A New Potential Indicator in Differentiating Patients with Lumbar Spinal Stenosis and Lumbar Intervertebral Disc Degeneration
Abstract
Background: Center of pressure (CoP) trajectory is one of the gait parameters that is widely used for clinical assessments. Moreover, the CoP trajectory could be adversely affected by anatomic and mechanical factors that involve foot function, which was shown to be correlated with musculoskeletal diseases. The aim of this study is to compare angle-associated parameters of gait in patients with different lumbar spinal disorders.
Methods: The subjects suffered from the same levels of spine impairment, including patients with lumbar spinal stenosis (LSS) and lumbar intervertebral disc degeneration (LIDD) were recruited in this study. The spatio-temporal angular parameters associated with the CoP of the subjects during their gait were collected and examined. The measurements were used to calculate the CoP angle and symmetry angle (SA). Then the butterfly diagram (BD) intersection angle was introduced as a new potential parameter in gait assessment.
Results: The results of the current study showed that CoPs and SAs did not vary between the two groups (P > 0.05). The BD intersection angle, however, indicated some variations between patients with LSS and LIDD (P < 0.05).
Conclusion: While the results showed that CoP angles and SAs did not differ between the LSS and LIDD groups, it is hypothesized that such disorders that affect the gait could be reflected in the BD intersection angle. Therefore, the BD intersection angle is suggested as a clinical indicator in clarifying patients with lumbar spinal disorders.
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22. Khanmohammadi R, Talebian S, Hadian MR, Olyaei G, Bagheri
H. The relative and absolute reliability of center of pressure trajectory during gait initiation in older adults. Gait Posture. 2017;52:194-201. doi: 10.1016/j.gaitpost.2016.11.042. [PubMed: 27915224].
23. Kalron A, Achiron A. The relationship between fear of falling to spatiotemporal gait parameters measured by an instrumented treadmill in people with multiple sclerosis. Gait Posture. 2014;39(2):739-44. doi: 10.1016/j.gaitpost.2013.10.012. [PubMed: 24200869].
24. Riva F, Bisi MC, Stagni R. Gait variability and stability measures: Minimum number of strides and within-session reliability. Comput Biol Med. 2014;50:9-13. doi: 10.1016/j.compbiomed.2014.04.001. [PubMed: 24792493].
25. Zifchock RA, Davis I, Higginson J, Royer T. The symmetry angle:
A novel, robust method of quantifying asymmetry. Gait Posture. 2008;27(4):622-7. doi: 10.1016/j.gaitpost.2007.08.006. [PubMed: 17913499].
26. Huang RC, Tropiano P, Marnay T, Girardi FP, Lim MR, Cammisa FP Jr. Range of motion and adjacent level degeneration after lumbar total disc replacement. Spine J. 2006;6(3):242-7. doi: 10.1016/j.spinee.2005.04.013. [PubMed: 16651217].
2. Cully A, Clune J, Tarapore D, Mouret JB. Robots that can adapt like animals. Nature. 2015;521(7553):503-7. doi: 10.1038/nature14422. [PubMed: 26017452].
3. Carriero A, Zavatsky A, Stebbins J, Theologis T, Shefelbine SJ. Determination of gait patterns in children with spastic diplegic cerebral palsy using principal components. Gait Posture. 2009;29(1):71-5. doi: 10.1016/j.gaitpost.2008.06.011. [PubMed: 18676146].
4. Wencel J, Olson KA. Lumbar spinal stenosis: A literature review. J Manual Manipulative Ther. 1999;7(3):141-8. doi: 10.1179/106698199790811663.
5. Clinchot DM, Kaplan PE, Lamb JF. Lumbar spinal stenosis in an elderly patient. J Gerontol A Biol Sci Med Sci. 1998;53(1):M72-M75. doi: 10.1093/gerona/53a.1.m72. [PubMed: 9467437].
6. Deyo RA, Mirza SK, Martin BI, Kreuter W, Goodman DC, Jarvik JG. Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA. 2010;303(13):1259-65. doi: 10.1001/jama.2010.338. [PubMed: 20371784]. [PubMed Central: PMC2885954].
7. Genevay S, Courvoisier DS, Konstantinou K, Kovacs FM, Marty M, Rainville J, et al. Clinical classification criteria for neurogenic claudication caused by lumbar spinal stenosis. The N-CLASS criteria. Spine J. 2018;18(6):941-7. doi: 10.1016/j.spinee.2017.10.003. [PubMed: 29031994].
8. Machado GC, Maher CG, Ferreira PH, Harris IA, Deyo RA, McKay D, et al. Trends, complications, and costs for hospital admission and surgery for lumbar spinal stenosis. Spine (Phila Pa 1976).
2017;42(22):1737-43.doi:10.1097/BRS.0000000000002207.
[PubMed: 28441309].
9. Iatridis JC, Kang J, Kandel R, Risbud MV. New horizons in spine research: Intervertebral disc repair and regeneration. J Orthop Res. 2017;35(1):5-7. doi: 10.1002/jor.23499. [PubMed: 28114734]. [PubMed Central: PMC5482231].
10. Jonsson B, Annertz M, Sjoberg C, Stromqvist B. A prospective and consecutive study of surgically treated lumbar spinal stenosis. Part II: Five-year follow-up by an independent observer. Spine (Phila Pa 1976). 1997;22(24):2938-44. doi:
10.1097/00007632-199712150-00017. [PubMed: 9431630].
11. Steurer J, Roner S, Gnannt R, Hodler J. Quantitative radiologic criteria for the diagnosis of lumbar spinal stenosis: A systematic literature review. BMC Musculoskelet Disord. 2011;12:175. doi: 10.1186/1471-2474-12-175. [PubMed: 21798008]. [PubMed Central: PMC3161920].
12. Chang A, Hurwitz D, Dunlop D, Song J, Cahue S, Hayes K, et al. The relationship between toe-out angle during gait and progression of medial tibiofemoral osteoarthritis. Ann Rheum Dis. 2007;66(10):1271-5. doi: 10.1136/ard.2006.062927. [PubMed: 17267516]. [PubMed Central: PMC1994298].
13. Kalron A, Frid L. The "butterfly diagram": A gait marker for neurological and cerebellar impairment in people with multiple sclerosis. J Neurol Sci. 2015;358(1-2):92-100. doi: 10.1016/j.jns.2015.08.028. [PubMed: 26318202].
14. Prosperini L, Fortuna D, Gianni C, Leonardi L, Pozzilli C. The diagnostic accuracy of static posturography in predicting accidental falls in people with multiple sclerosis. Neurorehabil Neural Repair. 2013;27(1):45-52. doi: 10.1177/1545968312445638. [PubMed: 22593115].
15. Fuller EA. Center of pressure and its theoretical relationship to foot pathology. J Am Podiatr Med Assoc. 1999;89(6):278-91. doi: 10.7547/87507315-89-6-278. [PubMed: 10384754].
16. De Cock A., Vanrenterghem J, Willems T, Witvrouw E, De Clercq D. The trajectory of the centre of pressure during barefoot running as a potential measure for foot function. Gait Posture. 2008;27(4):669-75. doi: 10.1016/j.gaitpost.2007.08.013. [PubMed: 17997096].
17. Sadeghi H, Allard P, Prince F, Labelle H. Symmetry and limb dominance in able-bodied gait: A review. Gait Posture. 2000;12(1):34-45. doi: 10.1016/s0966-6362(00)00070-9. [PubMed: 10996295].
18. Gouwanda D, Senanayake SM. Identifying gait asymmetry using gyroscopes-a cross-correlation and Normalized
Symmetry Index approach. J Biomech. 2011;44(5):972-8. doi:
10.1016/j.jbiomech.2010.12.013. [PubMed: 21306714].
19. Winter DA, Sienko SE. Biomechanics of below-knee amputee gait. J Biomech. 1988;21(5):361-7. doi: 10.1016/0021-9290(88)90142-x. [PubMed: 3417688].
20. Mawase F, Haizler T, Bar-Haim S, Karniel A. Kinetic adaptation during locomotion on a split-belt treadmill. J Neurophysiol. 2013;109(8):2216-27. doi: 10.1152/jn.00938.2012. [PubMed: 23365187].
21. Kalron A, Dvir Z, Frid L, Achiron A. Quantifying gait impairment using an instrumented treadmill in people with multiple sclerosis. ISRN Neurol. 2013;2013:867575. doi: 10.1155/2013/867575. [PubMed: 23878746]. [PubMed Central: PMC3708434].
22. Khanmohammadi R, Talebian S, Hadian MR, Olyaei G, Bagheri
H. The relative and absolute reliability of center of pressure trajectory during gait initiation in older adults. Gait Posture. 2017;52:194-201. doi: 10.1016/j.gaitpost.2016.11.042. [PubMed: 27915224].
23. Kalron A, Achiron A. The relationship between fear of falling to spatiotemporal gait parameters measured by an instrumented treadmill in people with multiple sclerosis. Gait Posture. 2014;39(2):739-44. doi: 10.1016/j.gaitpost.2013.10.012. [PubMed: 24200869].
24. Riva F, Bisi MC, Stagni R. Gait variability and stability measures: Minimum number of strides and within-session reliability. Comput Biol Med. 2014;50:9-13. doi: 10.1016/j.compbiomed.2014.04.001. [PubMed: 24792493].
25. Zifchock RA, Davis I, Higginson J, Royer T. The symmetry angle:
A novel, robust method of quantifying asymmetry. Gait Posture. 2008;27(4):622-7. doi: 10.1016/j.gaitpost.2007.08.006. [PubMed: 17913499].
26. Huang RC, Tropiano P, Marnay T, Girardi FP, Lim MR, Cammisa FP Jr. Range of motion and adjacent level degeneration after lumbar total disc replacement. Spine J. 2006;6(3):242-7. doi: 10.1016/j.spinee.2005.04.013. [PubMed: 16651217].
| Files | ||
| Issue | Vol 7, No 2 (2021) | |
| Section | Research Articles | |
| DOI | https://doi.org/10.18502/jost.v7i2.6999 | |
| Keywords | ||
| Kinetics; Gait; Spinal Stenosis; Intervertebral Disc Degeneration | ||
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How to Cite
1.
Eskandari F, Bahramizadeh Sajadi S, Katoozian HR. A New Potential Indicator in Differentiating Patients with Lumbar Spinal Stenosis and Lumbar Intervertebral Disc Degeneration. J Orthop Spine Trauma. 2021;7(2):44-7.
