Postural adjustments in adolescent idiopathic thoracic scoliosis during walking

Kuan-Wen Wu; Ting-Ming Wang; Chia-Chen Hu; Shih-Wun Hong; Pei-An Lee; Tung-Wu Lu

doi:10.1016/j.gaitpost.2018.12.024

Postural adjustments in adolescent idiopathic thoracic scoliosis during walking

Gait Posture. 2019 Feb:68:423-429. doi: 10.1016/j.gaitpost.2018.12.024. Epub 2018 Dec 18.

Authors

Kuan-Wen Wu¹, Ting-Ming Wang², Chia-Chen Hu³, Shih-Wun Hong⁴, Pei-An Lee³, Tung-Wu Lu⁵

Affiliations

¹ Department of Biomedical Engineering, National Taiwan University, Taiwan, ROC; Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taiwan, ROC; Department of Orthopaedic Surgery, National Taiwan University Hospital, Taiwan, ROC.
² Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taiwan, ROC; Department of Orthopaedic Surgery, National Taiwan University Hospital, Taiwan, ROC.
³ Department of Biomedical Engineering, National Taiwan University, Taiwan, ROC.
⁴ Department of Physical Therapy, Tzu Chi University, Taiwan, ROC.
⁵ Department of Biomedical Engineering, National Taiwan University, Taiwan, ROC; Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taiwan, ROC. Electronic address: twlu@ntu.edu.tw.

PMID: 30594870
DOI: 10.1016/j.gaitpost.2018.12.024

Abstract

Introduction: Adolescent idiopathic scoliosis (AIS) is the most common type of three-dimensional spinal deformity. Identifying the postural adjustments or changes for different phases and events is needed for developing programs to improve the AIS gait, but such information has been limited. The current study aimed to fill the gap via three-dimensional motion analysis of quiet standing and level walking in patients with severe thoracic AIS.

Materials and methods: Sixteen female adolescents with AIS (Lenke 1 or 2, age: 14.9 ± 1.7 years, height: 154.7 ± 5.0 cm, mass: 41.7 ± 7.2 kg) and sixteen sex-, age- and BMI-matched healthy controls (age: 14.8 ± 2.7 years, height: 154.9 ± 5.6 cm, mass: 44.7 ± 6.3 kg) participated in the current study with informed written consent. The kinematic and kinetic changes between the trunk, pelvis, and lower limb segments, and at the lumbosacral level at different gait events were measured during quiet standing and level walking.

Results: The homogeneity of the current patient group helped reduce the effects of the level and severity of spinal deformity on inter-subject variability that has been associated with controversies over reported gait variables in AIS. The current results support the hypothesis that postural adjustments involving the trunk, pelvis and lower limb segments were needed in severe thoracic AIS during both quiet standing and level walking, and differed between concave and convex sides at different key gait events during level walking.

Conclusions: Although scoliotic spinal deformity occurred mainly in the frontal plane, postural adjustments in all three planes were present at key events during level walking with associated joint loading changes in patients with severe thoracic AIS. Monitoring of such adjustments and the associated joint kinetic changes will be helpful for assessing the disease and treatment outcomes.

Keywords: Adolescent idiopathic scoliosis (AIS); Balance; Kinematics; Motion analysis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Biomechanical Phenomena
Child
Female
Gait Analysis / methods
Humans
Imaging, Three-Dimensional / methods
Kinetics
Lower Extremity / physiopathology
Pelvis / physiopathology
Postural Balance / physiology*
Posture / physiology*
Scoliosis / physiopathology*
Spatio-Temporal Analysis
Torso / physiopathology
Treatment Outcome
Walking / physiology*