Strategy on navigating obstacle in patients with lumbar spinal stenosis: Relationship among trunk and pelvic movement, swing toe clearance, and muscle coordination of the stance limb.
Level 4 - case-series / case-control
Case-control observational biomechanics study
PubMed 30010099 · doi:10.3233/BMR-170927
What was done
Ten patients with lumbar spinal stenosis (LSS) and ten control participants were evaluated while navigating an obstacle during walking. Researchers measured trunk and lower extremity kinematics using a three-dimensional motion analysis system. Surface electromyography was used to assess isolated contraction ratios of the gluteus medius (GMed) and vastus lateralis (VL) in the stance limb.
What was found
The abstract reports directional differences without reporting numerical values or p-values: - Normalized lead limb distance was significantly lower in the LSS group than in controls. - Spine flexion angle when the swinging limb toe was above the obstacle was higher in LSS patients, whereas the pelvic anterior tilting angle was lower. - LSS patients had a significantly lower isolated contraction ratio of the GMed in the trailing stance limb and a significantly higher isolated contraction ratio of the VL.
Why it matters
This study demonstrates how forward trunk posture and altered pelvic-muscle coordination in lumbar spinal stenosis impair obstacle clearance and stance-limb stability, which may inform targeted physical therapy protocols.
Limits
The sample size is very small (n = 20 total; 10 per group), limiting statistical power and generalizability. The abstract reports no numerical values, effect sizes, or p-values. Confounders, clinical symptom severity, and actual fall incidence were not reported.
Cited by
- supports The gluteus medius muscle controls hip position and movement, thereby controlling pelvic position and affecting the alignment of the lumbar spine via its connection at the sacrum.