Characterizing gait abnormalities in patients with symptomatic lumbar degenerative disc disease.

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.