Did you know that spinal deformities like scoliosis, kyphosis, and lordosis can significantly change how we walk? Our latest research reveals that these conditions alter lower limb movements, leading to different gait patterns. This affects balance and stability during walking. Understanding these changes is crucial for developing effective treatments to improve mobility and reduce discomfort. Read more about our findings and how they can help create better interventions for those with spinal deformities!

Spinal deformities are characterized by abnormal curvature and alignment of the spine1 , 2 . The common forms of spinal deformities in frontal plane include scoliosis and in sagittal plane includes hyper kyphosis, lordosis, as well as flatback and swayback syndromes3 . Adult scoliosis is defined as a spinal deformity in skeletally mature patients with a coronal Cobb angle greater than 10°, which can be idiopathic or degenerative due to age-related changes like disc degeneration and vertebral fractures4 . Adolescent idiopathic scoliosis affects 1–4% of adolescents5 . However, the overall prevalence was reported 0.47–5.2%. The ratio of females to males varies between 1.5:1 and 3:1, and this ratio significantly rises with age6 . Adult spinal deformity (ASD) includes various three-dimensional spinal abnormalities, such as scoliosis, hyper kyphosis, and sagittal imbalance7 , affecting 2–32% of adults and up to 68% of the elderly8 . Hyper kyphosis features excessive outward thoracic curvature, while lordosis involves an exaggerated inward lumbar curve. Spinal deformities leads to progressive changes that result in pain, neurological 9 and respiratory symptoms10 , and functional impairment, with manifestations ranging from cosmetic concerns to severe discomfort 9 and hindering rehabilitation efforts11 . These conditions profoundly influence biomechanics and gait12 , 13 .

Scoliosis, adult spinal deformity (ASD), and sagittal malalignment profoundly influence lower limb gait kinematics and spatiotemporal parameters14 . During locomotion, these spinal deformities can disrupt lower limb biomechanics through a kinematic chain and fascial slings15 , leading to compensatory adjustments in contralateral side16 . Changes such as altered cobb angle, pelvic tilt and trunk flexion can manifest as slower walking speed17 , reduced stride lengths16 , and increased joint stress11 . However, it is noteworthy that some studies indicated no significant change in these parameters18 – 20 . This disruption in normal biomechanics during alternating open and closed kinematics chain of walking, not only exacerbates back pain 12 and muscle fatigue 21 but also accelerates joint degeneration, ultimately restricting daily activities and diminishing overall health-related quality of life22 . Understanding these interconnected changes is essential for developing effective management and rehabilitation strategies for individuals affected by these conditions.

While these studies contribute significantly to foundational knowledge, they often fail to integrate these insights into a cohesive framework. Moreover, two studies with similar titles systematically reviewed publications in this area23 , 24 , they had different aims and inclusion criteria from our research. This lack of comprehensive synthesis highlights a significant gap in literature and underscores the need for quantitative insights into the impact of spinal deformities on gait kinematics. In light of this, the current study aims to bridge these gaps by systematically reviewing existing studies which assessed the impact of spinal deformities on lower limb kinematics (i.e., joint angles and spatiotemporal) during walking and to perform a meta-analysis to quantify the differences in gait parameters between individuals with spinal deformities and healthy controls. Understanding these differences in lower limb kinematics of individuals with spinal deformity will provide valuable insights for clinical decision making, developing targeted rehabilitation strategies and ultimately improving the management of individuals with spinal deformities.