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Secondary gait deviations in patients with and without neurological involvement: A systematic review.
MedLine Citation:
PMID:  23022156     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Pathologies that lead to biomechanical restrictions in human gait interfere with the tightly regulated muscle activation patterns that control the external moments. In order to maintain proper function, secondary mechanisms are required. The aims of this systematic review were (1) to identify secondary mechanisms in pathologic gait that have been described throughout the scientific literature by means of instrumented gait analysis, (2) to distinguish between active compensatory mechanisms and passive physical effects and (3) to identify common compensatory mechanisms that appear to be independent from the underlying disease. A comprehensive literature search revealed 4080 citations for review, whereof 148 studies entered the full-text review. Thirty-six studies were included and the quality of these studies was assessed by two independent reviewers (kappa=0.83). The quality of the included studies showed large variation and several methodological issues were identified. Five studies were further identified describing only passive physical effects, leaving a total of 31 studies reporting on compensations. The qualitative analysis revealed common compensations that appeared to be independent from the underlying pathology. In clinical practice, distinguishing primary from secondary gait deviations can be considered highly important since unnecessary treatment may be avoided. However, given the introduction of general principles of compensatory mechanisms and the fact that certain presumed "compensations" were identified as simple passive physical effects, secondary gait deviations have to be further investigated. Computer simulation studies are valuable, especially in respect of the distinction between compensations and physical effects. Furthermore, the need for a uniform terminology was highlighted.
Authors:
Stefan Schmid; Katrin Schweizer; Jacqueline Romkes; Silvio Lorenzetti; Reinald Brunner
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-27
Journal Detail:
Title:  Gait & posture     Volume:  -     ISSN:  1879-2219     ISO Abbreviation:  Gait Posture     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-10-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9416830     Medline TA:  Gait Posture     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier B.V.
Affiliation:
Bern University of Applied Sciences, Section of Health, Bern, Switzerland; ETH Zurich, Institute for Biomechanics, Zurich, Switzerland. Electronic address: stefanschmid79@gmail.com.
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