Abstract
BackgroundTrunk pelvic dissociation is fundamental to the compensatory mechanism for muscle weakness during body bending. We carried out an early investigation of gait changes in a sample of community-dwelling women ≥60 years without gait complaints. The primary objective was to correlate spine and pelvic angles with performance tests and accelerometry parameters. The secondary objective was to correlate performance tests with accelerometry.MethodsIn this cross-sectional study, 54 community-dwelling women ≥60 years were subjected to Falls Efficacy Scale-International (FES-I), performance tests (Berg Balance Scale, Timed Up and Go, and Gait analysis), and radiographic analysis of sagittal alignment (Thoracic and Lumbar Cobb, Pelvic Incidence, Sacral Slope, and Pelvic Tilt angles). Gait speed was assessed in a 10-m comfortable walk, and accelerometry parameters were obtained in a 30-m walk distance.ResultsThe sample, aged 72 ± 6 years, exhibited moderate correlation between Sacral Slope and Step Length (+ 0.615). Sacral Slope weakly correlated with FES-I (− 0.339), Berg Balance Scale (+ 0.367), and with further accelerometry data in the AP plane: RMS, (+ 0.439) and Stride Regularity (+ 0.475), p < 0.05, all. Lumbar Cobb weakly correlated with the following accelerometry data in the AP plane: Step Length (+ 0.405), RMS, (+ 0.392), and Stride Regularity (+ 0.345), p < 0.05, all. Additionally, Stride Regularity in AP moderately correlated with FES-I (0,561, p < 0.05), among other weak correlations between performance tests and accelerometry data in AP.ConclusionsEarly alterations in Sacral Slope and gait abnormalities in the AP plane may provide understanding of the early gait changes in robust older women.
Highlights
Trunk pelvic dissociation is fundamental to the compensatory mechanism for muscle weakness during body bending
Studies on the role of the sagittal alignment in gait have confirmed that compensation mechanisms of increased kyphosis in the elderly include a sequence of events, such as posterior pelvic tilting, increase in hip extension, knee flexion and increase ankle dorsiflexion [8]
In comparison to what has been reported for Brazilians older than 60 years [26], we observed an increase in the following pelvic angles mean ± standard deviation (SD): Pelvic Incidence (50.9° ± 6.6° vs. 57.9° ± 11.5°), Pelvic Tilt (13.8 ± 5° vs. 17.4 ± 8.0°) and Sacral Slope (37.4° ± 5.1° vs. 40.4° ± 7.8°)
Summary
Trunk pelvic dissociation is fundamental to the compensatory mechanism for muscle weakness during body bending. A compensatory mechanism to the alignment derangement between pelvis and trunk occurs as a deliberate strategy to overcome the decrease in muscle strength [1]. Studies on the role of the sagittal alignment in gait have confirmed that compensation mechanisms of increased kyphosis in the elderly include a sequence of events, such as posterior pelvic tilting, increase in hip extension, knee flexion and increase ankle dorsiflexion [8]. A study of the sagittal alignment and gait speed influences on falls of middle-aged and older males has shown that falls in the previous year was associated with the reduction in lumbar lordosis, sacral slope, and decrease of the gait speed [9]
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