Haddas Ram, Goheer Haseeb E, Wang Cindy, Rubery Paul, Ramirez Gabriel, Puvanesarajah Varun
University of Rochester Medical Center, Rochester, United States.
Eur Spine J. 2025 Jun 13. doi: 10.1007/s00586-025-08887-w.
To quantify and evaluate gait spatiotemporal and kinematic parameters in patients with symptomatic lumbar degeneration disc disease(LDD) with unilateral radiculopathy and/or neurogenic claudication.
Seventy-eight pre-operative patients with LDD and 27 healthy adult volunteers were identified at a single institution. Participants were fitted with a full-body external reflective marker set for gait analysis using a three-dimensional motion capture system. Participants performed a series of over-ground walking trials at a self-selected speed. Spatiotemporal and kinematic parameters of gait were compared between cohorts using linear mixed-effects regression models.
Compared with healthy participants, LDD patients had reduced cadence (101.3 steps/min vs. 110.9 steps/min, p < 0.001), step width (0.2 m vs. 0.1 m, p < 0.019), and step length (0.6 m vs. 0.7 m, p < 0.001). During the stance (ST) and swing (SW) phases of the gait cycle, LDD patients had significantly reduced hip extension (ST: 0.7° vs. 12.2° and SW: -7.6° vs. 3.8°) and sagittal plane hip range of motion (ST: 36.1° vs 42.5° and SW: 30.2° vs. 35.8°) on the symptomatic side compared to healthy subjects (p < 0.001). Furthermore, LDD patients had significantly greater anterior and posterior pelvic tilt when compared to healthy controls in both the swing and stance phases of the gait cycle.
Patients with LDD demonstrate significantly altered gait including reduced cadence and step-specific gait parameters compared to healthy controls. Additionally, LDD patients experienced modified hip excursion during both the swing and stance phases compared to healthy participants on the symptomatic side. This study comprehensively assesses clinically measurable spatiotemporal and kinematic gait parameters in patients with LDD and may provide further insight into disease-specific effects and compensatory mechanisms associated with symptomatic LDD.
量化并评估有症状的腰椎退变性椎间盘疾病（LDD）伴单侧神经根病和/或神经源性间歇性跛行患者的步态时空参数和运动学参数。
在单一机构中确定了78例术前LDD患者和27名健康成年志愿者。使用三维运动捕捉系统为参与者佩戴全身外部反光标记物套装以进行步态分析。参与者以自选速度进行一系列地面行走试验。使用线性混合效应回归模型比较队列之间的步态时空参数和运动学参数。
与健康参与者相比，LDD患者的步频降低（101.3步/分钟对110.9步/分钟，p <0.001）、步宽减小（0.2米对0.1米，p <0.019）以及步长缩短（0.6米对0.7米，p <0.001）。在步态周期的站立（ST）和摆动（SW）阶段，与健康受试者相比，LDD患者患侧的髋关节伸展明显减少（ST：0.7°对12.2°，SW：-7.6°对3.8°），矢状面髋关节活动范围也明显减小（ST：36.1°对42.5°，SW：30.2°对35.8°）（p <0.001）。此外，与健康对照组相比，LDD患者在步态周期的摆动期和站立期的骨盆前倾和后倾都明显更大。
与健康对照组相比，LDD患者表现出明显改变的步态，包括步频降低和特定步幅的步态参数。此外，与健康参与者相比，LDD患者在摆动期和站立期患侧的髋关节移动均有改变。本研究全面评估了LDD患者临床上可测量的步态时空参数和运动学参数，并可能为与有症状LDD相关的疾病特异性影响和代偿机制提供进一步的见解。
