Changes in kinematics, kinetics, and muscle activity in patients with lumbar spinal stenosis during gait: systematic review

Wang, Junsig; Ullah, Safi; Solano, Mitchell A.; Overley, Samuel C.; Bumpass, David B.; Mannen, Erin M.

doi:10.1016/j.spinee.2021.06.003

Cited by 13 publications

(15 citation statements)

References 32 publications

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“…Spatiotemporal gait parameters represent multiple measurements throughout the gait cycle and their sequencing. As their measurement and interpretation is simpler compared to kinematic parameters, changes of these parameters in patients with LSS have been published by multiple studies [3]. Our analysis revealed statistically significant differences of all major spatiotemporal gait parameters between patients and controls.…”

Section: Interpretation Of Spatiotemporal Gait Parametersmentioning

confidence: 54%

“…However, the complexity of 3D movement patterns limits their interpretation and implementation into clinical practice. Although several papers have published the results of gait analyses of patients with LSS, most are limited to analyzing spatiotemporal gait parameters [3]. These parameters are descriptive of the gait cycle and its characteristics, such as walking speed, cadence, step length, etc.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative Gait Analysis of Patients with Severe Symptomatic Spinal Stenosis Utilizing the Gait Profile Score: An Observational Clinical Study

Lodin

Jelínek

Sameš

et al. 2022

Sensors

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Lumbar spine stenosis (LSS) typically manifests with neurogenic claudication, altering patients’ gait. The use of optoelectronic systems has allowed clinicians to perform 3D quantitative gait analysis to quantify and understand these alterations. Although several authors have presented analysis of spatiotemporal gait parameters, data concerning kinematic parameters is lacking. Fifteen patients with LSS were matched with 15 healthy controls. Quantitative gait analysis utilizing optoelectronic techniques was performed for each pair of subjects in a specialized laboratory. Statistical comparison of patients and controls was performed to determine differences in spatiotemporal parameters and the Gait Profile Score (GPS). Statistically significant differences were found between patient and control groups for all spatiotemporal parameters. Patients had significantly different overall GPS (p = 0.004) and had limited internal/external pelvic rotation (p < 0.001) and cranial/caudal movement (p = 0.034), limited hip extension (p = 0.012) and abduction/adduction (p = 0.012) and limited ankle plantar flexion (p < 0.001). In conclusion, patients with LSS have significantly altered gait patterns in three regions (pelvis, hip and ankle) compared to healthy controls. Analysis of kinematic graphs has given insight into gait pathophysiology of patients with LSS and the use of GPS will allow us to quantify surgical results in the future.

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Section: Interpretation Of Spatiotemporal Gait Parametersmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Quantitative Gait Analysis of Patients with Severe Symptomatic Spinal Stenosis Utilizing the Gait Profile Score: An Observational Clinical Study

Lodin

Jelínek

Sameš

et al. 2022

Sensors

View full text Add to dashboard Cite

show abstract

“…However, approximately one third of the patients are not satisfied with the postoperative outcomes, mainly in terms of residual pain and poor function ( Weinstein et al, 2010 ; Rainville et al, 2012 ; Fritsch et al, 2017 ). Therefore, future biomechanical studies are required to assess how gait and posture change with surgical or rehabilitative treatments and whether these changes can contribute to the post-treatment improvement in patient outcomes and walking capacity ( Toosizadeh et al, 2015 ; Goto et al, 2017 ; Wang et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…A biomechanical assessment of spine posture and motion during walking is broadly lacking in patients with LSS, and the available results are not consistent ( Toosizadeh et al, 2015 ; Wang et al, 2021 ). To the authors’ knowledge and a recently published systematic review ( Wang et al, 2021 ), only three studies investigated spine kinematics (postural angles) in patients with LSS during walking, and two of them reported kinetic variables including hip and knee flexion moments and paravertebral muscle activities ( Kuwahara et al, 2016 ; Goto et al, 2017 ; Igawa et al, 2018 ). The study of Goto et al (2017) is the only one that measured the spine flexion angle of five men and one woman with LSS during the beginning of treadmill walking and when leg symptoms appeared.…”

Section: Introductionmentioning

confidence: 99%

Walking Biomechanics and Spine Loading in Patients With Symptomatic Lumbar Spinal Stenosis

Mousavi

Lynch

Allaire

et al. 2021

Front. Bioeng. Biotechnol.

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Symptomatic lumbar spinal stenosis is a leading cause of pain and mobility limitation in older adults. It is clinically believed that patients with lumbar spinal stenosis adopt a flexed trunk posture or bend forward and alter their gait pattern to improve tolerance for walking. However, a biomechanical assessment of spine posture and motion during walking is broadly lacking in these patients. The purpose of this study was to evaluate lumbar spine and pelvic sagittal angles and lumbar spine compressive loads in standing and walking and to determine the effect of pain and neurogenic claudication symptoms in patients with symptomatic lumbar spinal stenosis. Seven participants with symptomatic lumbar spinal stenosis, aged 44–82, underwent a 3D opto-electronic motion analysis during standing and walking trials in asymptomatic and symptomatic states. Passive reflective marker clusters (four markers each) were attached to participants at T1, L1, and S2 levels of the spine, with additional reflective markers at other spinal levels, as well as the head, pelvis, and extremities. Whole-body motion data was collected during standing and walking trials in asymptomatic and symptomatic states. The results showed that the spine was slightly flexed during walking, but this was not affected by symptoms. Pelvic tilt was not different when symptoms were present, but suggests a possible effect of more forward tilt in both standing (p = 0.052) and walking (p = 0.075). Lumbar spine loading during symptomatic walking was increased by an average of 7% over asymptomatic walking (p = 0.001). Our results did not show increased spine flexion (adopting a trunk-flexed posture) and only indicate a trend for a small forward shift of the pelvis during both symptomatic walking and standing. This suggests that provocation of symptoms in these patients does not markedly affect their normal gait kinematics. The finding of increased spine loading with provocation of symptoms supports our hypothesis that spine loading plays a role in limiting walking function in patients with lumbar spinal stenosis, but additional work is needed to understand the biomechanical cause of this increase.

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“…Previous studies have reported that patients with LSS might have impaired muscle function [ 5 , 6 ]. Evaluating the endurance of paraspinal muscles can directly reflect muscle function with a greater discriminative validity than contractile force [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Correlations between paraspinal extensor muscle endurance and clinical outcomes in preoperative LSS patients and clinical value of an endurance classification

Han

Zhou

Wang

et al. 2022

Journal of Orthopaedic Translation

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Changes in kinematics, kinetics, and muscle activity in patients with lumbar spinal stenosis during gait: systematic review

Cited by 13 publications

References 32 publications

Quantitative Gait Analysis of Patients with Severe Symptomatic Spinal Stenosis Utilizing the Gait Profile Score: An Observational Clinical Study

Quantitative Gait Analysis of Patients with Severe Symptomatic Spinal Stenosis Utilizing the Gait Profile Score: An Observational Clinical Study

Walking Biomechanics and Spine Loading in Patients With Symptomatic Lumbar Spinal Stenosis

Correlations between paraspinal extensor muscle endurance and clinical outcomes in preoperative LSS patients and clinical value of an endurance classification

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