Quantitative Gait Analysis of Patients with Severe Symptomatic Spinal Stenosis Utilizing the Gait Profile Score: An Observational Clinical Study.

Lumbar spine stenosis (LSS) typically manifests with neurogenic claudication, altering patients' gait. The use of optoelectronic systems has allowed clinicians to perform 3D quantitative gait analysis to quantify and understand these alterations. Although several authors have presented analysis of spatiotemporal gait parameters, data concerning kinematic parameters is lacking. Fifteen patients with LSS were matched with 15 healthy controls. Quantitative gait analysis utilizing optoelectronic techniques was performed for each pair of subjects in a specialized laboratory. Statistical comparison of patients and controls was performed to determine differences in spatiotemporal parameters and the Gait Profile Score (GPS). Statistically significant differences were found between patient and control groups for all spatiotemporal parameters. Patients had significantly different overall GPS (p = 0.004) and had limited internal/external pelvic rotation (p < 0.001) and cranial/caudal movement (p = 0.034), limited hip extension (p = 0.012) and abduction/adduction (p = 0.012) and limited ankle plantar flexion (p < 0.001). In conclusion, patients with LSS have significantly altered gait patterns in three regions (pelvis, hip and ankle) compared to healthy controls. Analysis of kinematic graphs has given insight into gait pathophysiology of patients with LSS and the use of GPS will allow us to quantify surgical results in the future.

Influence of school backpack load on plantar foot pressure during walking in 9-11 years old girls.

OBJECTIVE: This study aimed to assess the relative load of the midfoot and the metatarsals of both feet when schoolchildren walked with backpacks of different loads. METHODS: A group of 12 healthy girls (9.9 ± 0.8 years; 33.8 ± 6.7 kg, 1.40 ± 0.10 m) walked barefoot to assess plantar pressures during gait without load (L0%) and with a loaded backpack equal to 10% (L10%) and 20% (L20%) of their body weight. A Footscan® system (RSscan International, Belgium) was used to determine the contact area and relative pressure impulse in the midfoot and metatarsals on the dominant (DL) and non-dominant legs (NL). RESULTS: The effect of load was significant for the contact area of the midfoot for both NL (p = 0.013) and DL (p = 0.001). In the metatarsals, there was significantly greater relative impulse during L10% compared to L0% in the first (p = 0.041) and second (p = 0.050) metatarsals of the DL. Comparing the NL and DL showed significantly greater relative impulse on the DL in the fourth metatarsal during L10% (p = 0.023), greater contact area in the fifth metatarsal during L0% (p = 0.050), and greater impulse in the midfoot during L20% (p = 0.028) on the NL. CONCLUSIONS: The school backpack load influences relative plantar pressure distribution, especially in the midfoot. Further, our findings suggest greater propulsion of the DL and supporting function of the NL.

Quantitative gait analysis of patients with severe sacroiliac joint dysfunction: a prospective clinical study.

BACKGROUND: Sacroiliac joint (SIJ) dysfunction is a chronic painful condition responsible for up to 30% of back pain. Treatment modalities include physiotherapy, intraarticular analgesic injections, ablation techniques or SIJ fusion. The severity of SIJ dysfunction is commonly assessed via subjective pain or disability scales. Quantitative gait analysis offers an objective means of evaluating patients with SIJ dysfunction prior to its surgical treatment. METHODS: Ten patients diagnosed with severe SIJ dysfunction were matched with 10 healthy controls. All individuals underwent quantitative 3D gait analysis using the Qualisys program and statistical analysis was performed to identify significant differences in gait parameters between the two groups. RESULTS: Two groups of data were obtained; angular parameters described by the Gait Profile Score (GPS) and spatiotemporal parameters described in standard SI units. Statistically significant differences were found between the patient and control group for parameters: overall GPS (P=0.049), hip abduction/adduction (P=0.017) and ankle plantar/dorsal flexion (P=0.003), stride length (P=0.002), step length (P=0.001), swing time (P=0.03) and initial double limb support (P=0.02). CONCLUSIONS: This paper is the first to perform complex quantitative gait analysis of patients with SIJ dysfunction and to compare it with healthy individuals. These results can provide clinicians with baseline gait values for these patients to objectively quantify the extent of their disease.