Quantifying Gait and Balance Pathologies of Lumbar Spinal Stenosis Patients using the Gait Deviation Index and Limits of Stability Test
School of Engineering
Padnos College of Engineering and Computing
People with lumbar spinal stenosis have difficulty walking long distances due to pain, weakness, or perceived instability. Lumbar spinal stenosis is commonly corrected by a laminectomy to relieve the pressure on the spinal cord. There are limited studies on gait and balance before or after a laminectomy to quantifiably measure physical manifestation of the patient's symptoms. Surgical recommendations typically rely on subjective surveys of patients symptoms. The Gait Deviation Index (GDI) is a comprehensive index to measure overall gait pathology using data obtained from 3D motion capture systems. This study aimed to investigate the usefulness of the GDI in quantifying gait pathologies in patients with lumbar spinal stenosis during rested and fatigued walking. This study also used the Limits of Stability test to evaluate subjects balance in rested and fatigued states. Four test subjects with lumbar spinal stenosis and two control subjects with no known pathologies and typical gait profiles were evaluated. For the Limits of Stability test, the subjects stood on a force plate with a video monitor at eye level and attempted to move a cursor on the monitor toward the indicated box by leaning as far as they could without stepping or lifting a foot. The data necessary to evaluate the GDI was recorded with an eightcamera Vicon motion capture system. Correlation between two subjective tests, the Oswestry Low Back Pain Disability Questionnaire and the Lower Extremity Functionality Scale, and the GDI were analyzed. Three of the four test subjects had GDI scores from left to right side that were clinically significant. No test subject had clinically significant differences in GDI scores from rested to fatigued walking. The Limits of Stability tests revealed no trends toward abnormal balance in either rested or fatigued state. There was moderate correlation between the subjective scoring surveys and the GDI. The Gait Deviation Index (GDI) was useful for quantifying the overall gait pathology of people with lumbar spinal stenosis. The results suggest that people with lumbar spinal stenosis do not alter their gait due to extended walking periods. The Limits of Stability test may not be a useful tool in quantifying overall balance pathology in people with lumbar spinal stenosis. Further investigation with more subjects that also includes post-surgical gait analysis is needed to determine whether the GDI could be developed into an effective tool for determining which patients with lumber spinal stenosis would most likely benefit from a laminectomy procedure.
7th World Congress of Biomechanics
Ashby, Blake; Bjorum, Justin; and Gates, Marilyn, "Quantifying Gait and Balance Pathologies of Lumbar Spinal Stenosis Patients using the Gait Deviation Index and Limits of Stability Test" (2015). Faculty Scholarly Dissemination Grants. 671.