{"title":"Walking stress-induced changes in gait patterns and muscle activity: Patients with lumbar spinal stenosis versus asymptomatic controls","authors":"","doi":"10.1016/j.gaitpost.2024.08.083","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with symptomatic lumbar spinal stenosis (sLSS) are often limited in their walking range because of worsening symptoms, which is thought to induce changes in the gait pattern. The aim of this study was to determine whether changes in gait pattern and muscle activity in these patients are elicited by a walking stress and differ from asymptomatic controls.</p></div><div><h3>Methods</h3><p>Twenty patients with sLSS and 19 asymptomatic controls performed a 30-minute walking stress. Gait was assessed using seven inertial sensors and sagittal joint range of motion (ROM) was calculated during different phases of gait. Muscle activation of the gluteus medius, erector spinae and multifidus muscles was measured by surface electromyography (EMG) and integrated EMGs (normalized to the maximum during gait) were calculated. Differences between groups and time points (beginning and end) were assessed using mixed factorial analysis of variance.</p></div><div><h3>Results</h3><p>Patients had less knee extension ROM in terminal stance, less knee flexion ROM in swing and less overall hip flexion/extension ROM than controls (p ≤ 0.03). There were no functionally relevant changes in these parameters during the walking stress. The integrated EMG was greater in all muscles in patients than in controls and increased in both groups during the walking stress in the paraspinal but not in the gluteus medius muscle. There was no interaction between group and time for any of the parameters.</p></div><div><h3>Conclusion</h3><p>Differences in gait pattern and muscle activity between patients with sLSS and controls are generally present, but are not amplified by a walking stress.</p></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0966636224006052/pdfft?md5=1edf4637983f36825318b25a20e0feec&pid=1-s2.0-S0966636224006052-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gait & posture","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0966636224006052","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Patients with symptomatic lumbar spinal stenosis (sLSS) are often limited in their walking range because of worsening symptoms, which is thought to induce changes in the gait pattern. The aim of this study was to determine whether changes in gait pattern and muscle activity in these patients are elicited by a walking stress and differ from asymptomatic controls.
Methods
Twenty patients with sLSS and 19 asymptomatic controls performed a 30-minute walking stress. Gait was assessed using seven inertial sensors and sagittal joint range of motion (ROM) was calculated during different phases of gait. Muscle activation of the gluteus medius, erector spinae and multifidus muscles was measured by surface electromyography (EMG) and integrated EMGs (normalized to the maximum during gait) were calculated. Differences between groups and time points (beginning and end) were assessed using mixed factorial analysis of variance.
Results
Patients had less knee extension ROM in terminal stance, less knee flexion ROM in swing and less overall hip flexion/extension ROM than controls (p ≤ 0.03). There were no functionally relevant changes in these parameters during the walking stress. The integrated EMG was greater in all muscles in patients than in controls and increased in both groups during the walking stress in the paraspinal but not in the gluteus medius muscle. There was no interaction between group and time for any of the parameters.
Conclusion
Differences in gait pattern and muscle activity between patients with sLSS and controls are generally present, but are not amplified by a walking stress.
期刊介绍:
Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance.
The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.