Bilateral asymmetry in kinematic strategies for obstacle-crossing in adolescents with severe idiopathic thoracic scoliosis
Journal
Gait and Posture
Journal Volume
71
Pages
211
Date Issued
2019-06
Author(s)
Abstract
Introduction: Adolescent idiopathic scoliosis (AIS)is the most common three-dimensional spinal deformity pathology during adolescence, often accompanied with sensory integration and proprioception problems, which may lead to abnormal postural control and altered end-point control during functional activities. This paper identifies the effects of AIS on the end-point control and on angular kinematics of the trunk and pelvis-leg apparatus during obstacle-crossing for both the concave- and convex-side limb leading. Materials and Methods: Sixteen adolescents with severe Lenke 1 AIS (age: 14.9 ± 1.7 years, height: 154.7 ± 5.0 cm)and sixteen healthy controls (age: 14.8 ± 2.7 years, height: 154.9 ± 5.6 cm)each walked and crossed obstacles of 3 heights with either the concave- (AIS-A)or convex-side (AIS-V)limb leading. Angular motions of the trunk, pelvis and lower limbs, and toe-obstacle clearances were measured. Two-way analyses of variance were used to study between-subject (group)and within-subject (limb and height)effects on the variables. Whenever a height effect was found, a polynomial test was used to determine the linear trend. α = 0.05 was set for all tests. Results: Patients with AIS significantly reduced pelvic downward list but increased dorsiflexion in both stance and swing ankles at leading limb crossing when compared to controls (p < 0.05). During AIS-A, additional kinematic modifications were observed, i.e., increased stance hip adduction (4.2 ± 0.8°, p = 0.005)and increased swing knee flexion (12.6 ± 1.4°, p = 0.106), with significantly decreased leading toe-clearance (AIS-A: 121.4 ± 6.7 mm, controls: 140.1 ± 5.6 mm, p = 0.031). Conclusions: Patients with AIS adopted an altered kinematic strategy for successful obstacle-crossing. With the concave-side limb leading, more joint kinematic modifications with reduced toe-clearance were found when compared to those during the convex-side limb leading, suggesting an increased risk of tripping. Further studies on the kinematic strategies adopted by different types of AIS will be needed for a more complete picture of the functional adaptations in such patient group. ? 2019
Subjects
Gait
Kinematics
Obstacle
Scoliosis
SDGs
Other Subjects
adduction; adolescent; adolescent idiopathic scoliosis; ankle; Article; clinical article; controlled study; gait; human; joint mobility; kinematics; knee function; limb movement; pelvis; priority journal; standing; thoracic spine; trunk; adaptation; biomechanics; case control study; female; male; pathophysiology; scoliosis; severity of illness index; walking; Adaptation, Physiological; Adolescent; Biomechanical Phenomena; Case-Control Studies; Female; Humans; Male; Scoliosis; Severity of Illness Index; Walking
Publisher
Elsevier B.V.
Type
journal article