The Most Significant Factor Affecting Gait and Postural Balance in Patients' Activities of Daily Living Following Corrective Surgery for Deformity of the Adult Spine

Overview

Journal Medicina (Kaunas)

Publisher MDPI

Specialty General Medicine

Date 2022 Aug 26

PMID 36013585

Authors

Tomoyoshi Sakaguchi

Masato Tanaka

Naveen Sake

Kajetan Latka

Yoshihiro Fujiwara

Shinya Arataki

Taro Yamauchi

Kazuhiko Takamatsu

Yosuke Yasuda

Masami Nakagawa

Nana Takahashi

Tomoya Kishimoto

Affiliations

Soon will be listed here.

Abstract

: Gait ability and spinal postural balance affect ADL in patients who underwent adult spinal deformity (ASD) surgery. However, it is still unclear how to determine what the cause is. This study was done to investigate various factors affecting gait, postural balance and activities of daily living (ADL) in patients who were operated on for ASD over a period of one year, following corrective surgery. : A cohort of 42 (2 men, 40 women, mean age, 71.1 years) who were operated on for ASD were included in this study. According to Oswestry Disability Index (ODI), based on their ADL, patients were segregated into satisfied and unsatisfied groups. Gait and postural balance abilities were evaluated before and after the operative procedure. Radiographs of spine and pelvis as well as the rehabilitation data (static balance, standing on single-leg; dynamic postural adaptation, timed up and go test (TUG); Gait Capability, walk velocity for a distance of 10 m) were acquired 12 months after surgery and analyzed. Spinopelvic parameters such as (lumbar lordosis (LL), pelvic tilt (PT), sagittal vertical axis (SVA), pelvic incidence (PI)) were marked and noted. The factors which affect patients' satisfaction with their ADL were evaluated. : The ADL satisfied group included 18 patients (1 man, 17 women, mean age 68.6 years) and the unsatisfied group included 24 patients (1 man, 23 women, mean age 73.1 years). One year after the surgery, the two groups were tested. TUG (8.5 s vs. 12.8 s), 10 m walk velocity (1.26 m/s vs. 1.01 m/s), and single leg standing test (25 s vs. 12.8 s) were regarded as notably different. According to logistic regression analysis, only TUG was extracted as a significant factor. The cut-off value was 9.7 s, with sensitivity 75%, specificity 83%, area under the curve 0.824, and a 95% confidence interval of 0.695-0.953. : A significant factor among all evaluations in postoperative ASD patients was TUG, for which the cut-off value for ADL satisfaction was 9.7 s.

Citing Articles

Evaluation and Rehabilitation after Adult Lumbar Spine Surgery.

Sakaguchi T, Gunjotikar S, Tanaka M, Komatsubara T, Latka K, Ekade S J Clin Med. 2024; 13(10).

PMID: 38792457 PMC: 11122457. DOI: 10.3390/jcm13102915.

The relationship between orthodontic and orthopaedic interventions in the influence of postural position on the bite.

Kiosse V J Orthod Sci. 2024; 13:16.

PMID: 38784073 PMC: 11114448. DOI: 10.4103/jos.jos_207_23.

Use of a Triaxial Accelerometer to Measure Changes in Gait Sway and Related Motor Function after Corrective Spinal Fusion Surgery for Adult Spinal Deformity.

Sakaguchi T, Sake N, Tanaka M, Fujiwara Y, Arataki S, Taoka T J Clin Med. 2024; 13(7).

PMID: 38610688 PMC: 11012576. DOI: 10.3390/jcm13071923.

Ergonomic interventions and endodontic treatment outcomes: An analysis of dentist working posture and error rates.

Ratushnyi R, Stakhanska O Saudi Dent J. 2024; 36(3):466-470.

PMID: 38525173 PMC: 10960123. DOI: 10.1016/j.sdentj.2023.12.006.

Minimal Clinically Important Differences in Gait and Balance Ability in Patients Who Underwent Corrective Long Spinal Fusion for Adult Spinal Deformity.

Sakaguchi T, Meena U, Tanaka M, Xiang H, Fujiwara Y, Arataki S J Clin Med. 2023; 12(20).

PMID: 37892638 PMC: 10607759. DOI: 10.3390/jcm12206500.

References

Mannion A, Loibl M, Bago J, Vila-Casademunt A, Richner-Wunderlin S, Fekete T . What level of symptoms are patients with adult spinal deformity prepared to live with? A cross-sectional analysis of the 12-month follow-up data from 1043 patients. Eur Spine J. 2020; 29(6):1340-1352. DOI: 10.1007/s00586-020-06365-z. View

Kondo R, Yamato Y, Nagafusa T, Mizushima T, Hasegawa T, Kobayashi S . Effect of corrective long spinal fusion to the ilium on physical function in patients with adult spinal deformity. Eur Spine J. 2017; 26(8):2138-2145. DOI: 10.1007/s00586-017-4987-9. View

Schwab F, Dubey A, Gamez L, El Fegoun A, Hwang K, Pagala M . Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine (Phila Pa 1976). 2005; 30(9):1082-5. DOI: 10.1097/01.brs.0000160842.43482.cd. View

Smith J, Shaffrey C, Berven S, Glassman S, Hamill C, Horton W . Improvement of back pain with operative and nonoperative treatment in adults with scoliosis. Neurosurgery. 2009; 65(1):86-93. DOI: 10.1227/01.NEU.0000347005.35282.6C. View

Perera S, Mody S, Woodman R, Studenski S . Meaningful change and responsiveness in common physical performance measures in older adults. J Am Geriatr Soc. 2006; 54(5):743-9. DOI: 10.1111/j.1532-5415.2006.00701.x. View

Makino T, Takenaka S, Sakai Y, Yoshikawa H, Kaito T . Factors related to length of hospital stay after two-stage corrective surgery for adult spinal deformity in elderly Japanese. J Orthop Sci. 2020; 26(1):123-127. DOI: 10.1016/j.jos.2020.02.016. View

Stienen M, Maldaner N, Joswig H, Corniola M, Bellut D, Prommel P . Objective functional assessment using the "Timed Up and Go" test in patients with lumbar spinal stenosis. Neurosurg Focus. 2019; 46(5):E4. DOI: 10.3171/2019.2.FOCUS18618. View

Salbach N, Mayo N, Higgins J, Ahmed S, Finch L, Richards C . Responsiveness and predictability of gait speed and other disability measures in acute stroke. Arch Phys Med Rehabil. 2001; 82(9):1204-12. DOI: 10.1053/apmr.2001.24907. View

Greenwood J, McGregor A, Jones F, Mullane J, Hurley M . Rehabilitation Following Lumbar Fusion Surgery: A Systematic Review and Meta-Analysis. Spine (Phila Pa 1976). 2015; 41(1):E28-36. DOI: 10.1097/BRS.0000000000001132. View

10.

Shimada H, Suzuki T, Suzukawa M, Makizako H, Doi T, Yoshida D . Performance-based assessments and demand for personal care in older Japanese people: a cross-sectional study. BMJ Open. 2013; 3(4). PMC: 3641481. DOI: 10.1136/bmjopen-2012-002424. View

11.

Shumway-Cook A, Brauer S, Woollacott M . Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000; 80(9):896-903. View

12.

Granacher U, Lacroix A, Muehlbauer T, Roettger K, Gollhofer A . Effects of core instability strength training on trunk muscle strength, spinal mobility, dynamic balance and functional mobility in older adults. Gerontology. 2012; 59(2):105-13. DOI: 10.1159/000343152. View

13.

Konno S, Kikuchi S, Nagaosa Y . The relationship between intramuscular pressure of the paraspinal muscles and low back pain. Spine (Phila Pa 1976). 1994; 19(19):2186-9. DOI: 10.1097/00007632-199410000-00011. View

14.

Yagi M, Ohne H, Kaneko S, Machida M, Yato Y, Asazuma T . Does corrective spine surgery improve the standing balance in patients with adult spinal deformity?. Spine J. 2017; 18(1):36-43. DOI: 10.1016/j.spinee.2017.05.023. View

15.

Kebaish K, Neubauer P, Voros G, Khoshnevisan M, Skolasky R . Scoliosis in adults aged forty years and older: prevalence and relationship to age, race, and gender. Spine (Phila Pa 1976). 2010; 36(9):731-6. DOI: 10.1097/BRS.0b013e3181e9f120. View

16.

Roussouly P, Gollogly S, Berthonnaud E, Dimnet J . Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine (Phila Pa 1976). 2005; 30(3):346-53. DOI: 10.1097/01.brs.0000152379.54463.65. View

17.

Kimura H, Fujibayashi S, Otsuki B, Takahashi Y, Nakayama T, Matsuda S . Effects of Lumbar Stiffness After Lumbar Fusion Surgery on Activities of Daily Living. Spine (Phila Pa 1976). 2015; 41(8):719-27. DOI: 10.1097/BRS.0000000000001300. View

18.

Kozinc Z, Lofler S, Hofer C, Carraro U, Sarabon N . Diagnostic Balance Tests for Assessing Risk of Falls and Distinguishing Older Adult Fallers and Non-Fallers: A Systematic Review with Meta-Analysis. Diagnostics (Basel). 2020; 10(9). PMC: 7554797. DOI: 10.3390/diagnostics10090667. View

19.

Podsiadlo D, Richardson S . The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991; 39(2):142-8. DOI: 10.1111/j.1532-5415.1991.tb01616.x. View

20.

Everett C, Patel R . A systematic literature review of nonsurgical treatment in adult scoliosis. Spine (Phila Pa 1976). 2007; 32(19 Suppl):S130-4. DOI: 10.1097/BRS.0b013e318134ea88. View