[P3-0782] Changes of posture and muscle activities in trunk and legs after surgery in patients with lumbar spinal stenosis
キーワード：lumbar spinal stenosis, gait analysis, muscle activity
【Purpose】
Neurogenic intermittent claudication（IMC）is one of the main symptoms in patients with lumbar spinal stenosis（LSS）, however, postural change is often observed during walking. The aim of this study was to identify changes in posture and muscle activities in trunk and legs during walking in order to establish effective rehabilitation program for patients with LSS.
【Methods】
The study included 6 patients selected for an operation due to LSS. Gait analysis using Vicon Motion System® with electromyographic（EMG）recordings of the lumbar paraspinal muscles（LPM）and vastus lateralis muscle（VL）were carried out before and 2 weeks after operation.
In the session before surgery, the analyses were carried out at the beginning of walking（pre-b-IMC）and when the leg symptoms appeared（pre-a-IMC）. After surgery, the same analyses were done at the beginning of walking（post-b-IMC）and after walking for the distance which had caused IMC before surgery（post-a-IMC）. Statistical significance was set as p＜0.05.
【Results】
Thorax angle indicating the degree of trunk flexion was not different between pre-b-IMC and post-b-IMC, but different significantly between pre-a-IMC and post-a-IMC（4. 6±4.0°vs. 3.3±5.2°）. Knee angle was significantly different between pre-b-IMC and post-b-IMC（22.2±4.5°vs. 26.1±4.0°）and between pre-a-IMC and post-a-IMC（22.4±4.6°vs. 25.7±4.6°）. Knee flexion torque was also different significantly between pre-b-IMC and post-b-IMC（60.6±60.6 N mm vs. 125.0±57.6Nmm）and between pre-a-IMC and post-a-IMC（67.0±61.8 N mm vs. 126.0±64.3 N mm）. EMG activities of LPM decreased significantly after surgery in both measurements, whereas those of VL increased significantly before IMC（7.1±2.2% vs. 9.2±1.7%）.
【Discussion】
These postural changes may be inevitable, but we should improve those changes after surgery in rehabilitation to obtain better walking capacity.
Neurogenic intermittent claudication（IMC）is one of the main symptoms in patients with lumbar spinal stenosis（LSS）, however, postural change is often observed during walking. The aim of this study was to identify changes in posture and muscle activities in trunk and legs during walking in order to establish effective rehabilitation program for patients with LSS.
【Methods】
The study included 6 patients selected for an operation due to LSS. Gait analysis using Vicon Motion System® with electromyographic（EMG）recordings of the lumbar paraspinal muscles（LPM）and vastus lateralis muscle（VL）were carried out before and 2 weeks after operation.
In the session before surgery, the analyses were carried out at the beginning of walking（pre-b-IMC）and when the leg symptoms appeared（pre-a-IMC）. After surgery, the same analyses were done at the beginning of walking（post-b-IMC）and after walking for the distance which had caused IMC before surgery（post-a-IMC）. Statistical significance was set as p＜0.05.
【Results】
Thorax angle indicating the degree of trunk flexion was not different between pre-b-IMC and post-b-IMC, but different significantly between pre-a-IMC and post-a-IMC（4. 6±4.0°vs. 3.3±5.2°）. Knee angle was significantly different between pre-b-IMC and post-b-IMC（22.2±4.5°vs. 26.1±4.0°）and between pre-a-IMC and post-a-IMC（22.4±4.6°vs. 25.7±4.6°）. Knee flexion torque was also different significantly between pre-b-IMC and post-b-IMC（60.6±60.6 N mm vs. 125.0±57.6Nmm）and between pre-a-IMC and post-a-IMC（67.0±61.8 N mm vs. 126.0±64.3 N mm）. EMG activities of LPM decreased significantly after surgery in both measurements, whereas those of VL increased significantly before IMC（7.1±2.2% vs. 9.2±1.7%）.
【Discussion】
These postural changes may be inevitable, but we should improve those changes after surgery in rehabilitation to obtain better walking capacity.