Postural stability and dynamic balance in adult spinal deformity: prospective pilot study.



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OBJECTIVE: Evaluate dynamic balance and postural stability in patients with adult spinal deformity (ASD) compared with published age-matched normative data.

METHODS: Eleven patients with ASD were prospectively enrolled. Postural stability was tested using static and dynamic posturography; patients stood on a movable platform with integrated force plate and performed standardized sensory organization testing (SOT), evaluating the influence of sensory processing on postural stability under 6 conditions, and motor control testing, assessing reflexive postural reactions to an external perturbation. Patient performance was compared with that of published age-matched controls. Quality of life metrics included scores on the SRS-22 questionnaire, SF-36, and Morse Fall Scale. Correlations between postural stability and radiographic measurements were performed.

RESULTS: ASD patients demonstrated significantly lower SOT scores (P≤0.03) in 5 of 6 conditions tested, and greater latency of limb movement during backward translation (P=0.04) compared with controls. Lower SOT scores were associated with a history of falls. ASD patients who self-reported falling in the previous 6 months, when compared to nonfallers, demonstrated significantly lower SOT scores (P=0.04) and significantly lower SRS-22 self-image subscores (P=0.003). Thoracic kyphosis and mediolateral sway (predictor of falls) were positively correlated in the eyes open and eyes closed conditions (P≤0.04).

CONCLUSIONS: ASD patients demonstrated impaired postural stability, diminished sensory integration, and delayed response to external perturbations compared with normal control data. Postural stability and quality of life metrics correlated with self-reported falls. These findings suggest that ASD patients have abnormal postural stability and may be at elevated risk of falls.

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World Neurosurg



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