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Influence of spino-pelvic and postural alignment parameters on gait kinematics.

脊柱-骨盆和姿势对准参数对步态运动学的影响。

  • 影响因子:2.65
  • DOI:10.1016/j.gaitpost.2019.12.029
  • 作者列表:"Otayek J","Bizdikian AJ","Yared F","Saad E","Bakouny Z","Massaad A","Ghanimeh J","Labaki C","Skalli W","Ghanem I","Kreichati G","Assi A
  • 发表时间:2020-02-01
Abstract

INTRODUCTION:Postural alignment is altered with spine deformities that might occur with age. Alteration of spino-pelvic and postural alignment parameters are known to affect daily life activities such as gait. It is still unknown how spino-pelvic and postural alignment parameters are related to gait kinematics. RESEARCH QUESTION:To assess the relationships between spino-pelvic/postural alignment parameters and gait kinematics in asymptomatic adults. METHODS:134 asymptomatic subjects (aged 18-59 years) underwent 3D gait analysis, from which kinematics of the pelvis and lower limbs were extracted in the 3 planes. Subjects then underwent full-body biplanar X-rays, from which skeletal 3D reconstructions and spino-pelvic and postural alignment parameters were obtained such as sagittal vertical axis (SVA), center of auditory meatus to hip axis plumbline (CAM-HA), thoracic kyphosis (TK) and radiologic pelvic tilt (rPT). In order to assess the influence of spino-pelvic and postural alignment parameters on gait kinematics a univariate followed by a multivariate analysis were performed. RESULTS:SVA was related to knee flexion during loading response (β = 0.268); CAM-HA to ROM pelvic obliquity (β = -0.19); rPT to mean pelvic tilt (β = -0.185) and ROM pelvic obliquity (β = -0.297); TK to ROM hip flexion/extension in stance (β = -0.17), mean foot progression in stance (β = -0.329), walking speed (β = -0.19), foot off (β = 0.223) and step length (β = -0.181). SIGNIFICANCE:This study showed that increasing SVA, CAM-HA, TK and rPT, which is known to occur in adults with spinal deformities, could alter gait kinematics. Increases in these parameters, even in asymptomatic subjects, were related to a retroverted pelvis during gait, a reduced pelvic obliquity and hip flexion/extension mobility, an increased knee flexion during loading response as well as an increase in external foot progression angle. This was associated with a decrease in the walking pace: reduced speed, step length and longer stance phase.

摘要

介绍: 随着年龄的增长,可能发生的脊柱畸形改变了姿势对准。已知脊柱-骨盆和姿势对准参数的改变影响日常生活活动,例如步态。脊柱-骨盆和姿势对准参数如何与步态运动学相关仍然是未知的。 研究问题: 评估无症状成人脊柱-骨盆/姿势对准参数与步态运动学之间的关系。 方法: 134名无症状受试者 (年龄18-59岁) 进行3D步态分析,从中提取骨盆和下肢的运动学在3个平面。受试者随后接受全身双平面x线片,从中获得骨骼3D重建和脊柱-骨盆和姿势对准参数,如矢状纵轴 (SVA) 、耳道中心至髋关节轴铅垂线 (cam-ha) 、胸椎后凸畸形 (TK) 和放射学骨盆倾斜 (rPT)。为了评估脊柱骨盆和姿势对准参数对步态运动学的影响,进行了单变量和多变量分析。 结果: SVA有关膝关节屈曲期间加载响应 (β  =   0.268); CAM-HA ROM骨盆倾斜 (β  =  -0.19); rPT指骨盆倾斜 (β  =  -0.185) 和ROM骨盆倾斜 (β  =  -0.297); TK ROM屈髋/扩展的立场 (β  =  -0.17),平均足进展立场 (β  =  -0.329),行走速度 (β  =  -0.19),脚 (β  =   0.223) 和步长 (β  =  -0.181). 意义: 这项研究表明,增加SVA,CAM-HA,TK和rPT,这是已知的发生在成人脊柱畸形,可能会改变步态运动学。这些参数的增加,即使在无症状的受试者中,也与步态期间的骨盆后倾、骨盆倾斜度降低和髋关节屈曲/伸展活动度降低、负荷响应期间的膝关节屈曲增加以及外足进展角增加有关。这与步行速度的降低有关: 速度降低,步长和更长的站立阶段。

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来源期刊:European radiology
DOI:10.1007/s00330-019-06319-0
作者列表:["Delattre BMA","Boudabbous S","Hansen C","Neroladaki A","Hachulla AL","Vargas MI"]

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影响因子:2.98
发表时间:2020-01-01
DOI:10.1136/neurintsurg-2019-014962
作者列表:["Guo W","Liu H","Tan Z","Zhang X","Gao J","Zhang L","Guo H","Bai H","Cui W","Liu X","Wu X","Luo J","Qu Y"]

METHODS:BACKGROUND:The main surgical techniques for spontaneous basal ganglia hemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques. OBJECTIVE:To explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal ganglia hemorrhage. METHODS:Five hundred and sixteen patients with spontaneous basal ganglia hemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomy were reviewed retrospectively. Six-month mortality and the modified Rankin Scale score were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes. RESULTS:For the entire cohort, the 6-month mortality in the endoscopic aspiration group was significantly lower than that in the stereotactic aspiration group (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspiration group was lower than that in the craniotomy group, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysis was stratified by hematoma volume. The mortality in the endoscopic aspiration group was significantly lower than in the stereotactic aspiration group in the medium (≥40-<80 mL) (OR=2.438, 95% CI 1.101 to 5.402) and large hematoma subgroup (≥80 mL) (OR=66.532, 95% CI 6.345 to 697.675). Compared with the endoscopic aspiration group, a trend towards increased mortality was observed in the large hematoma subgroup of the craniotomy group (OR=8.721, 95% CI 0.933 to 81.551). CONCLUSION:Endoscopic aspiration can decrease the 6-month mortality of spontaneous basal ganglia hemorrhage, especially in patients with a hematoma volume ≥40 mL.

影响因子:0.96
发表时间:2020-02-01
DOI:10.1002/jcu.22762
作者列表:["Meng L","Zhao D","Yang Z","Wang B"]

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