identified a significantly reduced walking speed (on average 15.4% compared to normal values. At the same time, a reduction in cadence (by an average of 7.5%) and an increase of the stride time (by an average of 12%) were recorded. Our mean GDI values were 91.07, which is consistent with the results reported in the literature for comparable groups of AIS patients.
Our study demonstrated that AIS significantly affects gait stereotype. The differences compared to the group of healthy individuals within temporal-spatial parameters were confirmed for cadence, walking speed, duration and length of step and stride, and step width. The kinematic analysis of gait using the global (GDI) index in patients with AIS demonstrated its slight alteration. A better understanding of the change in movement stereotypes and gait in patients with AIS can bring wider possibilities for individualizing conservative treatment and also can help prevent secondary changes in the locomotor system.
adolescent idiopathic scoliosis, AIS, gait analysis, Gait Deviation Index, GDI.
本研究描述了青少年特发性脊柱侧凸(AIS)患者与健康人群相比步态参数(时空参数、由整体步态偏差指数表示的运动学参数)的变化。假设上述两组观察参数存在差异。
在一项回顾性研究中,将45例AIS患者(36名女孩和9名男孩,平均年龄15.2岁,胸椎曲线平均Cobb角47.3°,腰椎曲线平均Cobb角51.8°)的时空参数和步态偏差指数(GDI)与12名无肌肉骨骼病变的正常发育个体进行比较。通过单样本学生t检验评估AIS患者随访参数与正常值的差异,显著性水平为p = 0.05。
步态分析显示,与健康人群相比,AIS患者的步态模式存在显著偏差。在时空参数方面,步频、步行速度、步长、左腿步幅时间、步长、步幅长度和步宽存在统计学显著差异。该队列的平均GDI值达到91.07,表明步态有轻微改变,然而,即使这种变化在统计学上也是显著的。
在我们的AIS患者队列中,我们发现步行速度显著降低(与正常值相比平均降低15.4%)。同时,步频降低(平均降低7.5%),步幅时间增加(平均增加12%)。我们的平均GDI值为91.07,这与文献中报道的类似AIS患者组的结果一致。
我们的研究表明,AIS显著影响步态模式。在步频、步行速度、步幅和步长的持续时间和长度以及步宽方面,与健康个体组相比存在差异得到了证实。使用整体(GDI)指数对AIS患者进行步态运动学分析表明其有轻微改变。更好地理解AIS患者运动模式和步态的变化可以为个性化保守治疗带来更广泛的可能性,也有助于预防运动系统的继发性改变。
青少年特发性脊柱侧凸;AIS;步态分析;步态偏差指数;GDI