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

Jan Lodin,Petr Vachata,Martin Sameš,Marek Jelínek

doi:10.3390/s22041633

Abstract

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.

Highlights

Lumbar spine stenosis (LSS) is a common degenerative condition predominantly affecting patients over the age of 65 [1]
Our hypothesis was that gait patterns of patients with severe symptomatic spinal stenosis are significantly altered compared to healthy controls
The final cohort consisted of 15 patients (4 females and 11 males), mean age of 62.3, mean body mass index (BMI) 32.0, all of whom successfully underwent 3D quantitative motion analysis 2–4 weeks prior to lumbar decompression surgery

Summary

Introduction

Lumbar spine stenosis (LSS) is a common degenerative condition predominantly affecting patients over the age of 65 [1]. A hallmark of LSS is the presence of neurogenic claudication, defined as the paresthesia, dysesthesia, radiating from the buttocks distally [2]. This manifests as gait dysfunction, which results in the decline of patient quality of life. LSS, as it would allow them to assess the severity of the disease, monitor disease progression and analyze surgical success. Many have utilized modern motion capture and optoelectronic systems to perform complex 3D gait reconstructions, allowing detailed analysis of separate anatomical areas during the gait cycle. The complexity of 3D movement patterns limits their interpretation and implementation into clinical practice

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