Assessment of dynamic balance during walking in patients with adult spinal deformity
Article dans une revue avec comité de lecture
Purpose: To assess dynamic postural alignment in ASD during walking using a subject-specific 3D approach. Methods: 69 ASD (51 ± 20 years, 77%F) and 62 controls (34 ± 13 years, 62%F) underwent gait analysis along with full-body biplanar Xrays and filled HRQoL questionnaires. Spinopelvic and postural parameters were computed from 3D skeletal reconstructions, including radiographic odontoid to hip axis angle (ODHA) that evaluates the head's position over the pelvis (rODHA), in addition to rSVA and rPT. The 3D bones were then registered on each gait frame to compute the dynamic ODHA (dODHA), dSVA, and dPT. Patients with high dODHA (> mean + 1SD in controls) were classified as ASD-DU (dynamically unbalanced), otherwise as ASD-DB (dynamically balanced). Between-group comparisons and relationship between parameters were investigated. Results: 26 patients were classified as ASD-DU having an average dODHA of 10.4° (ASD-DB: 1.2°, controls: 1.7°), dSVA of 112 mm (ASD-DB: 57 mm, controls: 43 mm), and dPT of 21° (ASD-DB: 18°, controls: 14°; all p < 0.001). On static radiographs, ASD-DU group showed more severe sagittal malalignment than ASD-DB, with more altered HRQoL outcomes. The ASD-DU group had an overall abnormal walking compared to ASD-DB & controls (gait deviation index: 81 versus 93 & 97 resp., p < 0.001) showing a reduced flexion/extension range of motion at the hips and knees with a slower gait speed and shorter step length. Dynamic ODHA was correlated to HRQoL scores. Conclusion: Dynamically unbalanced ASD had postural malalignment that persist during walking, associated with kinematic alterations in the trunk, pelvis, and lower limbs, making them more prone to falls. Dynamic-ODHA correlates better with HRQoL outcomes than dSVA and dPT.
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Gait kinematic alterations in subjects with adult spinal deformity and their radiological determinants Article dans une revue avec comité de lectureKAWKABANI, Georges; SALIBY, Renée Maria; MEKHAEL, Mario; RACHKIDI, Rami; MASSAAD, Abir; GHANEM, Ismat; KHARRAT, Khalil; KREICHATI, Gaby; SAAD, Eddy; LAFAGE, Virginie; LAFAGE, Renaud; SKALLI, Wafa; ASSI, Ayman (Elsevier BV, 2021)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 ...
Article dans une revue avec comité de lectureSAAD, Eddy; SEMAAN, Karl; KAWKABANI, Georges; MASSAAD, Abir; SALIBY, Renée Maria; MEKHAEL, Mario; FAKHOURY, Marc; KARAM, Krystel Abi; JABER, Elena; GHANEM, Ismat; LAFAGE, Virginie; SKALLI, Wafa; RACHKIDI, Rami; ASSI, Ayman (Elsevier BV, 2022)Adults with spinal deformity (ASD) are known to have spinal malalignment affecting their quality of life and daily life activities. While walking kinematics were shown to be altered in ASD, other functional activities are ...
Article dans une revue avec comité de lectureOTAYEK, 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 ...
Toward understanding the underlying mechanisms of pelvic tilt reserve in adult spinal deformity: the role of the 3D hip orientation Article dans une revue avec comité de lectureMEKHAEL, 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 ...
O 095—How do postural parameters vary during gait in children with cerebral palsy? A 3D subject-speciﬁc skeletal segment registration technique Article dans une revue avec comité de lectureMASSAAD, Abir; ASSI, Ayman; BIZDIKIAN, Aren Joe; BAKOUNY, Ziad; KHALIL, Nour; GHANEM, Ismat; PILLET, Hélène; BONNET, Xavier; SKALLI, Wafa (Elsevier, 2018)Postural parameters, calculated in static position on frontal and sagittal radiographs, are altered in ambulant children with cerebral palsy (CP) and are known to be related to gait abnormalities [1,2]. Most of these ...