Pilot Study of an Integrated Gait and Spine Kinematics Protocol Using Optoelectronic Motion Analysis in Scoliosis Patients: Validation, Usability, and Comparison with Healthy Controls.

BACKGROUND

Gait analysis offers a comprehensive assessment of locomotion and postural control, which are often altered in individuals with spinal deformities. After validating a stereophotogrammetric protocol for whole-body kinematics, including spinal motion in healthy subjects, its application to clinical populations is needed to assess its clinical relevance. Patients treated with spinal arthrodesis for scoliosis may show reduced trunk mobility and compensatory gait strategies.

METHODS

The validated spinal protocol was applied to 10 patients with scoliosis who underwent arthrodesis and 5 healthy controls. For each participant, the range of motion (ROM) of the upper thoracic, lower thoracic, and lumbar districts was computed. Group differences were assessed with the Mann-Whitney U test, and time-normalized angular curves were compared using Statistical Parametric Mapping (SPM1d).

RESULTS

In the pathological group, the protocol showed moderate-to-excellent intra- and inter-operator reliability (ICC > 0.594). Compared with controls, patients exhibited a significant reduction in ROM in fused or adjacent districts. SPM analysis identified altered upper thoracic flexion-extension patterns, particularly relative to the lower thoracic segment, throughout the gait cycle.

CONCLUSIONS

The protocol demonstrated preliminary feasibility and sensitivity in identifying segmental and phase-dependent changes in spinal motion after arthrodesis, indicating that it may serve as a useful tool for exploratory postoperative gait evaluation.