title: An investigation of the value of tridimensional kinematic analysis in functional diagnosis of lumbar spinal stenosis.
abstract: Diagnosis of lumbar spinal stenosis (LSS) is based on clinical examination and imaging. The aim of this study was to evaluate the influence of 3D gait analysis as a tool in the differential diagnosis of LSS. Fourteen patients participated in the study that consisted of three phases: (1) capture six gait cycles after rest, (2) walk on a treadmill for a maximum of 20 min, (3) capture six gait cycles after effort. From these data, the kinematic variables were compared with the perception of pain and the cross sectional area of the spinal canal as measured by magnetic resonance. Most of correlations were weak and showed that the most significant results are reported by the Gait Deviation Index (GDI). The Gait Deviation Index demonstrated moderate negative correlation with the perception of pain after effort was made by both limbs. This means that there is a significant decrease in the overall function of the lower limbs according to the increase in pain symptoms. This situation may be reflected in decreased cadence and speed beyond the times of single support for the left limb, and the balance of the right limb, as part of a strategy to protect against pain and imbalance. We found no correlation between gait and pain in the cross-sectional area of the spinal canal. Therefore, we believe that there is no advantage for the patient to make a 3-D gait analysis because the analysis does not add relevant information to clinical diagnosis.
authors.affiliation: Department of Orthopaedics and Traumatology, Universidade de São Paulo, São Paulo, Brazil. Electronic address: garbelotti@terra.com.br.
authors.forename: Silvio Antonio
authors.initials: SA
authors.lastname: Garbelotti
authors.affiliation: Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil.
authors.forename: Paulo Roberto Garcia
authors.initials: PR
authors.lastname: Lucareli
authors.affiliation: Movement Analysis Laboratory, Albert Einstein Hospital, São Paulo, Brazil.
authors.forename: Amâncio
authors.initials: A
authors.lastname: Ramalho
authors.affiliation: Movement Analysis Laboratory, Albert Einstein Hospital, São Paulo, Brazil.
authors.forename: Wagner
authors.initials: W
authors.lastname: de Godoy
authors.affiliation: Movement Analysis Laboratory, Albert Einstein Hospital, São Paulo, Brazil.
authors.forename: Milena
authors.initials: M
authors.lastname: Bernal
authors.affiliation: Department of Orthopaedics and Traumatology, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Julia Maria
authors.initials: JM
authors.lastname: D'Andréa Greve
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena / Q000502:physiology*; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D005684:Gait; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology*; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D010146:Pain / Q000503:physiopathology; D013130:Spinal Stenosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D016138:Walking
keywords: Gait; Gait Deviation Index, Spinal stenosis; Low back pain; Magnetic resonance imaging