Joint biomechanics and inter-joint coordination in patients with lumbar spondylosis during functional activities
Date Issued
2010
Date
2010
Author(s)
Lo, Wei-Ching
Abstract
Spondylosis is a major cause of morbidity among the elderly and may extend beyond the patient’s obvious symptoms leading to severe disability, the lumbar spines being the most common areas of involvement. Apart from the changed spinal mechanics, neurological disorders are usually accompanied with spondylosis, both leading to altered mechanics and control of the whole body during functional activities of daily living, such as quiet standing, level walking, obstacle crossing and sit-to-stand. The altered motion patterns due to spondylosis can be variable depending on the spinal level of lesion as the mechanics and neurological control of lumbar spondylosis are fundamentally different. Owing to the limitation of sensitivity of clinical assessment tools, it remains unclear as to how the level of spondylosis affects the control and coordination of the joints on the performance of functional activities of daily living. Motion data including quiet standing, level walking, obstacle-crossing and sit-to-stand were measured using a motion analysis system equipped with 7 ultra-high resolution infrared cameras. The results were compared to the normal controls. As indicated by the center of pressure indexes, patients with lumbar spondylosis manifest greater index, suggesting a degradation of balance performance during quiet standing, especially in the medial-lateral direction. During level walking, patients with lumbar spondylosis were unable to maintain normal temporal-spatial parameters with slower walking speed and wider step width. The patients with patients in the current study maintain normal swing toe-clearance. However, slower crossing speed and smaller heel-obstacle distance were found in patients with lumbar spondylosis as this phenomenon was similar to that found during level walking. For the inter-joint coordination, continuous relative phase curves indicated that the two groups had relatively different inter-joint coordination patterns. During the task of sit-to-stand, the hip and knee joint owned relatively movable segments compared to the fix distal end at the ankle joints. In conclusion, patient group had altered postural control, joint biomechanics and inter-joint coordination.
Subjects
lumbar spondylosis
joint biomechanics
motion analysis
postural control
inter-joint coordination
Type
thesis
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