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Influence of Spino-Pelvic and Postural Alignment Parameters on Gait Kinematics

Type
Articles dans des revues avec comité de lecture
Author
OTAYEK, Joeffroy
301405 Université Saint-Joseph de Beyrouth [USJ]
BIZDIKIAN, Aren Joe
301405 Université Saint-Joseph de Beyrouth [USJ]
YARED, Fares
301405 Université Saint-Joseph de Beyrouth [USJ]
SAAD, Eddy
301405 Université Saint-Joseph de Beyrouth [USJ]
BAKOUNY, Ziad
301405 Université Saint-Joseph de Beyrouth [USJ]
MASSAAD, Abir
301405 Université Saint-Joseph de Beyrouth [USJ]
GHANIMEH, Joe
301405 Université Saint-Joseph de Beyrouth [USJ]
LABAKI, Chris
301405 Université Saint-Joseph de Beyrouth [USJ]
SKALLI, Wafa
1001017 Institut de Biomecanique Humaine Georges Charpak [IBHGC]
ISMAT, Ghanem
301405 Université Saint-Joseph de Beyrouth [USJ]
KREICHATI, Gaby
301405 Université Saint-Joseph de Beyrouth [USJ]
ASSI, Ayman
1001017 Institut de Biomecanique Humaine Georges Charpak [IBHGC]

URI
http://hdl.handle.net/10985/18876
DOI
10.1016/j.gaitpost.2019.12.029
Date
2020
Journal
Gait & Posture

Abstract

Introduction: Postural alignment is altered with spine deformities that might occur with age. Alteration of spino-pelvic and postural alignment parameters are known to affect daily life activities such as gait. It is still unknown how spino-pelvic and postural alignment parameters are related to gait kinematics. Research question: To assess the relationships between spino-pelvic/postural alignment parameters and gait kinematics in asymptomatic adults. Methods: 134 asymptomatic subjects (aged 18-59 years) underwent 3D gait analysis, from which kinematics of the pelvis and lower limbs were extracted in the 3 planes. Subjects then underwent full-body biplanar X-rays, from which skeletal 3D reconstructions and spino-pelvic and postural alignment parameters were obtained such as sagittal vertical axis (SVA), center of auditory meatus to hip axis plumbline (CAM-HA), thoracic kyphosis (TK) and radiologic pelvic tilt (rPT). In order to assess the influence of spino-pelvic and postural alignment parameters on gait kinematics a univariate followed by a multivariate analysis were performed. Results: SVA was related to knee flexion during loading response (β = 0.268); CAM-HA to ROM pelvic obliquity (β = -0.19); rPT to mean pelvic tilt (β = -0.185) and ROM pelvic obliquity (β = -0.297); TK to ROM hip flexion/extension in stance (β = -0.17), mean foot progression in stance (β = -0.329), walking speed (β = -0.19), foot off (β = 0.223) and step length (β = -0.181). Significance: This study showed that increasing SVA, CAM-HA, TK and rPT, which is known to occur in adults with spinal deformities, could alter gait kinematics. Increases in these parameters, even in asymptomatic subjects, were related to a retroverted pelvis during gait, a reduced pelvic obliquity and hip flexion/extension mobility, an increased knee flexion during loading response as well as an increase in external foot progression angle. This was associated with a decrease in the walking pace: reduced speed, step length and longer stance phase.

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