Abstract
Background The development of postural analysis thanks to force and pressure platforms, in order to determine the center of pressure, can be valuable in the setting of spinal malalignment. The purpose of this study was to compare “pressure” and “force” platforms for the evaluation of the center of pressure. In other words, can we neglect the horizontal ground reaction force in the evaluation of intersegmental moments during standing posture? Methods. Postural data from two healthy adult volunteers were analyzed. Analysis of the posture was done according to a protocol providing sagittal intersegmental moments. A set of 36 markers was used to divide the body in 10 segments. Postacquisition calculations were done in order to obtain the sagittal net intersegmental moments. To evaluate the differences in intersegmental moments between force and pressure platforms, the postacquisition calculations were done with a simulated pressure platform. Mean intersegmental moments between each body segment for each volunteer were compared. Findings There were significant differences between the 2 platforms in intersegmental moments for the lumbo-sacral junction, hips, knees, and ankles (p < 0.005). All differences were inferior to intrasubject variability measured with the force platform (p < 0.001). Results from intra- and interobserver comparisons showed that differences measured with the pressure platform were all inferior to the standard error obtained with the force platform for every intersegmental moment (p < 0.001). Interpretation The use of a simulated pressure platform to determine intersegmental moments has the same clinical efficiency as force platforms. Moreover, the possibility to set the platform into the radiograph room will allow in a second time a correlation between radiographic parameters and biomechanical constraints applied to the spine.
Highlights
Importance of spinal global sagittal alignment has been widely described in the literature and correlated with clinical outcomes [1,2,3]
Integration of pelvic parameters in spinal assessment was highly correlated with clinical outcomes [7] and helped to understand which factors were related to spinal deformities and which were acting as compensatory mechanism in order to maintain the head over the pelvis and a horizontal gaze [7,8,9,10]. e initial change in adult spinal deformity is a loss of lumbar lordosis, leading to an anterior global
Significant difference was found neither for the thoraco-lumbar junction (p 0.162) nor for the cervico-thoracic junction but due to the fact that this moment was calculated in a descending manner without taking into account ground reaction force
Summary
Importance of spinal global sagittal alignment has been widely described in the literature and correlated with clinical outcomes [1,2,3] Analysis of these radiographic parameters has led to a better understanding of normal alignment [4] as well as age-related changes [5, 6]. Integration of pelvic parameters in spinal assessment was highly correlated with clinical outcomes [7] and helped to understand which factors were related to spinal deformities and which were acting as compensatory mechanism in order to maintain the head over the pelvis and a horizontal gaze [7,8,9,10]. Standing posture might not be considered as a static condition but more like a permanent control of equilibrium
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