Chairs: Ram Haddas, PhD, MSc, MEng, and Isador H. Lieberman, MD, FRCSC, MBA
Patients with spinal disorders (spondylolisthesis, stenosis, adult degenerative scoliosis, cervical spondylotic myelopathy, sacroiliac joint dysfunction) demonstrate an altered gait pattern, with abnormalities in balance and muscle activation patterns. Such differences which can be measured with functional analysis include decreased step length, reduced range of motion in the upper and lower extremities, atypical sway and altered ground reaction forces. Spinal surgery has been shown to improve function and quality of life as assessed by patient reported disease specific and generic health clinical outcome questionnaires. These measures are considered objective, however can be misleading, inaccurate and lack sensitivity and specificity, due to multiple biases and data collection methods. While other orthopedic subspecialties are now routinely using functional analysis, spine surgeons have not yet recognized and underappreciate the benefit of clinical functional analysis. The purpose of this symposium is to evaluate the utility of functional analysis as an objective outcome measure in patients with spinal disorders before and after surgical intervention. Functional analysis can help validate patient reported success following surgical intervention, as well as provide fundamental understanding of the effects of surgical intervention on balance and mobility. The American Society of Biomechanics and Gait, and the Clinical Movement Analysis Society, have recommended the use of objective biomechanical measurements to monitor movement, tissue health and functional variables throughout the span of an individual’s life and be used to precisely assess the effectiveness of rehabilitation therapies designed to increase mobility, improve rehabilitation outcomes, and reduced health care costs.
Upon completion of this session, participants should gain strategies to:
- Practice Gap 1: Spine surgeons are unfamiliar with the interpretation of clinical functional analysis as an objective outcome measure during the treatment of those afflicted with spinal pathology;
- Practice Gap 2: Spine surgeons do not recognize the benefit of clinical function analysis over the use of patient reported outcome measures (PROMs);
- Practice Gap 3: Spine surgeons do not appreciate the benefit of clinical function analysis over the use of static imaging in assessing alignment, balance and function.
Agenda
Introduction
Isador H. Lieberman, MD, FRCSC, MBA & Ram Haddas, PhD, MSc, Meng
Practice Gap: What Do the Radiographs Tell Us and What Do They Not Tell Us
Bassel G. Diebo, MD
Tools in Function Analysis (Submission note: introduce the human motion, capture, EMG, force plate, etc. and what it can measure)
Erin M. Mannen, PhD
The Correlation of Functional Analysis Parameters and Outcome Questionnaires (Submission note: review the deficiencies of current questionnaires, present the relationships between functional analysis and the current questionnaires)
Peter B. Derman, MD, MBA
The Use of Function Analysis as Part of My Clinic: How Functional Analysis Can Help Me in My Practice
Isador H. Lieberman, MD, FRCSC, MBA
How We Can Make It Part of Standard of Care (Submission note: Present Texas Back Institute biomechanics lab as a model for function analysis as part of surgical evaluation and postop assessment)
Ram Haddas, PhD, MSc, Meng
Discussion and Q&A
All Faculty