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Master Thesis

Évaluation dynamique au cours de la marche en pré et post opératoire chez des sujets âgés en état de déséquilibre sagittal rachidien : étude prospective

Abstract : Introduction: the incidence of sagittal imbalance increases with age, and the origin of art and education quality of life. Current evaluations are based on static studies, not taking into account the role of postural muscles. Our objective is to study the sagittal balance of elderly subjects (> 65 years), before and after spinal surgery correction, our secondary objective is to study paravertebral muscle function. Material and methods: we performed a preoperative and 6-month postoperative follow-up in 8 subjects over the age of 65, presenting one or more criteria for previous imbalance of statics according to Schwab. A clinical evaluation (VAS (lumbar and radicular), ODI, JOA, EIFEL, SF12), a radiographic evaluation (SVA, radiographic lumbar lordosis (T12L3S1-R), a kinematic analysis by 3D accelerometry, a kinetic analysis of gait parameters, an EMG analysis and finally muscle function evaluation according to two tests (SPPB and the functional test of Dubousset). Results: VAS lumbar and radicular, ODI, EIFEL, JOA scores and step width were statistically different after surgery. SVA-D and SVA-R are correlated in positive ways, the SVA-D increases after each bipodal support phase, and the amplitude of hip flexion is not altered after surgery. The muscle activity of the Erector Spinae is more prolonged and less systematized than the healthy subject, without impact of the surgery; the values of EMG of surface (muscular strength) are little modified in post-operative (not significant). The Dubousset test is not statistically different in postoperative, correlated with walking speed, JOA, SF12 PCS and preoperative SPPB. Conclusion: dynamic walking analysis provides additional information on the evolution of sagittal parameters after correction surgery. SVA increases after each phase of bipodal support of the cycle. The muscle activity of Spinae Erectors is modified (longer and disorderly activation) from preoperative. The functional test of Dubousset could be interesting in the evaluation of the deep postural musculature in preoperative.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01655149
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Submitted on : Monday, December 4, 2017 - 4:29:30 PM
Last modification on : Tuesday, December 12, 2017 - 1:20:25 AM

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Jean-Étienne Castelain. Évaluation dynamique au cours de la marche en pré et post opératoire chez des sujets âgés en état de déséquilibre sagittal rachidien : étude prospective . Médecine humaine et pathologie. 2017. ⟨dumas-01655149⟩

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