Walking Sticks and a Walker Comparison during Gait in Adult Degenerative Scoliosis Patients

Abstract

Adult degenerative scoliosis results from age-related changes leading to segmental instability, deformity, and stenosis. Patients with degenerative adult scoliosis demonstrate an altered gait pattern. Use of a walker tends to cause a more kyphotic posture due to its lower hand grips, and due to the way patients must reach forward with this position using both hands, forcing a kyphotic moment into their gate cycle. Whereas a walker forces patients into kyphosis, the higher grips of walking sticks allow for more upright posture and improved sagittal alignment. The purpose of this study is to compare and contrast the benefits of walking sticks versus a walker on the biomechanics of the lower extremity in people with degenerative scoliosis, as evaluated by gait analysis. Ten patients with symptomatic degenerative scoliosis have been deemed appropriate surgical candidates. Each patient performed a series of overground gait trials with a comfortable self-selected speed under three testing conditions: 1. with walking sticks, 2. with a walker, and 3. without any device. The use of walking sticks resulted in significantly slower, longer stride and step times along with bigger ankle, knee, and hip flexion range of motions in comparison to the walker. Walking sticks did improve the biomechanics and did facilitate positioning of the trunk and lower extremity during walking in adult degenerative scoliosis patients.