Friday, September 28, 2018 3:00 PM–4:00 PM abstracts: spinal deformity analysis: 225. The correlation of spinopelvic parameters with biomechanical parameters measured by gait and balance analyses in patients with adult degenerative scoliosis

Abstract

BACKGROUND CONTEXT Gait and balance analyses can provide an objective measure of function. Patients with adult degenerative scoliosis (ADS) demonstrate an altered gait and balance patterns. Spinopelvic parameters are commonly used by clinicians to evaluate patients with ADS. However, few studies have examined the correlation between patients’ spinopelvic parametersoutcome and objective biomechanical gait and balance analyses. PURPOSE To determine the correlation between spinopelvic parameters with objective biomechanical measures of function. STUDY DESIGN/SETTING A prospective cohort study. PATIENT SAMPLE Thirty-nine patients with symptomatic ADS who have been deemed appropriate surgical candidates. OUTCOME MEASURES CVA, SVA, Cobb angle, PI-LL and T1PAalong with gait spatiotemporal parameters and COM and head sway during functional balance test. METHODS Gait and functional balance analyses were performed the week before surgery. Spatiotemporal parameters (ie gait speed, cadence, stride length, width and time etc.) were calculated during the gait evaluation. The functional balance test was similar to a Romberg's test. COM and head displacements in the sagittal and coronal planes and total sway amount along with spine and lower extremity neuromuscular activity were calculated. Furthermore, spinopelvic parameters were obtained on the same day of testing. Correlations were determined between the spinopelvic parameters and objective gait and balance analyses biomechanical data using Pearson's Product Correlation in SPSS. RESULTS The CVA was correlated with walking speed (r=0.343, p=.050), single support time (r=0.336, p=.050) during gait and external oblique (r=0.551, p=.008) muscle activity during the balance test. The SVA was correlated with horizontal COM (r=0.55, p=.004) and head (r=0.716, p=.001) sway in the coronal plane and gluteus maximus (r=0.450, p=.031) muscle activity during the balance test. The Cobb angle was correlated with COM total sway (r=-0.381, p=.050) and multifidus (r=−0.432, p=.035) muscle activity during the balance test. The PI-LL was correlated with single support time (r=0.493, p=.004) during gait and multifidus (r=0.406, p=.050) and semitendinosus (r=0.472, p=.023) muscle activity during the balance test. The T1PA was correlated with head sway in the coronal plane (r=0.403, p=.046) and external oblique (r=−0.484, p=.022) and gluteus maximus (r=0.387, p=.050) muscle activity during the balance test. CONCLUSIONS This study demonstrated a strong correlation between biomechanical parameters as measured with objective gait and balance analyses and spinopelvic parametersas measured with CVA, SVA, Cobb angle, PI-LL and T1PA. With higher values of the spinopelvic parameters, single support time, COM and head sway and neuromuscular activity were increased. Quantified gait and balance analyses can be a useful tool to evaluate patient outcomes. Objective functional performance measures can help to improve the evaluation and understanding of the biomechanical effects of spinal disorders on locomotion.