Kinematic comparison of the use of walking sticks versus a rolling walker during gait in adult degenerative scoliosis patients

Study design: A repeated-measurement, single-center, prospective study. Objective: To compare the spatiotemporal and kinematic data using gait analysis in adult degenerative scoliosis (ADS) patients using walking sticks (WS) versus rolling walkers (RW). Summary of background data: ADS patients undergo compensatory changes that can result in an altered gait pattern. RW are frequently prescribed, but result in a forward flexed kyphotic posture during ambulation. Gait using WS allows for more upright alignment in ADS patients. Methods: Fifty-three ADS patients with symptomatic degenerative scoliosis performed over-ground walking at self-selected speed with WS and with a RW. Trunk and lower extremity angles along with spatiotemporal parameters were measured and compared. Results: When using WS, patients exhibited less flexion at the head (WS: − 4.8° vs. RW: 11.0°, p= 0.001), and lumbar spine (WS: − 0.9° vs. RW: 4.2°, p= 0.001); while there was significantly more extension, of the cervical spine (WS: − 1.6° vs. RW: − 7.4°, p= 0.002) when using the RW. At the initial contact phase of gait, patients using WS showed decreased flexion at the ankle (WS 0.7° vs. RW: 3.8°, p= 0.018), knee (WS: 0.3° vs. RW: 4.8°, p= 0.001), hip (WS: 22.6° vs. RW: 27.3°, p= 0.001), and pelvis (WS: 10.2° vs. RW: 14.8°, p= 0.001). In contrast, the use of WS resulted in slower ambulation (WS: 0.6 m/s vs. RW: 0.7 m/s, p= 0.001). Conclusions: In ADS patients who have not undergone surgical correction, the use of WS resulted in a more upright posture, which may be more beneficial to the compensatory changes that lead to gait disturbance in ADS patients. Ambulation using WS resulted in slower gait versus a RW, due to the momentum induced by the forward flexed posture when using a RW. We recommend the use of WS for patients with ADS as it improves gait kinematics and may be a safer option.