An observational study in Adult Spinal Deformity, sponsored by The University of Hong Kong. Completed at 1 site in Hong Kong. Per ClinicalTrials.gov, last updated 2020-05-06.
Sponsored by The University of Hong Kong · Observational
This study intends to investigate the changes in gait pattern in adult spinal deformity (ASD) patients with sagittal imbalance. It will investigate the gait kinematics in patients who have a mismatch of their spinopelvic parameters, and a positive sagittal balance. The investigators hypothesise that patients with abnormal spinopelvic parameters may demonstrate a pathological gait pattern.
With an ageing population, ASD presents as a significant health issue with increasing incidence. Most of the earlier literature concentrated on radiographic measurements of the deformity in the coronal plane, and its surgical correction. However, recent publications have demonstrated that sagittal spinopelvic alignment plays a critical role in pain and disability in patients with ASD, and is a primary determinant of health related quality of life measures. There is substantial evidence that restoration of these parameters after spinal reconstructive surgery is correlated with good clinical outcome.
Maintenance of the ideal sagittal alignment allows an individual to maintain an erect posture with minimal energy expenditure. When there is progressive loss of lumbar lordosis, compensatory mechanisms involving the pelvis, hips and knees occur to extend adjacent segments of the kyphotic spine to allow for compensation of anterior translation of the axis of gravity. However, this compensatory mechanism may potentially result in adverse effect. One of the main disabilities in ASD patients with sagittal imbalance is their decreased walking tolerance. The change in the spinal alignment along with these compensatory mechanisms may result in an inefficient gait worsening their walking tolerance.
Few studies in the literature have investigated the changes in gait pattern in patients with sagittal imbalance. Of those, the patient group was heterogeneous, and the only criterion of sagittal imbalance was a positive sagittal vertical axis (SVA), which the investigators now know is not a complete assessment of the sagittal alignment. The investigators propose to study the change in gait pattern in individuals with abnormal spinopelvic parameters, and how this may affect their quality of lives.
Patients with diagnosis of ADS will be recruited in this study conducted by the Department of Orthopaedics and Traumatology.
All patients diagnosed with ASD, fulfilling the following radiographic criteria based on whole spine lateral film are eligible for recruitment:
Exclusion Criteria:
All patients will undergo gait analysis using reflective surface markers placed at different locations on the head, trunk, upper and lower extremities, and pelvis. All patients will complete an analog pain scale, Oswestry, and SRS-22 questionnaires. These are health-related quality of life questionnaires that provide subjective assessment.
Diagnostic Test: Gait Analysis
All patients will undergo gait analysis using reflective surface markers placed at different locations on the head, trunk, upper and lower extremities, and pelvis. All patients will complete an analog pain scale, Oswestry, and SRS-22 questionnaires. These are health-related quality of life questionnaires that provide subjective assessment.
Evaluate the effect of sagittal imbalance on the gait cycle using reflective surface markers
To evaluate the effect of sagittal imbalance on the gait cycle using reflective surface markers
Time frame: 1 year
Investigate the difference in gait kinematics between normal and abnormal sagittal balance using reflective surface markers
To investigate the difference in gait kinematics between normal and abnormal sagittal balance using reflective surface markers
Time frame: 1 year
Investigate the efficiency in gait differences between normal and abnormal sagittal balance using reflective surface markers
To investigate the efficiency in gait differences between normal and abnormal sagittal balance using reflective surface markers
Time frame: 1 year
Investigate different muscle recruitment in gait cycles between normal and abnormal sagittal balance using a submaximal graded exercise test
To investigate different muscle recruitment in gait cycles between normal and abnormal sagittal balance using a submaximal graded exercise test
Time frame: 1 year
Plan to share: No
This study is completed, as verified in May 2020. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
The University of Hong Kong