Gait kinematic alterations in subjects with adult spinal deformity and their radiological determinants
TypeArticles dans des revues avec comité de lecture
Background: Adults with spinal deformity (ASD) are known to have postural malalignment affecting their quality of life. Classical evaluation and follow-up are usually based on full-body static radiographs and health related quality of life questionnaires. Despite being an essential daily life activity, formal gait assessment lacks in clinical practice. Research Question: What are the main alterations in gait kinematics of ASD and their radiological determinants? Methods: 52 ASD and 63 control subjects underwent full-body 3D gait analysis with calculation of joint kinematics and full-body biplanar X-rays with calculation of 3D postural parameters. Kinematics and postural parameters were compared between groups. Determinants of gait alterations among postural radiographic parameters were explored. Results: ASD had increased sagittal vertical axis (SVA:34 ± 59 vs −5 ± 20 mm), pelvic tilt (PT:19 ± 13 vs 11 ± 6°) and frontal Cobb (25 ± 21 vs 4 ± 6°) compared to controls (all p < 0.001). ASD displayed decrease walking speed (0.9 ± 0.3 vs 1.2 ± 0.2 m/s), step length (0.58 ± 0.11 vs 0.64 ± 0.07 m) and increased single support (0.45 ± 0.05 vs 0.42 ± 0.04 s). ASD walked with decreased hip extension in stance (−3 ± 10 vs −7 ± 8°), increased knee flexion at initial contact and in stance (10 ± 11 vs 5 ± 10° and 19 ± 7 vs 16 ± 8° respectively), and decreased knee flexion/extension ROM (55 ± 9 vs 59 ± 7°). ASD had increased trunk flexion (12 ± 12 vs 6 ± 11°) and reduced dynamic lumbar lordosis (−11 ± 12 vs −15 ± 7°, all p < 0.001). Sagittal knee ROM, walking speed and step length were negatively determined by SVA; lack of lumbar lordosis during gait was negatively determined by radiological lumbar lordosis. Significance: Static compensations in ASD persist during gait, where they exhibit a flexed attitude at the trunk, hips and knees, reduced hip and knee mobility and loss of dynamic lordosis. ASD walked at a slower pace with increased single and double support times that might contribute to their gait stability. These dynamic discrepancies were strongly related to static sagittal malalignment.
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Toward understanding the underlying mechanisms of pelvic tilt reserve in adult spinal deformity: the role of the 3D hip orientation MEKHAEL, Mario; KAWKABANI, Georges; SALIBY, Renée Maria; SKALLI, Wafa; SAAD, Eddy; JABER, Elena; RACHKIDI, Rami; KHARRAT, Khalil; KREICHATI, Gaby; GHANEM, Ismat; LAFAGE, Virginie; ASSI, Ayman (Springer Science and Business Media LLC, 2021)Purpose: To explore 3D hip orientation in standing position in subjects with adult spinal deformity (ASD) presenting with different levels of compensatory mechanisms. Methods: Subjects with ASD (n = 159) and controls ...
OTAYEK, Joeffroy; BIZDIKIAN, Aren Joe; YARED, Fares; SAAD, Eddy; BAKOUNY, Ziad; MASSAAD, Abir; GHANIMEH, Joe; LABAKI, Chris; SKALLI, Wafa; ISMAT, Ghanem; KREICHATI, Gaby; ASSI, Ayman (ELSEVIER, 2020)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 ...
Roussouly's sagittal spino-pelvic morphotypes as determinants of gait in asymptomatic adult subjects. BAKOUNY, Ziad; ASSI, Ayman; MASSAAD, Abir; SAGHBINI, Elie; LAFAGE, Virginie; SKALLI, Wafa; GHANEM, Ismat; KREICHATI, Gaby (ELSEVIER, 2017)Sagittal alignment is known to greatly vary between asymptomatic adult subjects; however, there are no studies on the possible effect of these differences on gait. The aim of this study is to investigate whether asymptomatic ...
How the type of sagittal alignment defined by Roussouly determines the gait of asymptomatic adult subject ASSI, Ayman; BAKOUNY, Ziad; MASSAAD, Abir; LAFAGE, Virginie; SAGHBINI, Elie; KREICHATI, Gaby; SKALLI, Wafa; GHANEM, Ismat (ELSEVIER, 2016)While curvatures of the sagittal spine are known to greatly differ among asymptomatic adult subjects, there are no studies that determine whether this heterogeneous normality affects gait. This study aimed to elucidate the ...
ASSI, Ayman; BAKOUNY, Ziad; BIZDIKIAN, Aren Joe; OTAYEK, Joeffroy; YARED, Fares; LAFAGE, Virginie; KHALIL, Nour; MASSAAD, Abir; GHANEM, Ismat; SKALLI, Wafa (ELSEVIER, 2018)Patients with adult spinal deformities (ASD) are known to have altered postural alignment aﬀecting their quality of life and activities of daily living, especially gait. The Sagittal Vertical Axis (SVA), a postural parameter ...