Effects of spinal deformities on lower limb kinematics during walking: a systematic review and meta-analysis

Abstract Spinal deformities characterized by malalignment of the spinal column, including scoliosis, hyper kyphosis, and lordosis, can significantly impact lower limb kinematics, potentially leading to altered gait patterns. We aimed to synthesize existing literature investigating the effect of spin...

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Main Authors: Fateme Khorramroo, Seyed Hamed Mousavi, Reza Rajabi
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-88886-5
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author Fateme Khorramroo
Seyed Hamed Mousavi
Reza Rajabi
author_facet Fateme Khorramroo
Seyed Hamed Mousavi
Reza Rajabi
author_sort Fateme Khorramroo
collection DOAJ
description Abstract Spinal deformities characterized by malalignment of the spinal column, including scoliosis, hyper kyphosis, and lordosis, can significantly impact lower limb kinematics, potentially leading to altered gait patterns. We aimed to synthesize existing literature investigating the effect of spinal deformities on lower limb kinematics during walking. We searched Four databases including PubMed, Web of Science, Scopus and Embase from their inception through 29th December 2024. The Newcastle-Ottawa Scale was applied to assess quality of included studies and the Grading of Recommendations Assessment, Development and Evaluation (GRADE system) was employed to assess the overall quality of the evidence in the meta-analysis. Mean differences and 95% confidence intervals (CI) were calculated with random effects model in RevMan version 5.4. The review included 35 studies with 1941 participants. Regarding scoliosis, strong evidence suggested a significant increase in right leg stance% and non-significant changes in left leg cadence, right and left leg speed and ankle transverse ROM in individuals with scoliosis compared to controls. Sensitivity analysis showed strong evidence of decrease in right leg stride length and ankle sagittal ROM, decrease in left leg single support and non-significant change in left leg step length. Individuals with sagittal malalignment showed strong evidence of significant reduction in velocity; moderate evidence suggested a significant increase in double support and a decrease in stride length, knee and hip sagittal ROM. Sensitivity analysis revealed strong evidence of a significant decrease in cadence during walking in individuals with sagittal trunk malalignment compared to controls. Participants with adult spinal deformity exhibited strong evidence of increased double support and decreased cadence during walking compared to controls. Spinal deformities significantly alter lower limb kinematics during gait. Our findings highlight the essential need for clinicians to take gait alterations into account when developing targeted interventions for individuals with spinal deformity.
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spelling doaj-art-9116bf86d51447789d798d47ed0e9dbf2025-02-09T12:34:54ZengNature PortfolioScientific Reports2045-23222025-02-0115112410.1038/s41598-025-88886-5Effects of spinal deformities on lower limb kinematics during walking: a systematic review and meta-analysisFateme Khorramroo0Seyed Hamed Mousavi1Reza Rajabi2Department of Sport Injuries and Biomechanics, Faculty of Sport Sciences and Health, University of TehranDepartment of Sport Injuries and Biomechanics, Faculty of Sport Sciences and Health, University of TehranDepartment of Sport Injuries and Biomechanics, Faculty of Sport Sciences and Health, University of TehranAbstract Spinal deformities characterized by malalignment of the spinal column, including scoliosis, hyper kyphosis, and lordosis, can significantly impact lower limb kinematics, potentially leading to altered gait patterns. We aimed to synthesize existing literature investigating the effect of spinal deformities on lower limb kinematics during walking. We searched Four databases including PubMed, Web of Science, Scopus and Embase from their inception through 29th December 2024. The Newcastle-Ottawa Scale was applied to assess quality of included studies and the Grading of Recommendations Assessment, Development and Evaluation (GRADE system) was employed to assess the overall quality of the evidence in the meta-analysis. Mean differences and 95% confidence intervals (CI) were calculated with random effects model in RevMan version 5.4. The review included 35 studies with 1941 participants. Regarding scoliosis, strong evidence suggested a significant increase in right leg stance% and non-significant changes in left leg cadence, right and left leg speed and ankle transverse ROM in individuals with scoliosis compared to controls. Sensitivity analysis showed strong evidence of decrease in right leg stride length and ankle sagittal ROM, decrease in left leg single support and non-significant change in left leg step length. Individuals with sagittal malalignment showed strong evidence of significant reduction in velocity; moderate evidence suggested a significant increase in double support and a decrease in stride length, knee and hip sagittal ROM. Sensitivity analysis revealed strong evidence of a significant decrease in cadence during walking in individuals with sagittal trunk malalignment compared to controls. Participants with adult spinal deformity exhibited strong evidence of increased double support and decreased cadence during walking compared to controls. Spinal deformities significantly alter lower limb kinematics during gait. Our findings highlight the essential need for clinicians to take gait alterations into account when developing targeted interventions for individuals with spinal deformity.https://doi.org/10.1038/s41598-025-88886-5MalalignmentBiomechanicsScoliosisKyphosisLordosisSpatiotemporal
spellingShingle Fateme Khorramroo
Seyed Hamed Mousavi
Reza Rajabi
Effects of spinal deformities on lower limb kinematics during walking: a systematic review and meta-analysis
Scientific Reports
Malalignment
Biomechanics
Scoliosis
Kyphosis
Lordosis
Spatiotemporal
title Effects of spinal deformities on lower limb kinematics during walking: a systematic review and meta-analysis
title_full Effects of spinal deformities on lower limb kinematics during walking: a systematic review and meta-analysis
title_fullStr Effects of spinal deformities on lower limb kinematics during walking: a systematic review and meta-analysis
title_full_unstemmed Effects of spinal deformities on lower limb kinematics during walking: a systematic review and meta-analysis
title_short Effects of spinal deformities on lower limb kinematics during walking: a systematic review and meta-analysis
title_sort effects of spinal deformities on lower limb kinematics during walking a systematic review and meta analysis
topic Malalignment
Biomechanics
Scoliosis
Kyphosis
Lordosis
Spatiotemporal
url https://doi.org/10.1038/s41598-025-88886-5
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AT rezarajabi effectsofspinaldeformitiesonlowerlimbkinematicsduringwalkingasystematicreviewandmetaanalysis