Changes in Kinematics, Kinetics, and Muscle Activity in Patients with Lumbar Spinal Stenosis During Gait: Systematic Review

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BACKGROUND CONTEXT: Lumbar spinal stenosis (LSS) is one of the most common orthopaedic conditions and affects more than half a million people over the age of 65 in the US. Patients with LSS have gait dysfunction and movement deficits due to pain and symptoms caused by compression of the nerve roots within a narrowed spinal canal.

PURPOSE: The purpose of the current systematic review was to summarize existing literature reporting biomechanical changes in gait function that occur with LSS, and identify knowledge gaps that merit future investigation in this important patient population.

STUDY DESIGN/SETTING: This study is a systematic literature review.

OUTCOME MEASURES: The current study included biomechanical variables (e.g., kinematic, kinetic, and muscle activity parameters).

METHODS: Relevant articles were selected through MEDLINE, Scopus, Embase, and Web of Science. Articles were included if they: 1) included participants with LSS or LSS surgery, 2) utilized kinematic, kinetic, or muscle activity variables as the primary outcome measure, 3) evaluated walking or gait tasks, and 4) were written in English.

RESULTS: A total of 11 articles were included in the current systematic review. The patients with LSS exhibited altered gait function as compared to healthy controls. Improvements in some biomechanical variables were found up to one year after surgery, but most gait changes were found within one month after surgery.

CONCLUSIONS: Although numerous studies have investigated gait function in patients with LSS, gait alterations in joint kinetics and muscle activity over time remain largely unknown. In addition, there are limited findings of spinal kinematics in patients with LSS during gait. Thus, future investigations are needed to investigate longer-term gait changes with regard to spinal kinematics, joint kinetics, and muscle activity beyond one month after LSS surgery.