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Weak trunk extensors in adult spinal deformity patients are related to sagittal malalignment and kinematic limitations

Article dans une revue avec comité de lecture
Author
SAADÉ, Maria
301405 Université Saint-Joseph de Beyrouth [USJ]
RACHKIDI, Rami
301405 Université Saint-Joseph de Beyrouth [USJ]
ccRTEIL, Ali
301405 Université Saint-Joseph de Beyrouth [USJ]
AYOUB, Elma
301405 Université Saint-Joseph de Beyrouth [USJ]
JABER, Elena
301405 Université Saint-Joseph de Beyrouth [USJ]
ccCHAAYA, Celine
301405 Université Saint-Joseph de Beyrouth [USJ]
NASSIM, Nabil
301405 Université Saint-Joseph de Beyrouth [USJ]
ccMEKHAEL, Elio
301405 Université Saint-Joseph de Beyrouth [USJ]
REHAYEM, Rami
301405 Université Saint-Joseph de Beyrouth [USJ]
NAHED, Julien Abi
RAMADAN, Bilal
301405 Université Saint-Joseph de Beyrouth [USJ]
KARAM, Mohamad
301405 Université Saint-Joseph de Beyrouth [USJ]
ccGHANEM, Ismat
301405 Université Saint-Joseph de Beyrouth [USJ]
MASSAAD, Abir
301405 Université Saint-Joseph de Beyrouth [USJ]
ASSI, Ayman
301405 Université Saint-Joseph de Beyrouth [USJ]
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]

URI
http://hdl.handle.net/10985/26287
DOI
10.1016/j.gaitpost.2025.01.018
Date
2025-01
Journal
Gait & Posture

Abstract

Background: Adult spinal deformity (ASD) is associated with muscles' degeneration that affects postural control and outcomes of an eventual corrective surgery. Evaluation of ASD is usually based on static radiographs and more recently on functional assessment. However, there has been limited exploration of muscle strength weakness in ASD. The aim was to investigate the relationship between trunk muscles' strength in ASD and its relationship with radiographic and kinematic alterations and quality-of-life decline. Methods: 28 ASD and 18 asymptomatic subjects underwent biplanar radiographs with 3D calculation of spino-pelvic and global postural parameters. 3D movement analysis of gait, sitting to standing and stair ascent, was studied allowing the calculation of head, trunk and lower limbs 3D kinematics. Participants filled out health related quality of life questionnaires. A single operator measured 4 times the strength of the trunk muscles, using a hand-held dynamometer, to assess measurements' reliability. ASD population was divided into two groups based on the strength of trunk extensors: ASD-weak extensors (N = 11 patients having trunk extensors strength<mean-1SD in controls) and ASD-normal extensors (N = 17). Radiographic, kinematic, and quality of life scores were compared between groups. Results: Measurements of muscle strengths using the hand-held dynamometer were reliable (ICC>0.94). On standing radiographs, the ASD-weak extensors group showed an increased positive sagittal malalignment compared to the other groups (SVA=61 mm vs ASD-normal extensors: 18 mm, controls: -4 mm, p < 0.001). This sagittal malalignment remained during movement (kinematic-SVA=223 mm vs ASD-normal extensors:178 mm, controls:138 mm, p < 0.001). Muscle strength weakness was correlated to the decline of quality-of-life scores (PCS-SF36: r = 0.48, VAS for pain: ρ=-0.39). Conclusions: This study showed that weak trunk extensors are associated with sagittal malalignment in static position, kinematic limitations during daily life activities and reduced quality of life scores. Future studies will investigate the effect of muscle strengthening on both static and dynamic alignment in ASD and their quality of life.

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