Walking Biomechanics and Spine Loading in Patients With Symptomatic Lumbar Spinal Stenosis

Symptomatic lumbar spinal stenosis is a leading cause of pain and mobility limitation in older adults. It is clinically believed that patients with lumbar spinal stenosis adopt a flexed trunk posture or bend forward and alter their gait pattern to improve tolerance for walking. However, a biomechani...

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Autores principales:	Seyed Javad Mousavi, Andrew C. Lynch, Brett T. Allaire, Andrew P. White, Dennis E. Anderson
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	lumbar spinal stenosis trunk posture spine motion compressive loading optoelectronic motion capture gait Biotechnology TP248.13-248.65
Acceso en línea:	https://doaj.org/article/0d177e948f234205b57a09c54f75cf3e
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spelling	oai:doaj.org-article:0d177e948f234205b57a09c54f75cf3e2021-11-18T07:00:06ZWalking Biomechanics and Spine Loading in Patients With Symptomatic Lumbar Spinal Stenosis2296-418510.3389/fbioe.2021.751155https://doaj.org/article/0d177e948f234205b57a09c54f75cf3e2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fbioe.2021.751155/fullhttps://doaj.org/toc/2296-4185Symptomatic lumbar spinal stenosis is a leading cause of pain and mobility limitation in older adults. It is clinically believed that patients with lumbar spinal stenosis adopt a flexed trunk posture or bend forward and alter their gait pattern to improve tolerance for walking. However, a biomechanical assessment of spine posture and motion during walking is broadly lacking in these patients. The purpose of this study was to evaluate lumbar spine and pelvic sagittal angles and lumbar spine compressive loads in standing and walking and to determine the effect of pain and neurogenic claudication symptoms in patients with symptomatic lumbar spinal stenosis. Seven participants with symptomatic lumbar spinal stenosis, aged 44–82, underwent a 3D opto-electronic motion analysis during standing and walking trials in asymptomatic and symptomatic states. Passive reflective marker clusters (four markers each) were attached to participants at T1, L1, and S2 levels of the spine, with additional reflective markers at other spinal levels, as well as the head, pelvis, and extremities. Whole-body motion data was collected during standing and walking trials in asymptomatic and symptomatic states. The results showed that the spine was slightly flexed during walking, but this was not affected by symptoms. Pelvic tilt was not different when symptoms were present, but suggests a possible effect of more forward tilt in both standing (p = 0.052) and walking (p = 0.075). Lumbar spine loading during symptomatic walking was increased by an average of 7% over asymptomatic walking (p = 0.001). Our results did not show increased spine flexion (adopting a trunk-flexed posture) and only indicate a trend for a small forward shift of the pelvis during both symptomatic walking and standing. This suggests that provocation of symptoms in these patients does not markedly affect their normal gait kinematics. The finding of increased spine loading with provocation of symptoms supports our hypothesis that spine loading plays a role in limiting walking function in patients with lumbar spinal stenosis, but additional work is needed to understand the biomechanical cause of this increase.Seyed Javad MousaviSeyed Javad MousaviAndrew C. LynchBrett T. AllaireAndrew P. WhiteAndrew P. WhiteDennis E. AndersonDennis E. AndersonFrontiers Media S.A.articlelumbar spinal stenosistrunk posturespine motioncompressive loadingoptoelectronic motion capturegaitBiotechnologyTP248.13-248.65ENFrontiers in Bioengineering and Biotechnology, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	lumbar spinal stenosis trunk posture spine motion compressive loading optoelectronic motion capture gait Biotechnology TP248.13-248.65
spellingShingle	lumbar spinal stenosis trunk posture spine motion compressive loading optoelectronic motion capture gait Biotechnology TP248.13-248.65 Seyed Javad Mousavi Seyed Javad Mousavi Andrew C. Lynch Brett T. Allaire Andrew P. White Andrew P. White Dennis E. Anderson Dennis E. Anderson Walking Biomechanics and Spine Loading in Patients With Symptomatic Lumbar Spinal Stenosis
description	Symptomatic lumbar spinal stenosis is a leading cause of pain and mobility limitation in older adults. It is clinically believed that patients with lumbar spinal stenosis adopt a flexed trunk posture or bend forward and alter their gait pattern to improve tolerance for walking. However, a biomechanical assessment of spine posture and motion during walking is broadly lacking in these patients. The purpose of this study was to evaluate lumbar spine and pelvic sagittal angles and lumbar spine compressive loads in standing and walking and to determine the effect of pain and neurogenic claudication symptoms in patients with symptomatic lumbar spinal stenosis. Seven participants with symptomatic lumbar spinal stenosis, aged 44–82, underwent a 3D opto-electronic motion analysis during standing and walking trials in asymptomatic and symptomatic states. Passive reflective marker clusters (four markers each) were attached to participants at T1, L1, and S2 levels of the spine, with additional reflective markers at other spinal levels, as well as the head, pelvis, and extremities. Whole-body motion data was collected during standing and walking trials in asymptomatic and symptomatic states. The results showed that the spine was slightly flexed during walking, but this was not affected by symptoms. Pelvic tilt was not different when symptoms were present, but suggests a possible effect of more forward tilt in both standing (p = 0.052) and walking (p = 0.075). Lumbar spine loading during symptomatic walking was increased by an average of 7% over asymptomatic walking (p = 0.001). Our results did not show increased spine flexion (adopting a trunk-flexed posture) and only indicate a trend for a small forward shift of the pelvis during both symptomatic walking and standing. This suggests that provocation of symptoms in these patients does not markedly affect their normal gait kinematics. The finding of increased spine loading with provocation of symptoms supports our hypothesis that spine loading plays a role in limiting walking function in patients with lumbar spinal stenosis, but additional work is needed to understand the biomechanical cause of this increase.
format	article
author	Seyed Javad Mousavi Seyed Javad Mousavi Andrew C. Lynch Brett T. Allaire Andrew P. White Andrew P. White Dennis E. Anderson Dennis E. Anderson
author_facet	Seyed Javad Mousavi Seyed Javad Mousavi Andrew C. Lynch Brett T. Allaire Andrew P. White Andrew P. White Dennis E. Anderson Dennis E. Anderson
author_sort	Seyed Javad Mousavi
title	Walking Biomechanics and Spine Loading in Patients With Symptomatic Lumbar Spinal Stenosis
title_short	Walking Biomechanics and Spine Loading in Patients With Symptomatic Lumbar Spinal Stenosis
title_full	Walking Biomechanics and Spine Loading in Patients With Symptomatic Lumbar Spinal Stenosis
title_fullStr	Walking Biomechanics and Spine Loading in Patients With Symptomatic Lumbar Spinal Stenosis
title_full_unstemmed	Walking Biomechanics and Spine Loading in Patients With Symptomatic Lumbar Spinal Stenosis
title_sort	walking biomechanics and spine loading in patients with symptomatic lumbar spinal stenosis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/0d177e948f234205b57a09c54f75cf3e
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Walking Biomechanics and Spine Loading in Patients With Symptomatic Lumbar Spinal Stenosis

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