Spine - 2026-07-20 - Journal Article
Degenerative Spinal Disease Subtypes Exhibit Distinct Gait and Neuromuscular Signatures: A Retrospective Study Integrating Spatiotemporal and Surface Electromyography Parameters.
Fan Z, Pan F, Cheng J, Wang W, Xiao L, Zhao W, Zhang Y, Wang Y, Wang D, Hu T, Yao R, Liu L, Han D, Chen X, Lu J, Lu S
Topics
Key Takeaway
ASD, LSS, and CSM each produce distinct neuromuscular signatures on sEMG—ASD and LSS show increased RMSmax and decreased median frequency versus controls (P<0.001), while all three DSD subtypes demonstrate significantly higher bilateral muscle asymmetry indices than healthy elderly controls.
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Summary
This retrospective cross-sectional study asked whether ASD, LSS, and CSM produce distinguishable gait and neuromuscular profiles using synchronized 3D motion capture and sEMG of erector spinae, multifidus, gluteus maximus, and rectus abdominis. All three DSD groups showed reduced gait speed, lower step frequency, prolonged double-support time, increased step width, and elevated bilateral asymmetry indices versus healthy controls (P<0.001). ASD and LSS specifically demonstrated increased RMSmax and decreased median frequency, indicating greater muscle recruitment effort and earlier neuromuscular fatigue compared to CSM and controls.
Key Limitation
Absence of disease severity grading within each DSD subtype prevents determination of whether observed neuromuscular differences reflect distinct pathophysiology or simply differing disease burden across groups.
Original Abstract
STUDY DESIGN
A retrospective study.
OBJECTIVE
To characterize subtype-specific gait patterns and neuromuscular adaptations in DSD using integrated 3D motion capture and surface electromyography (sEMG).
BACKGROUND
Degenerative spinal diseases (DSD), including lumbar spinal stenosis (LSS), adult spinal deformity (ASD), and cervical spondylotic myelopathy (CSM), commonly impair gait in elderly patients.
MATERIALS AND METHODS
In this retrospective cross-sectional study, 148 participants (31 ASD, 40 LSS, 35 CSM, 42 healthy controls) underwent gait analysis with a BTS motion capture system and sEMG assessment of erector spinae, multifidus, gluteus maximus, and rectus abdominis muscles. Spatiotemporal parameters, root mean square maximum (RMSmax) and median frequencies (MF) were compared across stance and swing phases. Nonparametric statistical analyses were performed with significance at P<0.05.
RESULTS
The study included 106 patients with degenerative spinal diseases and 42 healthy elderly controls. A three-dimensional motion capture system and surface electromyography were used to synchronously analyze complete gait cycle parameters. The results showed that compared to the HC group, all three patient groups exhibited significantly reduced gait speed, lower step frequency, prolonged double-support time, increased step width, and increased asymmetry in lower limb gait parameters (P <0.001). sEMG analysis revealed that the ASD and LSS groups had increased RMSmax values and decreased MF (P <0.001). The asymmetry indices of bilateral muscles in all three patient groups were higher than those in the HC group (P <0.001), indicating compromised neuromuscular control related to disease-specific pathology.
CONCLUSION
The study systematically revealed abnormal gait parameters and distinct activation patterns of core muscles in patients with degenerative spinal conditions, along with their underlying causes. Patients in the DSD group exhibited poorer bilateral lower limb gait stability and walking speed, with different muscle activation patterns due to varying causes.
LEVEL OF EVIDENCE
Level IV.