Gait behaviors as an objective surgical outcome in XXXX : A systematic review.

@entity1 @entity1643 @entity612 @entity1635 @entity74 @entity850
BACKGROUND: Objective motor performance measures, especially gait assessment, could improve evaluation of @entity1643 surgeries. However, no study has compared the relative effectiveness of gait parameters for assessing motor performance in @entity1643 after surgery. The purpose of the current review was to determine the sensitive gait parameters that address physical improvements in each specific @entity74 after surgical intervention. METHODS: Articles were searched with the following inclusion criteria: 1) population studied consisted of individuals with @entity1643 requiring surgery; 2) @entity1643 was measured objectively using gait assessment tests pre- and post-surgery. The quality of the selected studies was assessed using Delphi consensus, and meta-analysis was performed to compare pre- and post-surgical changes. FINDINGS: Thirteen articles met inclusion criteria, which, almost exclusively, addressed two types of spinal disorders/interventions: 1) @entity1635 /spinal fusion; and 2) @entity850 /decompression. For @entity1 with @entity1635 , improvements in hip and shoulder motion (effect size=0.32-1.58), energy expenditure (effect size=0.59-1.18), and activity symmetry of upper-body muscles during gait were present after spinal fusion. For @entity1 with @entity612 , increases in gait speed, stride length, cadence, symmetry, walking smoothness, and walking endurance (effect size=0.60-2.50), and decrease in gait variability (effect size=1.45) were observed after decompression surgery. INTERPRETATION: For @entity1 with @entity1635 , gait improvements can be better assessed by measuring upper-body motion and EMG rather than the lower extremities. For @entity1 with @entity612 , motor performance improvements can be captured by measuring walking spatio-temporal parameters, gait patterns, and walking endurance.
