Interest of Walking Sticks to Increase Walking Activity of People With Sagittal Imbalance of Spine

Aging is associated with a number of highly prevalent spinal pathologies, characterized by static disorders affecting spinal balance in the sagittal plane especially. These postural disorders are a source of pain, activity limitation and reduced quality of life. Treatment of spinal static disorders is essentially symptomatic based on medical care and rehabilitation and includes the use of spinal orthosis. Adherence to spinal orthosis is poor.

Walking requires dynamic stabilization capacities, which are affected by static disorders of the spine. In the case of walking difficulties associated with sagittal imbalance of spine, the walking aid most frequently assessed in the literature is the rollator. Using a rollator promotes anterior flexion of the spine and prevents physiological dissociation of the scapular and pelvic girdles.

Walking sticks help maintain sagittal alignment of the spine, improving the subject's dynamic stability while respecting the physiological gait pattern (dissociation of the scapular and pelvic belts).

To date, no study has assessed the impact of using walking sticks to increase walking activity in a population of people with sagittal imbalance of spine.

Deterioration in overall spinal balance and reduced stabilization capabilities are associated with increased risk of falls.

Inclusion criteria

• Adult ≥ 50 years
• VAS (Sagittal Vertical Axis, C7-S1, EoS (clinical follow-up)) > 5cm
• Able to do transfers alone
• Able to walk 10 minutes or 400 meters in a row
• Self-reported Walking difficulties
• Person living at home
• Person willing and consenting to participate in the study
• Health insurance

Exclusion criteria

• Current use of walking sticks
• Advanced and symptomatic osteoarthritis of the lower limbs
• Static disorder of the fixed spine
• Introduction of a straightening brace in the 3 months preceding the start of the study
• Static disorder explained by infectious, tumoral, congenital or neurodegenerative pathologies
• Uncompensated lower-limb length inequality (> 2cm)
• Lower limb motor deficit
• Upper limb pathology preventing cane use
• Proprioceptive or vestibular pathology
• Inability to write, speak or read French
• Cognitive and/or behavioral disorders
• Participation in other research on spinal balance and/or gait, or that could influence these factors during the study period
• People under tutorship or curatorship
• Free state medical assistance