Effects of a Verbal Intervention for Head and Neck Posture on Lumbar Lordosis Angles in Healthy Young and Older Adults: a Preliminary Study

Background Postural rehabilitation plays an important role in the treatment of non-specific low back pain. Although pelvic inclination has been widely used to improve lumbar lordosis, the effect of cervical anterior inclination on lumbar lordosis in young and older adults, in sitting and standing posture is still unclear. This preliminary study was designed to examine the influence of changing the cervical anterior angle on the lumbar lordosis angle, through alterations of the head position under the natural sitting and standing conditions, aiming to provide a basis for establishing a new postural rehabilitation strategy.Methods Thirty-eight older (68.4 ± 5.9 years old) and 36 young (24.0 ± 2.2 years old) healthy adults participated in this study. The four spinal regional angles - cervical anterior angle, thoracic kyphosis angle, lumbar lordosis angle, and pelvic foreword inclination angle were measured in standing and relaxed sitting postures to determine the effects of a postural cueing, “inclining head backward and performing chin tuck”, for the head and neck posture on lumbar lordosis angle.Results In the standing posture, the pelvic foreword inclination angle in the older group was significantly smaller (P <0.001) than that in the young group, and increased significantly (P <0.001) post the postural cueing. In addition, the thoracic kyphosis angle in the standing (P = 0.001) and sitting (P = 0.003) positions was significantly reduced post the postural cueing. However, the lumbar lordosis angle post postural cueing increased significantly in both the standing position (P <0.001) and sitting position (P <0.001).Conclusion The results suggest that increasing the cervical anterior angle can indeed increase the lumbar lordosis angle, and the cervical anterior inclination can be used as an alternative to pelvic foreward inclination to improve the lumbar lordosis angle. Furthermore, the change of head and neck posture can reduce the thoracic kyphosis angle, making it possible to establish a new non-invasive body posture rehabilitation strategy.(approval number TJUS2019032)

CHANGES IN SPINAL RANGE OF MOTION AFTER 16 WEEKS TRAINING PROGRAM IN PUBERTAL CHILDREN

The aim of the present research was to improve the neglect behavior of pubertal children in an intervention program. Within the framework of the program, the main function of the spinal column and the strength and extensibility of the muscles responsible for posture were investigated. The participants included in the study are 7th grade children of the Neumann János Elementary School in Szombathely, Hungary, (nb=7); (ng=10). The Idiag M360 Spinal Mouse was used to investigate the physiological curvatures and main function of the spinal column before and after the program. The device was used to examine the children's spines in standing, bending forward and again in a standing position after the Matthiass test was performed. Pre-intervention (1) and post-intervention (2) data showed significant decreases in all assessed characteristics and similar increases in sacrum to hip ratio (Sac/Hip) (9.83±4.36 - 21.63±4.39); p<0.000. The greatest change was found in the Th11/12 dorsal vertebral body angles (4.50±2.05 - -0.30±0.25); p<0.000. As a result of the postural improvement program, the degree of pelvic tilt and, in parallel, the physiological curvature of lumbar lordosis was reduced to within the age-specific reference values.

Effect of lumbar lordosis angle in adolescent baseball players on the development of lumbar spondylolysis v1

Background: Lumbar spondylolysis is a stress fracture of the lumbar vertebral arch that occurs frequently in adolescents. Lumbar spondylolysis has a high prevalence in athletes, especially baseball players. When lumbar spondylolysis occurs, restriction of sports activities is inevitable until the bony union is achieved. Therefore, prevention of the onset of lumbar spondylolysis is necessary, and it is necessary to elucidate the risk factors that influence the onset of the disease. An increase in lumbar lordosis angle may influence the development of lumbar spondylolysis because the lumbar lordosis angle increases the compressive stress in the vertebral arch. However, there are no reports on the effect of lumbar lordosis angle and the development of lumbar spondylolysis in adolescent baseball players. Therefore, the purpose of this study was to investigate the effect of lumbar lordosis angle on the development of lumbar spondylolysis in adolescent baseball players. METHODS: Eligible patients were those who visited the orthopedic clinic from January 1, 2018, to October 31, 2021. The selection criteria were male baseball players aged 11-18 years who visited the clinic, and the exclusion criteria were those whose superior endplate of L1 and superior endplate of S1 could not be identified in the MRI images. The existence of development of lumbar spondylolysis, lumbar lordosis angle, age, and pitching experience of the above patients will be assessed based on electronic medical records and imaging findings. Statistical analysis was performed using logistic regression analysis, with the objective variable being the existence of lumbar spondylolysis and the explanatory variables being the lumbar lordosis angle, age, and previous pitching experience.Discussion: This study examines the effect of the lumbar lordosis angle on the development of lumbar spondylolysis in adolescent baseball players. An increase in lumbar lordosis angle may influence the development of lumbar spondylolysis and may be a risk factor for the development of lumbar spondylolysis.

Sagittal spine disposition and pelvic tilt during outdoor fitness equipment use and their associations with kinanthropometry proportions in middle-aged and older adults

Background Outdoor fitness training has become popular as a tool for improving the health, especially middle-aged and older adults. For this purpose, outdoor fitness equipment (OFE) have been installed in public areas. However, their safety and effectiveness are still unknown. The aim of the present research was to analyze the sagittal disposition of the spine and pelvic tilt during the use of OFE, and to determine the influence of anthropometric variables on these factors in middle-aged and older adults. Methods Seventy healthy volunteers, 56 women and 14 men (age: 63.14 ± 8.19 years) participated in the study. Sagittal spine disposition and pelvic tilt were measured using a Spinal Mouse®, in the relaxed standing position, and during the use of the OFE. In addition, kinanthropometry variables were also measured according to the guidelines of the International Society for the Advancement of Kinanthropometry. Results Regarding thoracic kyphosis, a significant decrease was found in thoracic kyphosis in the initial position (IP) in single bonny rider (SBR) (p = 0.006) and row (p = 0.046), and a significant increase in the final position (FP) in the row (p = 0.011), surfboard (p < 0.001) and air walker (p = 0.027) machines. In relation to the lumbar curvature and pelvic tilt, a significant decrease in lumbar lordosis and a decrease in pelvic anteversion were observed in the IP and FP in SBR and row; and in the bike (p < 0.001) machine. In the surfboard machine, a significant decrease in lumbar lordosis was found (p = 0.002), with no changes in pelvic tilt. According to the multiple linear regression analysis, the subjects with a higher cormic index and height were more at risk of increasing their thoracic kyphosis, decreasing lumbar lordosis and/or decreasing pelvic anteversion towards pelvic retroversion. Conclusions Middle-aged and older adults show spinal misalignments when using the OFE with respect to the standing position, showing a decrease in the thoracic kyphosis in IP of SBR and ROW, and a significant increase in the surfboard and air walker, and in the FP of Row, in the lumbar lordosis in all the OFE in sitting and some in standing, and in the pelvic anteversion in all the OFE in sitting. The variables height and the cormic index explained most of the changes in sagittal spine disposition.

Comparison of Spinal Alignment between XLIF, TLIF, PLIF, and PLF in the Treatment of Single Level Spondylolisthesis: A Retrospective Study

Background: Most lumbar spinal fusion procedures are performed to increase fusion potential, correct a deformity, and decompress spinal nerve roots. Nowadays, there are several spinal fusion techniques such as extreme lateral lumbar interbody fusion (XLIF), transforaminal lumbar interbody fusion (TLIF), posterior lumbar interbody fusion (PLIF), and posterolateral fusion (PLF). However, there are no studies directly comparing their capacity to alter lumbar lordosis, segmental lordosis, intervertebral disc height, foraminal height, and the grade of slip for treating single level spondylolisthesis in Thailand. Objective: To compare which lumbar interbody technique amongst XLIF, TLIF, PLIF, and PLF, is the most effective in restoring spinal alignment in cases such as lumbar lordosis, increased segmental lordosis, increased intervertebral disc height, increased foraminal height, and a reduced slip grade in spondylolisthesis patients. Materials and Methods: The medical records and radiographs of single level spondylolisthesis patients treated in Siriraj hospital between 2002 and 2017 were retrospectively reviewed. Clinical data and radiographic parameters such as lumbar lordosis, segmental lordosis, intervertebral disc height, foraminal height, and grade of slip, including preoperative and postoperative data were collected and analyzed. An inter-observer/ intra-observer reliability test for all parameters was also performed. Results: Two hundred forty patients including 192 females and 48 males with a mean age of 60.1 years were included in the present study. There was no statistically significant difference in demographic data except in younger patients in the PLF group and those with shorter length of stays in the XLIF group. The present study results indicated that there was a statistically significant increase in lumbar lordosis, increased foraminal height, and decreased slip grade in the XLIF group when compared to other three groups as TLIF, PLIF, and PLF. Conclusion: All spinal fusion techniques could improve lumbar spinal alignment, however, XLIF is superior to other procedures, especially in lumbar lordosis, foraminal height restoration, and slip grade. Keywords: Lumbar spondylolisthesis; Extreme lateral lumbar interbody fusion; Transforaminal lumbar interbody fusion; Posterior lumbar interbody fusion; Posterolateral fusion; Lumbar lordosis

The Sagittal Integral Morphotype in Male and Female Rowers

The goal of this study was to describe the integrated spinal assessment of the sagittal morphotype in rowers to determine whether the intense practice of rowing causes a modification of the sagittal curvatures of the spine, its relationship with the rowing technique, and training background. The second goal was to analyse how the dorsal and lumbar curves behave in the three phases of the rowing gesture, and to determine which phases can be detrimental to the correct development of the spine during growth. We analysed the spine curvatures in the sagittal plane of 29 females and 82 males, which were measured with an inclinometer in standing, slump sitting, maximal trunk flexion and during rowing performance. The average value of thoracic kyphosis in the rowers was 30° (mean, 30 + 8.27°). Thoracic hyperkyphosis was found in only two rowers (1.8%). Lumbar lordosis was within normal range in 84.1% of the males (mean, 27 + 9.57°) and 75.9% of female rowers (mean, 33°). Functional thoracic hyperkyphosis was observed in 57.4% of the males and 17.1% of the females. Functional lumbar hyperkyphosis was observed in 28 of the 69 males (40.5%) and five of 22 females (17.2%). Rowing seems to provide adequate spine alignment in the sagittal plane on standing. The integrated spinal assessment of the sagittal morphotype showed that half or our rowers presented with functional thoracic hyperkyphosis, and 43.2% presented with functional lumbar hyperkyphosis. Spine behaviour during the rowing technique shows that the thoracic kyphosis (98.2%) and lumbar spine (91%) perform within normative ranges and could explain the adequate positioning of the spine in the sagittal plane on standing. Years of rowing training tend to reduce thoracic kyphosis in males.

Postural analysis in female Bharatanatyam dancers: a cross-sectional study

Background Gaining proficiency in Bharatanatyam dance form necessitates maintenance of different postures for prolonged duration. These repetitive movements place tremendous physical demands on the body at young age and may alter the postural profile of the dancer. The study aimed to evaluate the differences in terms of posture between female Bharatanatyam dancers and age-matched non-dancers. A cross-sectional study was conducted in 40 female Bharatanatyam dancers and 40 age-matched female non-dancers in the age group of 18 to 30 years. Analysis of erect standing posture of dancers and non-dancers was conducted in a reserved environment using a photogrammetric method. Static photographs of the subjects were taken in the sagittal plane. The measurement of the angles of the digitized photographs was performed using KINOVEA 0.8.15 software. Head protrusion angle, cervical lordosis angle, thoracic kyphosis angle, lumbar lordosis angle, and pelvic tilt angle were evaluated. Results There was no significant difference between the dancers and non-dancers with respect to head protrusion angle (p = 0.081), cervical lordosis (p = 0.15), and thoracic kyphosis (p = 0.33). Significant differences were identified between the dancers and non-dancers for lumbar lordosis (p = 0.00) and pelvic tilt (p = 0.00) using independent t test with dancers. Higher values of lumbar lordosis and pelvic tilt were observed in dancers. Conclusion Increased lumbar lordosis and anterior pelvic tilt were observed in Bharatanatyam dancers as compared to non-dancers. Hence, it is vital to establish preventive measures like postural re-education, muscular balance, and flexibility to prevent erroneous postural patterns capable of causing pain and injuries.