《Chinese Journal of Rehabilitation Theory and Practice》 ›› 2022, Vol. 28 ›› Issue (10): 1178-1189.doi: 10.3969/j.issn.1006-9771.2022.10.008

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Biomechanical differences of adolescent idiopathic scoliosis during static standing and level walking: a meta-analysis

KE Jingyue1,MA Shengnan1,ZHANG Xiaohui2,LI Guqiang3()   

  1. 1. School of Rehabilitation Medicine, Binzhou Medical University, Yantai, Shandong 264003, China
    2. Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264003, China
    3. School of Institute of Rehabilitation Engineering, Binzhou Medical University, Yantai, Shandong 264003, China
  • Received:2022-03-15 Revised:2022-08-24 Published:2022-10-25 Online:2022-11-08
  • Contact: LI Guqiang E-mail:lgq100@bzmc.edu.cn
  • Supported by:
    Key Research Project in the Early Stage of the "14th Five-Year Plan" for the Career Planning of the Disabled and Research Project of China Disabled Persons' Federation in 2019(CJFJRRB29-2019)

Abstract:

Objective To identify the biomechanical deviations of patients with adolescent idiopathic scoliosis (AIS) during static standing and level walking.

Methods Cross-sectional, observational studies comparing biomechanical characteristics between individuals with AIS and healthy controls were searched in the databases of PubMed, Web of Science, EMBASE, Cochrane Library, CNKI, CBM, Wanfang data and VIP. The retrieval time was from the establishment of the database to August, 2021. Quality assessment and data extraction were performed independently by two reviewers. The data were analyzed with RevMan 5.4.

Results A total of 23 studies were finally included, with a total of 1 092 subjects. The overall methodological quality was moderate to high level. During static standing, the sway area (ES = 0.69, 95%CI 0.35 to 1.02, P <0.001), anteroposterior transfer speed (ES = 0.59, 95%CI 0.29 to 0.89, P <0.001) and mediolateral transfer speed (ES = 0.47, 95%CI 0.12 to 0.83, P <0.05) of plantar pressure center were more in AIS group than in the control group, however, there was no significant difference in the inclination of pelvic frontal plane (ES = 0.10, 95%CI -0.16 to 0.36, P> 0.05). During walking, the sagittal range of motion of knee (ES = -0.59, 95%CI -1.00 to -0.17, P = 0.005) and ankle (ES = -0.55, 95%CI -0.96 to -0.14, P = 0.008) were less in AIS group than in the control group, and the duration of EMG activity of the gluteus medius (ES = 1.21, 95%CI 0.23 to 2.18, P = 0.02), the quadratus lumborum (ES = 1.13, 95%CI 0.68 to 1.57, P <0.001) and the erector spinae (ES = 1.20, 95%CI 0.75 to 1.65, P <0.001) was longer in AIS group than in the control group, while no significant difference was observed in the step speed (ES = -0.12, 95%CI -0.45 to 0.21, P = 0.49). Compared with the control group, the step length of the spinal concave side (ES = -0.37, 95%CI -0.72 to -0.02, P =0.04) was shorter, but the overall step length (ES = -0.22, 95%CI -0.76 to 0.31, P = 0.42) was not significantly different in AIS group.

Conclusion Compared with the healthy controls, some characteristic biomechanical changes were exhibited in the AIS patients, including spatiotemporal characteristics, kinematic and mechanical characteristics, and electromyographic signal characteristics.

Key words: adolescent idiopathic scoliosis, biomechanics, static standing, walking, meta-analysis

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