Ram Haddas1, Alexander Satin2, Isador Lieberman2. 1. Texas Back Institute, 6020 West Parker Road, Plano, TX, 75093, USA. rhaddas@texasback.com. 2. Texas Back Institute, 6020 West Parker Road, Plano, TX, 75093, USA.
Abstract
STUDY DESIGN: A nonrandomized, prospective, concurrent control cohort study. OBJECTIVE: To further develop cone of economy (CoE) measurements by identifying compensatory mechanisms at the extremes of the CoE and comparing balance control strategies in a group of adult degenerative scoliosis (ADS) patients with non-scoliotic controls. The CoE concept was first proposed by Dubousset and is frequently referred to when assessing balance in spinal deformity patients. Recently, a method that quantifies the CoE of individual patients through 3D video kinematic and electromyography data was developed. However, this method lacks measurements that describe the motor control strategies utilized by spinal disorder patients to maintain balance. PATIENT SAMPLE: Twenty ADS patients and 15 non-scoliotic controls. METHODS: All test subjects were fitted with a full body marker set. Each subject performed a series of functional balance tests (Romberg's with eyes opened) while being recorded in a human motion capture system. Three-dimensional CoE dimensions, range of sway (RoS), overall sway and lower extremity and trunk range of motion (RoM) were measured and analyzed. RESULTS: Patients with ADS demonstrated greater overall sway and RoS in the sagittal and coronal planes compared to controls. Moreover, ADS patients presented with more hip flexion and trunk flexion at maximal points of sway and more ankle, knee, hip and trunk RoM when swaying in comparison with controls. CONCLUSIONS: ADS patients have larger CoE dimensions and increased sway when compared to non-scoliotic controls. ADS patients rely on a hip balance control "strategy" and lower extremity RoM to maintain balance, which differed from control subjects. Unlike prior attempts to define compensatory mechanisms in ADS patients, the described technique utilizes dynamic, three-dimensional measurements to define what is occurring within the CoE. By expanding on prior CoE measurements, we were able to define a unique dynamic balance control strategy for each patient.
STUDY DESIGN: A nonrandomized, prospective, concurrent control cohort study. OBJECTIVE: To further develop cone of economy (CoE) measurements by identifying compensatory mechanisms at the extremes of the CoE and comparing balance control strategies in a group of adult degenerative scoliosis (ADS) patients with non-scoliotic controls. The CoE concept was first proposed by Dubousset and is frequently referred to when assessing balance in spinal deformitypatients. Recently, a method that quantifies the CoE of individual patients through 3D video kinematic and electromyography data was developed. However, this method lacks measurements that describe the motor control strategies utilized by spinal disorderpatients to maintain balance. PATIENT SAMPLE: Twenty ADSpatients and 15 non-scoliotic controls. METHODS: All test subjects were fitted with a full body marker set. Each subject performed a series of functional balance tests (Romberg's with eyes opened) while being recorded in a human motion capture system. Three-dimensional CoE dimensions, range of sway (RoS), overall sway and lower extremity and trunk range of motion (RoM) were measured and analyzed. RESULTS:Patients with ADS demonstrated greater overall sway and RoS in the sagittal and coronal planes compared to controls. Moreover, ADSpatients presented with more hip flexion and trunk flexion at maximal points of sway and more ankle, knee, hip and trunk RoM when swaying in comparison with controls. CONCLUSIONS:ADSpatients have larger CoE dimensions and increased sway when compared to non-scoliotic controls. ADSpatients rely on a hip balance control "strategy" and lower extremity RoM to maintain balance, which differed from control subjects. Unlike prior attempts to define compensatory mechanisms in ADSpatients, the described technique utilizes dynamic, three-dimensional measurements to define what is occurring within the CoE. By expanding on prior CoE measurements, we were able to define a unique dynamic balance control strategy for each patient.
Entities:
Keywords:
Adult degenerative scoliosis; Balance control strategies; Cone of economy; Range of motion; Romberg’s test; Sway
Authors: Javier Pizones; Francisco Javier Sánchez Perez-Grueso; Lucía Moreno-Manzanaro; Fernando Escámez; Caglar Yilgor; Alba Vila-Casademunt; Nicomedes Fernández-Baíllo; José Miguel Sánchez-Márquez; Ibrahim Obeid; Frank Kleinstück; Ahmet Alanay; Ferran Pellisé Journal: Eur Spine J Date: 2021-11-08 Impact factor: 3.134
Authors: Aneta Dąbrowska; Marzena A Olszewska-Karaban; Anna K Permoda-Białozorczyk; Dominika A Szalewska Journal: Biomed Res Int Date: 2020-07-04 Impact factor: 3.411