Changes in gait pattern in patients with scoliosis
Journal Title: Rehabilitacja Medyczna - Year 2006, Vol 10, Issue 4
Abstract
Introduction. Scoliosis is the most common orthopaedic disorder among children and adolescents thus constituting a serious social problem. 3D deformation of the spine changes the mechanics of the whole body. The aim of this work was to assesschanges in gait pattern in patients with scoliosis.Material and methods. Patients: 25 girls aged 12-16 years with idiopathic scoliosis greater than 20 degrees, not treated earlier. Method: objective gait analysis using the system VICON 460 synchronized with dynamic electromyography system and dynamographic platform. Measured parameters: spatio-temporal, kinematic, surface EMG of selected limb and trunk muscles. Calculations were performed with Polygon software.Results. Decreased pelvic tilt was found in 90 % of patients, together with an increased pelvic tilt range. In 2/3 of patients, the pelvis was obliqued in the frontal plane, and in the majority, the pelvis was rotated in the transverse plane with respect to the line of progression. The orientation of the hip joints in the frontal and transverse planes was incorrect in half of the patients, and the knees were slightly flexed at initial contact. In some patients, there was a diminished range of motion of the hip joints in the saggital plane, accompanied by an increased internal pelvic rotation at the initial contact. In all patients, the feet were dorsiflexed in the ankle joints in the swing phase, and in the transverse plane, there was an internal rotation of the feet with respect to the shank. In all patients, there was also an abnormal, asymmetrical activity of the trunk muscles, and of the greatest gluteal muscles.Conclusions. Scoliosis changes body mechanics and the orientation of the pelvis at least in one plane (in most cases – in all three planes). Compensatory mechanisms occur that may lead to further pathologies. The increased dorsiflexion of the feet in the swing phase was a surprising finding. As the maximum flexion of the knees in this phase is correct, the increased dorsiflexion could not have served as a compensatory mechanism helping in foot clearance.
Authors and Affiliations
Małgorzata Syczewska, Anna Łukaszewska, Beata Górak, Krzysztof Graff
Keywords
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