Gait and dynamic balance in adults with spina bifida

Martina Bendt; Emelie Butler Forslund; Göran Hagman; Claes Hultling; Åke Seiger; Erika Franzén

doi:10.1016/j.gaitpost.2022.06.016

Gait and dynamic balance in adults with spina bifida

Gait Posture. 2022 Jul:96:343-350. doi: 10.1016/j.gaitpost.2022.06.016. Epub 2022 Jul 2.

Authors

Martina Bendt¹, Emelie Butler Forslund², Göran Hagman³, Claes Hultling⁴, Åke Seiger⁵, Erika Franzén⁶

Affiliations

¹ Karolinska Institutet, Department of Neurobiology, Care Science and Society, Division of Physiotherapy, Aleris Rehab Station, Stockholm, Sweden. Electronic address: martina.bendt@ki.se.
² Karolinska Institutet, Department of Neurobiology, Care Science and Society, Division of Clinical Geriatrics, Aleris Rehab Station, Stockholm, Sweden. Electronic address: emelie.butler.forslund@rehabstation.se.
³ Karolinska Institutet, Department of Neurobiology, Care Science and Society, Karolinska University Hospital, Stockholm, Sweden. Electronic address: goran.hagman@ki.se.
⁴ Karolinska Institutet, Department of Neurobiology, Care Science and Society, Division of Clinical Geriatrics, Spinalis Foundation, Sophiahemmet University College, Stockholm, Sweden. Electronic address: claes@spinalis.se.
⁵ Karolinska Institutet, Department of Neurobiology, Care Science and Society, Division of Clinical Geriatrics, Aleris Rehab Station, Stockholm, Sweden. Electronic address: ake.seiger@ki.se.
⁶ Karolinska Institutet, Department of Neurobiology, Care Science and Society, Division of Physiotherapy, Allied Health Professionals, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholms Sjukhem R and D Unit, Stockholm, Sweden. Electronic address: erika.franzen@ki.se.

PMID: 35820238
DOI: 10.1016/j.gaitpost.2022.06.016

Abstract

Background: Spina bifida (SB) is a complex congenital malformation, often causing impaired gait performance depending on the level and extent of malformation. Research regarding gait and balance performance in adults with SB, has not been sufficiently described yet.

Research question: What are the characteristics of spatiotemporal gait parameters and balance performance in adults with SB? Further, do persons with muscle function (MF) level 3 differ regarding gait and balance performance from those with MF level 1-2?

Methods: Cross-sectional observational study at an outpatient clinic. 41 adults with SB (18-65 years), who walked regularly. Spatiotemporal parameters of gait was assessed with the APDM system and balance performance with the Mini Balance Evaluation Systems Test (Mini-BESTest). Muscle strength in the legs was assessed with 0-5 manual muscle test, and participants were classified according to level of MF into groups MF1, MF2, and MF3. Two-sided t-test was used for parametric independent variables, and Cohen's d was used for effect sizes. The Mann-Whitney U test was used for non-parametric independent data and effect size was calculated by the z value (r = z/√n).

Results: Mean gait speed was 0.96 (SD 0.20) m/s and mean stride length 1.08 m (SD 0.17), individuals with MF3 showed significantly slower gaitspeed and shorter stride length (p < 0.05). Lumbar rotation was 21° (SD 11), and thoracic lateral sway 15° (IQR 15) with significantley difference (p < 0.001 and p < 0.05) for individuals in MF3. Mini-BESTest showed a mean score of 11.3 (SD 6.9), and individuals with MF3 showed significantly lower scores (p ≤ 0.001).

Significance: Gait and balance performance was reduced compared to normative data in almost all parameters, especially in persons with less muscle function. Increased knowledge from advanced gait analysis may help healthcare professionals to design rehabilitation programmes, in order to achieve and maintain a sustainable gait and balance performance.

Keywords: APDM; Balance control; Gait analysis; Mini-BESTest; Movement pattern; Walking.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cross-Sectional Studies
Gait / physiology
Humans
Postural Balance* / physiology
Spinal Dysraphism* / complications
Walking Speed