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      Hip Extensor Strength Influences Dynamic Postural Changes during Gait in Patients with Adult Spinal Deformity: A Cross-Sectional Study Using Three-Dimensional Motion Analysis

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      https://www.riss.kr/link?id=A108327912

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      다국어 초록 (Multilingual Abstract)

      Study Design: Single-hospital cross-sectional study.Purpose: The aim of the present study was to investigate the physical functions influencing dynamic postural change in patients with adult spinal deformity (ASD).Overview of Literature: Dynamic postu...

      Study Design: Single-hospital cross-sectional study.Purpose: The aim of the present study was to investigate the physical functions influencing dynamic postural change in patients with adult spinal deformity (ASD).Overview of Literature: Dynamic postural change leading to increased forward lean during gait is a problem in patients with ASD; however, the relationship between this change and trunk and hip extensor strength is unclear.Methods: Thirty patients with ASD aged ≥50 years who were admitted to our hospital between July 2016 and September 2019 were included in this study. X-ray parameters (i.e., sagittal vertical axis, pelvic tilt, and pelvic incidence minus lumbar lordosis) were evaluated from the full-length standing radiographs of the subjects. Trunk and hip extensor strength was evaluated using a hand-held dynamometer. Dynamic postural changes (i.e., sagittal trunk shift during standing, sagittal trunk shift during gait, and delta sagittal trunk shift) were assessed using a three-dimensional motion analysis system. The relationships between dynamic postural change and various X-ray parameters, as well as trunk and hip extensor strength, were examined using multivariable analysis.Results: Multivariable analysis showed that hip extensor strength is the factor most strongly associated with dynamic postural change among the X-ray parameters and physical functions assessed in this study (<i>β</i>=−0.41, <i>R<sup>2</sup></i>=0.12).Conclusions: We demonstrated the association between dynamic postural change and hip extensor strength in patients with ASD. Our results may be useful to healthcare providers treating patients with ASD. Interventions for dynamic postural change in patients with ASD should focus on hip extensor strength.

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      참고문헌 (Reference) 논문관계도

      1 Kado DM, "Vertebral fractures and mortality in older women : a prospective study : study of Osteoporotic Fractures Research Group" 159 : 1215-1220, 1999

      2 Miura K, "Thoracic kyphosis and pelvic anteversion in patients with adult spinal deformity increase while walking : analyses of dynamic alignment change using a three-dimensional gait motion analysis system" 29 : 840-848, 2020

      3 Glassman SD, "The impact of positive sagittal balance in adult spinal deformity" 30 : 2024-2029, 2005

      4 von Elm E, "The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)statement : guidelines for reporting observational studies" 12 : 1495-1499, 2014

      5 Katzman WB, "Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults : results from the study of hyperkyphosis, exercise, and function(SHEAF)randomized controlled trial" 28 : 2831-2841, 2017

      6 Marks MC, "Standing lateral radiographic positioning does not represent customary standing balance" 28 : 1176-1182, 2003

      7 Bao H, "Spino-femoral muscles affect sagittal alignment and compensatory recruitment : a new look into soft tissues in adult spinal deformity" 29 : 2998-3005, 2020

      8 Schwab F, "Scoliosis Research Society-Schwab adult spinal deformity classification : a validation study" 37 : 1077-1082, 2012

      9 Schwab F, "Sagittal plane considerations and the pelvis in the adult patient" 34 : 1828-1833, 2009

      10 Mar DE, "Representative dynamic ranges of spinal alignment during gait in patients with mild and severe adult spinal deformities" 21 : 518-527, 2021

      1 Kado DM, "Vertebral fractures and mortality in older women : a prospective study : study of Osteoporotic Fractures Research Group" 159 : 1215-1220, 1999

      2 Miura K, "Thoracic kyphosis and pelvic anteversion in patients with adult spinal deformity increase while walking : analyses of dynamic alignment change using a three-dimensional gait motion analysis system" 29 : 840-848, 2020

      3 Glassman SD, "The impact of positive sagittal balance in adult spinal deformity" 30 : 2024-2029, 2005

      4 von Elm E, "The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)statement : guidelines for reporting observational studies" 12 : 1495-1499, 2014

      5 Katzman WB, "Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults : results from the study of hyperkyphosis, exercise, and function(SHEAF)randomized controlled trial" 28 : 2831-2841, 2017

      6 Marks MC, "Standing lateral radiographic positioning does not represent customary standing balance" 28 : 1176-1182, 2003

      7 Bao H, "Spino-femoral muscles affect sagittal alignment and compensatory recruitment : a new look into soft tissues in adult spinal deformity" 29 : 2998-3005, 2020

      8 Schwab F, "Scoliosis Research Society-Schwab adult spinal deformity classification : a validation study" 37 : 1077-1082, 2012

      9 Schwab F, "Sagittal plane considerations and the pelvis in the adult patient" 34 : 1828-1833, 2009

      10 Mar DE, "Representative dynamic ranges of spinal alignment during gait in patients with mild and severe adult spinal deformities" 21 : 518-527, 2021

      11 Seko T, "Reliability and validity of seated hip extensor strength measurement by handheld dynamometer in older adults" 42 : E39-44, 2019

      12 Schwab FJ, "Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity : a prospective multicenter analysis" 38 : E803-12, 2013

      13 Engsberg JR, "Preoperative gait comparisons between adults undergoing long spinal deformity fusion surgery(thoracic to L4, L5, or sacrum)and controls" 26 : 2020-2028, 2001

      14 Takenaka H, "Predictors of walking ability after surgery for lumbar spinal canal stenosis : a prospective study" 19 : 1824-1831, 2019

      15 Pohtilla JF, "Kinesiology of hip extension at selected angles of pelvifemoral extension" 50 : 241-250, 1969

      16 Bae J, "Impact of fatigue on maintenance of upright posture : dynamic assessment of sagittal spinal deformity parameters after walking 10 minutes" 42 : 733-739, 2017

      17 Kado DM, "Hyperkyphotic posture and risk of injurious falls in older persons : the Rancho Bernardo Study" 62 : 652-657, 2007

      18 Yilgor C, "Global Alignment and Proportion(GAP)score : development and validation of a new method of analyzing spinopelvic alignment to predict mechanical complications after adult spinal deformity surgery" 99 : 1661-1672, 2017

      19 Kim HJ, "Failure of pelvic compensation in patients with severe positive sagittal imbalance : comparison between static radiographs and gait analysis of spinopelvic parameters in adult spinal deformity and lumbar stenosis" 44 : E759-65, 2019

      20 Bansal S, "Exercise for improving age-related hyperkyphotic posture : a systematic review" 95 : 129-140, 2014

      21 Ken Sasaki ; Michio Hongo ; Naohisa Miyakoshi ; Toshiki Matsunaga ; Shin Yamada ; Hiroaki Kijima ; Yoichi Shimada, "Evaluation of Sagittal Spine-Pelvis-Lower Limb Alignment in Elderly Women with Pelvic Retroversion while Standing and Walking Using a Three-Dimensional Musculoskeletal Model" 대한척추외과학회 11 (11): 562-569, 2017

      22 Itoi E, "Effect of back-strengthening exercise on posture in healthy women 49 to 65 years of age" 69 : 1054-1059, 1994

      23 Lee CS, "Dynamic sagittal imbalance of the spine in degenerative flat back : significance of pelvic tilt in surgical treatment" 26 : 2029-2035, 2001

      24 Shiba Y, "Dynamic global sagittal alignment evaluated by three-dimensional gait analysis in patients with degenerative lumbar kyphoscoliosis" 25 : 2572-2579, 2016

      25 Arima H, "Discrepancy between standing posture and sagittal balance during walking in adult spinal deformity patients" 42 : E25-30, 2017

      26 Lamartina C, "Classification of sagittal imbalance based on spinal alignment and compensatory mechanisms" 23 : 1177-1189, 2014

      27 Diebo BG, "Adult spinal deformity" 394 : 160-172, 2019

      28 Kobayashi T, "A longitudinal study of congruent sagittal spinal alignment in an adult cohort" 29 : 671-676, 2004

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