Secondary gait deviations in patients with and without neurological Involvement : A systematic review

Schmid, Stefan; Schweizer, Katrin; Romkes, Jacqueline; Lorenzetti, Silvio; Brunner, Reinald (2013). Secondary gait deviations in patients with and without neurological Involvement : A systematic review Gait & Posture, 37(4), pp. 480-493. Elsevier 10.1016/j.gaitpost.2012.09.006

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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.

Item Type:	Journal Article (Original Article)
Division/Institute:	School of Health Professions School of Health Professions > Physiotherapy
Name:	Schmid, Stefan0000-0001-5138-9800; Schweizer, Katrin; Romkes, Jacqueline; Lorenzetti, Silvio and Brunner, Reinald
ISSN:	0966-6362
Publisher:	Elsevier
Language:	English
Submitter:	Stefan Schmid
Date Deposited:	26 Nov 2019 12:18
Last Modified:	18 Dec 2020 13:29
Publisher DOI:	10.1016/j.gaitpost.2012.09.006
ARBOR DOI:	10.24451/arbor.9098
URI:	https://arbor.bfh.ch/id/eprint/9098