Khorramroo Fateme, Mousavi Seyed Hamed, Rajabi Reza
Department of Sport Injuries and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran.
Sci Rep. 2025 Feb 7;15(1):4608. doi: 10.1038/s41598-025-88886-5.
Spinal deformities characterized by malalignment of the spinal column, including scoliosis, hyper kyphosis, and lordosis, can significantly impact lower limb kinematics, potentially leading to altered gait patterns. We aimed to synthesize existing literature investigating the effect of spinal deformities on lower limb kinematics during walking. We searched Four databases including PubMed, Web of Science, Scopus and Embase from their inception through 29th December 2024. The Newcastle-Ottawa Scale was applied to assess quality of included studies and the Grading of Recommendations Assessment, Development and Evaluation (GRADE system) was employed to assess the overall quality of the evidence in the meta-analysis. Mean differences and 95% confidence intervals (CI) were calculated with random effects model in RevMan version 5.4. The review included 35 studies with 1941 participants. Regarding scoliosis, strong evidence suggested a significant increase in right leg stance% and non-significant changes in left leg cadence, right and left leg speed and ankle transverse ROM in individuals with scoliosis compared to controls. Sensitivity analysis showed strong evidence of decrease in right leg stride length and ankle sagittal ROM, decrease in left leg single support and non-significant change in left leg step length. Individuals with sagittal malalignment showed strong evidence of significant reduction in velocity; moderate evidence suggested a significant increase in double support and a decrease in stride length, knee and hip sagittal ROM. Sensitivity analysis revealed strong evidence of a significant decrease in cadence during walking in individuals with sagittal trunk malalignment compared to controls. Participants with adult spinal deformity exhibited strong evidence of increased double support and decreased cadence during walking compared to controls. Spinal deformities significantly alter lower limb kinematics during gait. Our findings highlight the essential need for clinicians to take gait alterations into account when developing targeted interventions for individuals with spinal deformity.
以脊柱排列不齐为特征的脊柱畸形，包括脊柱侧弯、重度驼背和脊柱前凸，会显著影响下肢运动学，可能导致步态模式改变。我们旨在综合现有文献，研究脊柱畸形对步行过程中下肢运动学的影响。我们检索了四个数据库，包括PubMed、科学网、Scopus和Embase，检索时间从各数据库创建至2024年12月29日。应用纽卡斯尔-渥太华量表评估纳入研究的质量，并采用推荐分级评估、制定与评价（GRADE系统）来评估荟萃分析中证据的总体质量。在RevMan 5.4版本中使用随机效应模型计算平均差异和95%置信区间（CI）。该综述纳入了35项研究，共1941名参与者。关于脊柱侧弯，有力证据表明，与对照组相比，脊柱侧弯患者的右腿站立百分比显著增加，左腿步频、左右腿速度和踝关节横向活动度无显著变化。敏感性分析显示，有力证据表明右腿步幅长度和踝关节矢状面活动度降低，左腿单支撑时间减少，左腿步长无显著变化。矢状面排列不齐的个体有有力证据表明速度显著降低；中等证据表明双支撑显著增加，步幅长度、膝关节和髋关节矢状面活动度降低。敏感性分析显示，有力证据表明与对照组相比，矢状躯干排列不齐的个体在步行过程中的步频显著降低。与对照组相比，患有成人脊柱畸形的参与者在步行过程中有有力证据表明双支撑增加，步频降低。脊柱畸形在步态期间显著改变下肢运动学。我们的研究结果强调，临床医生在为脊柱畸形患者制定针对性干预措施时，必须考虑步态改变。
