Shiomi A
Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1995 Sep;69(9):665-74.
We have investigated the differences in gait between 68 idiopathic scoliosis patients and 186 normal subjects, and differences in gait before and after treatment of the scoliosis by two different methods. The idiopathic scoliosis patients were divided into two groups according to which treatment they had received; one group of 17 cases had been treated by spinal fusion and the other group of 51 cases had been treated by bracing. Gait analysis was performed using a 1.2 m wide and 10.8 m long force plate walkway. Three components of each step (the lateral, horizontal and vertical components) were measured. Gait velocity, step length, step width and cadence were evaluated as temporal and distance factors, and symmetry, reappearance, smoothness, sway, rhythm and impact were evaluated as gait factors.
Before treatment, there was no difference in any temporal or distance factor between the scoliosis patients and the normal subjects. However, the index of symmetry, and of sway, in the vertical component prior to treatment in the scoliosis patients was significantly inferior to that in the normal subjects. A positive correlation was found between the index of sway in the vertical component and the pretreatment Cobb angle. This correlation was found in the right-convex single curve group and in the double curve group, but not in the left-convex single curve group. After spinal fusion, the step width became wider and the index of sway significantly improved, but index of symmetry was unchanged. No gait factor became worse postoperatively. In contrast, in the bracing group, the step width became wider, but the index of symmetry, and of sway in the vertical component, did not improve with the brace. The gait of scoliosis patients could be objectively and quantitatively analyzed by the force plate. The gait analysis was useful for evaluating the effects of spinal fusion, and of brace treatment, in idiopathic scoliosis patients.
我们研究了68例特发性脊柱侧凸患者与186名正常受试者之间的步态差异，以及两种不同方法治疗脊柱侧凸前后的步态差异。特发性脊柱侧凸患者根据所接受的治疗方法分为两组；一组17例接受了脊柱融合术治疗，另一组51例接受了支具治疗。使用一条宽1.2米、长10.8米的测力板通道进行步态分析。测量每一步的三个分量（横向、水平和垂直分量）。将步态速度、步长、步宽和步频作为时间和距离因素进行评估，将对称性、再现性、平滑性、摇摆、节奏和冲击力作为步态因素进行评估。
治疗前，脊柱侧凸患者与正常受试者在任何时间或距离因素上均无差异。然而，脊柱侧凸患者治疗前垂直分量的对称性指数和摇摆指数明显低于正常受试者。垂直分量的摇摆指数与治疗前Cobb角之间存在正相关。这种相关性在右凸单曲线组和双曲组中存在，但在左凸单曲线组中不存在。脊柱融合术后，步宽变宽，摇摆指数明显改善，但对称性指数未改变。术后没有步态因素变差。相比之下，在支具组中，步宽变宽，但对称性指数和垂直分量的摇摆指数并未因支具而改善。测力板可对脊柱侧凸患者的步态进行客观定量分析。步态分析有助于评估特发性脊柱侧凸患者脊柱融合术和支具治疗的效果。
