Pelvic, trunk and upper limb biomechanics during walking in individuals with spinal deformities: a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Spinal deformities represent a major public health concern, characterized by abnormal curvature and alignment of the spine. We aimed to investigate the alterations in pelvic, trunk, and upper limb biomechanics during walking in individuals with spinal deformities compared to healthy controls. METHODS: We searched four databases including PubMed, Web of Science, Scopus and Embase from their inception through 2nd january 2025. Two authors screened studies and separately extracted data from included studies. The Newcastle-Ottawa Scale was applied to assess quality of included studies. GRADE was employed to assess the overall quality of the evidence in the meta-analysis. Subgroup and sensitivity analyses were performed to address potential heterogeneity. Mean differences and 95% confidence intervals (CI) were calculated with random effects model in RevMan version 5.4. RESULTS: Seventeen studies with a total of 893 participants were included in the systematic review. In scoliosis, meta-analysis showed strong evidence of increased thorax-pelvis sagittal ROM, strong evidence of non-significant increase in SVA, moderate evidence of increased pelvic frontal ROM, sagittal thoracic curve ROM, CVA, and moderate evidence of non-significant change in 3-dimensional thorax movement, sagittal lumbar ROM, thorax-pelvis frontal and transverse ROM compared to controls during walking. The meta-analysis for other variables related to scoliosis indicated moderate evidence of non-significant changes. Meta-analysis showed moderate evidence of increased sagittal pelvic ROM in sagittal trunk malalignment, and moderate evidence of non-significant increase in pelvic ROM in adult spinal deformities compared to controls during walking. CONCLUSION: This review highlights the complexity of pelvic, trunk and upper limb biomechanics in individuals with spinal deformities. Understanding these alterations is essential for creating targeted interventions and improving clinical outcomes. TRIAL REGISTRATION: The protocol was registered with PROSPERO (CRD42024602489).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.024 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.031 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".