Evaluation of the Immediate Effect of Bracing on Gait Symmetry, Lower-Limb Kinematics, and Trunk and Pelvic Motion during Level Walking in Adolescents with Idiopathic Scoliosis

Abstract

Background Previous research using gait pathology in patients with adolescent idiopathic indicates gait asymmetry based on ground reaction force components, lower-limb joints, pelvic, and trunk excursion during level walking. However, evidence evaluating the effect of trunk bracing on these parameters and on symmetry of gait pattern is scarce. The aims of this study are to evaluate the range of motion of lower-limb joints as well as pelvic and trunk segments and to assess the symmetry of gait pattern in adolescents with idiopathic scoliosis when compared with normal subjects. The effect of trunk bracing on the aforementioned parameters is also investigated. Method Ten scoliotic patients (eight girls and two boys) aged between 10 and 16 years and ten normal subjects with comparable age, height, and weight were recruited for this study. A three-dimensional gait analysis system and Visual3D software were used to evaluate joint range of motion of scoliotic patients in two conditions: with and without brace, as well as from the normal subjects without brace. The symmetry of gait was assessed by use of the asymmetry index. Results The results of this study showed that scoliosis led to a decrease in frontal hip, knee, pelvic, and trunk motion. Moreover, it was shown that patients with scoliosis walk with more restricted knee, pelvic, and trunk motions in the sagittal plane. There was no significant difference between the asymmetry index value between walking with and without orthosis. In our study, it was shown that the only discrepancy in the gait pattern between scoliotic patients and healthy subjects is an asymmetrical pelvic movement in the frontal plane. Conclusion The results of this study demonstrate that trunk bracing influences the pelvic range of motion and improved symmetry of range of motions of the pelvis. However, bracing did not influence the kinematic parameters of hip, knee, and ankle joints significantly. Copyright © 2017 by the American Academy of Orthotists and Prosthetists.