{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T16:01:37Z","timestamp":1789833697500,"version":"4.0.1"},"reference-count":35,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Background: Traditional gait assessments in adult degenerative scoliosis (ADS) often rely on prohibitively expensive, laboratory-bound optoelectronic systems that lack clinical accessibility. This research aims to independently evaluate both lower limbs using a wearable Inertial Measurement Unit (IMU) system, in contrast to studies that employ a unilateral reference, thereby elucidating the unique bilateral asymmetries and dynamic stability patterns exhibited in ADS. Methods: Gait patterns of 20 ADS patients and 15 healthy controls were analyzed using the Rokoko Smartsuit Pro. Segmental kinematic data were integrated with anthropometric mass distribution models to calculate the total body center of mass (CoM). Spatiotemporal parameters, joint range of motion (RoM), and CoM excursions in three planes were statistically compared between the groups. Results: ADS patients exhibited a cautious gait strategy characterized by significantly reduced step speed, shortened step lengths, and increased step width (p&lt;0.05). Temporal analysis showed prolonged stride, stance, and double support time (p&lt;0.001), while cadence remained comparable to healthy controls. A triple-joint deficit, including hip, knee, and ankle, was identified in the sagittal plane, especially with peak flexion reductions reaching up to 55% in the left knee and 38% in the right knee, highlighting profound functional asymmetry (p&lt;0.001). Additionally, the CoM analysis reflected these stability restrictions, showing increased horizontal excursion and reduced vertical oscillation. Conclusions: Our findings suggest that ADS is associated with distinct, bilateral alterations in the lower limb kinematic chain and notable adaptations in dynamic balance parameters, characterized by a cautious gait strategy and profound sagittal triple-joint asymmetries. These findings highlight the feasibility of full-body wearable IMU technology in capturing objective, bilateral gait alterations, providing a foundational baseline that could complement standard static radiography in future clinical evaluations.<\/jats:p>","DOI":"10.3390\/s26113617","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T17:18:16Z","timestamp":1780679896000},"page":"3617","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comprehensive Evaluation of Gait Analysis and Kinematics in Adult Degenerative Scoliosis Using Wearable Motion Capture Technologies"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2076-2400","authenticated-orcid":false,"given":"Samet","family":"\u00c7\u0131kla\u00e7and\u0131r","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, Izmir Katip \u00c7elebi University, Izmir 35620, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0802-4376","authenticated-orcid":false,"given":"Ibrahim","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Izmir Katip \u00c7elebi University, Izmir 35620, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"A94","DOI":"10.1227\/01.NEU.0000325485.49323.B2","article-title":"Adult degenerative scoliosis: A review","volume":"63","author":"Birknes","year":"2008","journal-title":"Neurosurgery"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1007\/s00586-005-1053-9","article-title":"The adult scoliosis","volume":"14","author":"Aebi","year":"2005","journal-title":"Eur. Spine J."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Amran, N.N., Basaruddin, K.S., Ijaz, M.F., Yazid, H., Basah, S.N., Muhayudin, N.A., and Sulaiman, A.R. (2023). Spine Deformity Assessment for Scoliosis Diagnostics Utilizing Image Processing Techniques: A Systematic Review. Appl. Sci., 13.","DOI":"10.20944\/preprints202308.0973.v1"},{"key":"ref_4","first-page":"19","article-title":"Adolescent idiopathic scoliosis: Common questions and answers","volume":"101","author":"Kuznia","year":"2020","journal-title":"Am. Fam. Physician"},{"key":"ref_5","first-page":"29","article-title":"Use of predictive analytics for the screening of patients with adolescent idiopathic scoliosis with quantitative gait analysis","volume":"113","author":"Boulay","year":"2024","journal-title":"Gait Posture"},{"key":"ref_6","unstructured":"Stergiou, N. (2020). Biomechanics and Gait Analysis, Academic Press."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1097\/BRS.0000000000003796","article-title":"Influence of etiology and onset of deformity on spatiotemporal, kinematic, kinetic, and electromyography gait variables in patients with scoliosis\u2014A prospective, comparative study","volume":"46","author":"Garg","year":"2021","journal-title":"Spine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.medengphy.2020.11.005","article-title":"Gait analysis in neurological populations: Progression in the use of wearables","volume":"87","author":"Celik","year":"2021","journal-title":"Med. Eng. Phys."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.3171\/2010.1.FOCUS09271","article-title":"Adult degenerative scoliosis: Evaluation and management","volume":"28","author":"Silva","year":"2010","journal-title":"Neurosurg. Focus"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/s40279-022-01760-6","article-title":"Wearables for running gait analysis: A systematic review","volume":"53","author":"Mason","year":"2023","journal-title":"Sport. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2629","DOI":"10.1007\/s11042-019-08275-9","article-title":"Human gait assessment using a 3D marker-less multimodal motion capture system","volume":"79","author":"Rodrigues","year":"2020","journal-title":"Multimed. Tools Appl."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Prasanth, H., Caban, M., Keller, U., Courtine, G., Ijspeert, A., Vallery, H., and Von Zitzewitz, J. (2021). Wearable sensor-based real-time gait detection: A systematic review. Sensors, 21.","DOI":"10.3390\/s21082727"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"044504","DOI":"10.1115\/1.4049199","article-title":"Wearable motion capture system evaluation for biomechanical studies for hip joints","volume":"143","author":"Mihcin","year":"2021","journal-title":"J. Biomech. Eng."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1007\/s00586-018-5569-1","article-title":"The use of gait analysis in the assessment of patients afflicted with spinal disorders","volume":"27","author":"Haddas","year":"2018","journal-title":"Eur. Spine J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"E33","DOI":"10.1097\/BSD.0000000000000939","article-title":"The correlation of spinopelvic parameters with biomechanical parameters measured by gait and balance analyses in patients with adult degenerative scoliosis","volume":"33","author":"Haddas","year":"2020","journal-title":"Clin. Spine Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2572","DOI":"10.1007\/s00586-016-4648-4","article-title":"Dynamic global sagittal alignment evaluated by three-dimensional gait analysis in patients with degenerative lumbar kyphoscoliosis","volume":"25","author":"Shiba","year":"2016","journal-title":"Eur. Spine J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2591","DOI":"10.1007\/s00586-019-06252-2","article-title":"The Gait Deviation Index as an indicator of gait abnormality among degenerative spinal pathologies","volume":"29","author":"Mar","year":"2020","journal-title":"Eur. Spine J."},{"key":"ref_18","first-page":"485","article-title":"Center of Mass of Human\u2019s Body Segments","volume":"21","author":"Adolphe","year":"2017","journal-title":"Mech. Mech. Eng."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1080\/02701367.1983.10605290","article-title":"Anatomical data for analyzing human motion","volume":"54","author":"Plagenhoef","year":"1983","journal-title":"Res. Q. Exerc. Sport"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.gaitpost.2011.03.024","article-title":"Normative spatiotemporal gait parameters in older adults","volume":"34","author":"Hollman","year":"2011","journal-title":"Gait Posture"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.gaitpost.2018.12.024","article-title":"Postural adjustments in adolescent idiopathic thoracic scoliosis during walking","volume":"68","author":"Wu","year":"2019","journal-title":"Gait Posture"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1007\/s00586-010-1292-2","article-title":"Gait in thoracolumbar\/lumbar adolescent idiopathic scoliosis: Effect of surgery on gait mechanisms","volume":"19","author":"Mahaudens","year":"2010","journal-title":"Eur. Spine J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"100306","DOI":"10.1016\/j.xnsj.2023.100306","article-title":"Gait alterations in patients with adult spinal deformity","volume":"17","author":"Huysmans","year":"2024","journal-title":"N. Am. Spine Soc. J. (NASSJ)"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1743-0003-7-9","article-title":"Kinematic aspects of trunk motion and gender effect in normal adults","volume":"7","author":"Chung","year":"2010","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/1743-0003-7-28","article-title":"Gait patterns in Prader-Willi and Down syndrome patients","volume":"7","author":"Cimolin","year":"2010","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1007\/s00586-009-0899-7","article-title":"Gait in adolescent idiopathic scoliosis: Kinematics and electromyographic analysis","volume":"18","author":"Mahaudens","year":"2009","journal-title":"Eur. Spine J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.gaitpost.2010.11.006","article-title":"Gait patterns during different walking conditions in older adults with and without knee osteoarthritis\u2014Results from the Baltimore Longitudinal Study of Aging","volume":"33","author":"Ko","year":"2011","journal-title":"Gait Posture"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"155","DOI":"10.2174\/1874325001610010155","article-title":"Clinical and biomechanical evaluations of staged bilateral total knee arthroplasty patients with two different implant designs","volume":"10","author":"Renaud","year":"2016","journal-title":"Open Orthop. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/1743-0003-6-37","article-title":"Characterizing multisegment foot kinematics during gait in diabetic foot patients","volume":"6","author":"Sawacha","year":"2009","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Han, S.H., Kim, C.O., Kim, K.J., Jeon, J., Chang, H., Kim, E.S., and Park, H. (2019). Quantitative analysis of the bilateral coordination and gait asymmetry using inertial measurement unit-based gait analysis. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0222913"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.clinbiomech.2005.01.003","article-title":"Evaluation of segmental postural characteristics during quiet standing in control and idiopathic scoliosis patients","volume":"20","author":"Zabjek","year":"2005","journal-title":"Clin. Biomech."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.gaitpost.2018.01.031","article-title":"Trunk rotation alters postural sway but not gait in female children and early adolescents: Results from a school-based screening for scoliosis","volume":"61","author":"Pau","year":"2018","journal-title":"Gait Posture"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Koca, R., and Koca, Y.B. (2025). Anatomy-Based assessment of spinal posture using IMU sensors and machine learning. Sensors, 25.","DOI":"10.3390\/s25195963"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Karpiel, I., Zi\u0119bi\u0144ski, A., Kluszczy\u0144ski, M., and Feige, D. (2021). A survey of methods and technologies used for diagnosis of scoliosis. Sensors, 21.","DOI":"10.3390\/s21248410"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Trabassi, D., Castiglia, S.F., Bini, F., Marinozzi, F., Ajoudani, A., Lorenzini, M., Chini, G., Varrecchia, T., Ranavolo, A., and De Icco, R. (2024). Optimizing rare disease gait classification through data balancing and generative AI: Insights from hereditary cerebellar ataxia. Sensors, 24.","DOI":"10.3390\/s24113613"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/11\/3617\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T17:30:34Z","timestamp":1780680634000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/11\/3617"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":35,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["s26113617"],"URL":"https:\/\/doi.org\/10.3390\/s26113617","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,5]]}}}