Kinematic, kinetic, and musculoskeletal modeling analysis of gait in patients with cervical myelopathy using a severity classification.
A severity classification
Cervical myelopathy
Gait disturbance
Genu recurvatum
Muscle-tendon velocity
Musculoskeletal modeling analysis
Rehabilitation
The Japan Orthopaedic Association score
Three-dimensional gait analysis
Journal
The spine journal : official journal of the North American Spine Society
ISSN: 1878-1632
Titre abrégé: Spine J
Pays: United States
ID NLM: 101130732
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
29
11
2019
revised:
29
01
2020
accepted:
30
01
2020
pubmed:
8
2
2020
medline:
1
7
2021
entrez:
8
2
2020
Statut:
ppublish
Résumé
Although a few reports have shown a change in gait motion in cervical myelopathy (CM) patients using a three-dimensional (3D) gait analysis system, there has been no detailed quantitative investigation of their gait including musculoskeletal modeling parameters. Also, 3D gait analysis using a classification of severity has not been substantiated. This study aimed to investigate kinematic, kinetic, and musculoskeletal modeling parameters of gait motion in CM patients using a severity classification. Prospective cohort and cross-sectional study. Forty-two patients with CM and 40 healthy, age-matched volunteers. Lower extremity spatiotemporal, kinematic, kinetic, and musculoskeletal modeling parameters. Subjects were classified as to its severity using the Japan Orthopaedic Association score excluding the upper extremity items: group 1 (>10 points); group 2 (7-9 points); and group 3 (<6 points). A 3D motion analysis system and musculoskeletal modeling software were used to obtain the spatiotemporal, kinematic (the lower extremity joints angles in the sagittal plane), kinetic (the lower extremity joints moment and power in the sagittal plane), and musculoskeletal modeling parameters (the muscle-tendon length and velocity). Genu recurvatum, deteriorated lower-extremity joint motion, and muscle-tendon velocity were observed in severe CM patients (group 3). Muscle-tendon velocities of the long head of the biceps femoris in controls and mild CM patients (groups 1 and 2) showed a bimodal waveform in the negative direction during the initial contact and preswing phases, whereas these characteristics were not present in severe CM patients (group 3). The strategies of the knee joint moment during gait motion in severe CM patients were different from those of the normal gait pattern. The imbalance between agonist and antagonist muscle tissue during gait could be involved in the occurrence of genu recurvatum. It might be important for CM patients to consider improving the contraction or extension velocity of the biceps femoris muscle during each gait phase from the early stages of symptoms.
Sections du résumé
BACKGROUND CONTEXT
Although a few reports have shown a change in gait motion in cervical myelopathy (CM) patients using a three-dimensional (3D) gait analysis system, there has been no detailed quantitative investigation of their gait including musculoskeletal modeling parameters. Also, 3D gait analysis using a classification of severity has not been substantiated.
PURPOSE
This study aimed to investigate kinematic, kinetic, and musculoskeletal modeling parameters of gait motion in CM patients using a severity classification.
STUDY DESIGN
Prospective cohort and cross-sectional study.
PATIENT SAMPLE
Forty-two patients with CM and 40 healthy, age-matched volunteers.
OUTCOME MEASURES
Lower extremity spatiotemporal, kinematic, kinetic, and musculoskeletal modeling parameters.
METHODS
Subjects were classified as to its severity using the Japan Orthopaedic Association score excluding the upper extremity items: group 1 (>10 points); group 2 (7-9 points); and group 3 (<6 points). A 3D motion analysis system and musculoskeletal modeling software were used to obtain the spatiotemporal, kinematic (the lower extremity joints angles in the sagittal plane), kinetic (the lower extremity joints moment and power in the sagittal plane), and musculoskeletal modeling parameters (the muscle-tendon length and velocity).
RESULTS
Genu recurvatum, deteriorated lower-extremity joint motion, and muscle-tendon velocity were observed in severe CM patients (group 3). Muscle-tendon velocities of the long head of the biceps femoris in controls and mild CM patients (groups 1 and 2) showed a bimodal waveform in the negative direction during the initial contact and preswing phases, whereas these characteristics were not present in severe CM patients (group 3).
CONCLUSIONS
The strategies of the knee joint moment during gait motion in severe CM patients were different from those of the normal gait pattern. The imbalance between agonist and antagonist muscle tissue during gait could be involved in the occurrence of genu recurvatum. It might be important for CM patients to consider improving the contraction or extension velocity of the biceps femoris muscle during each gait phase from the early stages of symptoms.
Identifiants
pubmed: 32032676
pii: S1529-9430(20)30042-5
doi: 10.1016/j.spinee.2020.01.014
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1096-1105Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.