Compensatory Ground Reaction Forces during Scoliotic Gait in Subjects with and without Right Adolescent Idiopathic Scoliosis

Abstract

Although the asymmetries of scoliotic gait in adolescent idiopathic scoliosis (AIS) groups have been extensively studied, recent studies indicated conflicting results regarding the ground reaction forces (GRFs) during gait in subjects with spinal deformity. The asymmetry during the stance phase might be clarified with three-dimensional (3D) compensations of GRFs between similar characteristics of subjects with and without AIS. The purpose of this study was to compare the normalized 3D GRF differences during the stance phase of gait while considering age, BMI, and Cobb angle between subjects with and without right AIS. There were 23 subjects with right convexity of thoracic idiopathic scoliosis and 22 age- and gender-matched control subjects. All subjects were right upper/lower limb dominant, and the outcome measures included the Cobb angles, normalized GRF, and KAI. The mediolateral (M/L) third peak force on the dominant limb decreased in the AIS group (t = 2.58, p = 0.01). Both groups demonstrated a significant interaction with the 3D indices (F = 5.41, p = 0.02). The post-hoc analysis identified that the M/L plane of asymmetry was significantly different between groups. The Cobb angles were negatively correlated with the vertical asymmetry index (r = −0.45, p = 0.03); however, there was no significant correlation with age (r = −0.10, p = 0.65) or body mass index (r = −0.28, p = 0.20). The AIS group demonstrated decreased GRF in the dominant limb M/L plane of the terminal stance phase. This compensatory motion was confirmed by a significant group difference on the M/L plane of the KAI. This KAI of vertical asymmetry correlated negatively with the Cobb angle. The asymmetric load transmission with compensatory vertical reactions was evident due to abnormal loading in the stance phase. These kinetic compensatory patterns need to be considered with asymmetry on the dominant limb when developing rehabilitation strategies for patients with AIS.

Neurophysiological, balance and motion evidence in adolescent idiopathic scoliosis: A systematic review

“…Subjects with AIS showed significantly reduced stance [ 52 , 53 ] and increased swing phases [ 52 , 54 ] compared to controls. Abnormalities in ground reaction forces (GRF) during gait were also reported: Bruynell et al [ 55 , 56 ] found stronger anteroposterior and vertical as well as weaker mediolateral impulses of the ground reaction forces during gait initiation in subjects with AIS, while Sung et al [ 57 ] found a greater mediolateral peak force in the dominant limb. Zhu et al [ 54 ] showed that the ratio of impulses between the big toe and the first metatarsal was greater in subjects with AIS than in healthy subjects.…”

“…AIS did not seem to affect walking speed, stride length, and cadence of the subjects [ 21 , 52 , 60 ]. Subjects with AIS showed greater gait asymmetries [ 54 , 56 , 57 , 60 ], particularly in terms of GRF, step length, stance duration, and swing phases between the right and left feet. Yang et al [ 60 ] confirmed a generally lower correlation between left and right body segments (i.e., shank, thigh, pelvis, trunk) in the frontal and transverse planes in subjects with AIS compared to controls.…”

Predicting Elderly Falls Using the Roll Factor in the "Smart Walk Trainer" Equipment for Body Weight-Balance Analysis

“…(Shumway-Cook & Woollacott, 2007;Pirker & Katzenschlager, 2017). Balance and posture of the body while standing and walking are essential to perform activities in daily life to prevent and minimize the risk of accidents that result in injury for all ages, possibly more for the older (Heglund, 1981;Beckham et al, 2014;Sung & Park, 2021;Shahabpoor & Pavic, 2017). Balance and the ability to bear weight play crucial roles in the well-being and quality of life of the elderly population.…”