Identifying relations between posture and pain in lower back pain patients: a narrative review

Posture is a “body’s attitude or the positioning of the limbs when standing or sitting.” There are many examples of different postures which include lordotic posture, swayback posture, flat back, and anterior pelvic tilt. Everyone in some of the other parts of their life considers pain as an unpleasant feeling or sensation that is experienced. Specifically, low back pain can be relentless and daunting to many people who often recovered without the need of a health care professional or any treatment by changing their posture or performing the movement. Various factors are leading to low back pain other than the postural fault, for instance, age, sedentary lifestyle, anxiety, and sleep. However, for back pain, posture has become deep-rooted in people’s thoughts. Health care professionals have instructed people to correct their posture to fight back pain. As people become older, the posture becomes worse, but this does not appear to cause pain. If any person cannot move his/her body, that does not mean that they are having a problem involving posture; that is actually because of a problem relating to movement. A study proved that there is no difference in the lordotic angle of the populace having an issue with LBP. There is a decrease in the range and speed of the movement performed. What matters is the movement rather than the appearance of standing or sitting. The primary aim of this paper is to improve knowledge and understanding of the association between posture and LBP, as, speaking about recent researches, they have observed no association between posture and LBP. There are many studies published to support this evidence. People call the importance of posture and alignment for while performing a heavy deadlift, land a jump, or any strenuous activity. Therefore, an urge to write a paper on this topic is to change the mindset of many people worrying out there about their postural faults or their appearances by providing information about varying their static posture to conform to some ideal and keep moving to improve their function.

CLAY HEADS OF ANTHROPOMORPHIC STATUETTES DISCOVERED BY THE EXCAVATIONS OF THE CHALCOLITHIC UPPER HORIZON AT TELL YUNATSITE, BULGARIA

Тема настоящей публикации - головы от статуэток финального халколита на телле Юнаците. Особенности их моделировки и пропорции рассматриваются на фоне обобщенной морфологии и пропорций головы человека. Их отклонения от условных констант позволяют оценить характер стилизации. Большинство голов в коллекции имеет укороченное темя и плоские затылки, нос лепился от уровня темени. По соотношению высоты, ширины и толщины глиняные головы разделены на три совокупности: 1. Наиболее узкие головы (рис. 1: 1, 2); 2. Головы несколько шире шеи с плоскими затылками (рис. 1: 3); 3. Относительно широкие, чаще всего с прямым затылком, укороченным теменем и приподнятым лицом (рис. 1: 4-9; 2; 3). Рассматриваются особенности морфологии широких голов, их пропорции и размеры. На некоторых головках имеются прически. В отдельных случаях выявлены штифты либо штифтовые углубления. На памятниках культур Караново VI - Гумельница - Коджадермен (КГК) и Криводол - Сэлкуца III встречаются те же особенности моделировки уплощенных голов, что свидетельствует о широком распространении групп данного типа и, возможно, указывает на существование общего канона их стилизации. Выделены три размерных варианта широких голов: крупные, средние и мелкие. Поскольку данные о контексте находок часто ограничены, разницы в распределении для групп широких головок выявить не удалось. Судя по целым изображениям, широкие головы как без отверстий по сторонам лица, так и с отверстиями могут принадлежать статуэткам любого пола. This publication reports on the heads from the statuettes dating to the final stage of the Chalcolithic at Tell Yunatsite. Specific features of their modelling and proportions are reviewed in the context of generalized morphology and proportions of the human head. Their deviations from notional constants offer an opportunity to evaluate characteristics of their stylization. Most heads in the collection have a shortened top of the head and a flat back of the head, with the nose attached from the top. Regarding the height-width-thickness ratio, the clay heads are divided into three groups: 1. The most narrow heads (Fig. 1: 1, 2); 2. Heads with flat backs that are slightly wider than the neck (Fig. 1: 3); and 3. Relatively wide heads, in most cases, with the straight back of the head, the shortened top and the raised face (Fig. 1: 4-9; 2; 3). The paper examines specific features of morphology of the wide heads, their proportions and size. Some heads have a hair-do. Some statuettes reveal studs or grooves for studs. The sites of Karanovo VI - Gumelnitsa - Kodzhadermen and Krivodol - Salcuta III sometimes yield flattened heads with the same modelling, which suggests a common canon for their stylization. Three variants of wide head size are singled out such as large, medium and small. As the data on the context of the finds are often limited, it was not possible to identify differences in the distribution of the wide heads. Based on the preserved heads, the wide heads with and without apertures on the face sides can belong to the statuettes of any sex.

Effect of Different Exercise Types on the Cross-Sectional Area and Lumbar Lordosis Angle in Patients with Flat Back Syndrome

Flat back syndrome (FBS) is a sagittal imbalance wherein the normal spinal curvature is reduced. This study aimed to compare the effects of different exercise programs on the cross-sectional area (CSA) of the lumbar muscles, lumbar lordosis angle (LLA), lumbar disability, and flexibility in patients with FBS. Thirty-six females with flexible FBS were randomly allocated to the corrective exercise group (CEG, n = 12), resistance exercise group (REG, n = 12), and physical therapy group (PTG, n = 12). CEG and REG patients participated in a 12-week exercise intervention for 60 min three times per week. The CSA, LLA, Oswestry disability index (ODI), and sit-and-reach test were measured before and after intervention. CSA showed a significant difference between groups (p < 0.01), with CEG and REG demonstrating a significant increase (p < 0.05 and p < 0.05, respectively). LLA showed a significant difference between groups (p < 0.001); CEG showed a higher increase than did REG (p < 0.01) and PTG (p < 0.001). ODI also showed a significant difference between groups (p < 0.001), being lower in CEG than in REG (p < 0.001) and PTG (p < 0.001). Lumbar flexibility significantly improved in all groups, albeit with a significant difference (p < 0.001). Although corrective and resistance exercise programs effectively improve these parameters, corrective exercise is superior to other interventions for patients with FBS.

Differences in regional and global lumbar angle during slumped sitting and upright sitting among global three subgroups

OBJECTIVE: The purpose of this study was to investigate differences in regional lumbar lordosis (RLL) and global lumbar lordosis (GLL) angle during slumped sitting and upright sitting among three global subgroups. METHODS: A total of 48 young asymptomatic volunteers stood in a comfortable posture, sat upright, and sat in a slumped position for 5 seconds, with inertial measurement units attached to the T10, L3, and S2 vertebrae. According to standing measurement, the participants were categorized into flat-back (GLL < 20∘), normal lordosis (20∘⩽ GLL < 30∘), and hyper-lordosis (30∘⩽ GLL < 40∘) groups. RESULTS: Both the GLL and RLL in the flat-back group were reduced lumbar lordosis in the upright sitting posture and increased lumbar kyphosis in the slumped sitting postures compared to the other groups (p< 0.05), but the range of motion during the transition from upright sitting to slumped sitting was lower than that of the normal and hyper-lordosis groups (p< 0.05). GLL in standing was a moderate correlation with GLL and RLL during upright sitting (p< 0.05). However, there was a strong correlation between GLL and RLL kinematics during upright and slumped sitting (p< 0.05). CONCLUSIONS: Flat-back posture is a potential source of low back pain during both upright and slumped sitting compared to the normal and hyper-lordosis groups. Posture measurements in a standing and sitting position conducted to assess lordosis should consider the relationship between GLL and RLL.

Effects of lower trunk movement in flat-back syndrome during stair climbing: A technical note

OBJECTIVE: This study investigated the differences in trunk sway during stair climbing between people with normal spinal alignment and people with flat-back syndrome. METHODS: Twelve male volunteers with flat-back syndrome (global angle < 20 degrees) and 12 male volunteers with normal spinal alignment (global angle between 20 degrees and 30 degrees) were enrolled. An accelerator was attached to the third lumbar spine and the sway of each participant’s trunk was measured during stair climbing. RESULT: Participants with flat-back syndrome showed significant differences in vector, anteroposterior sway, and vertical sway of the trunk during stair climbing (p< 0.05). However, mediolateral sway of the trunk and gait time did not significantly differ between groups (p> 0.05). CONCLUSION: Our findings can be used as baseline data for prevention of back pain. Furthermore, increased trunk sway can cause increased energy usage, leading to inefficient gait. Further research is needed to prevent this problem.

Epidemiology of senile spinal diseases: a study based on the Health Insurance Review & Assessment Service database

According to the Statistics Korea in 2020, the elderly population aged 65 or older accounted for 15.7% of the total population, and by 2025 it will reach 20.3%, which will enter the super-aged society. In an aging society, many degenerative diseases occur with age. In particular, the spine is a structure that acts as a pillar of our body, and as we age, degenerative changes come. Representative senile spinal diseases include disc disease, spinal stenosis, spinal spondylolisthesis, scoliosis, kyphosis, and flat back syndrome. This study intends to examine the epidemiologic characteristics and trends of senile spinal diseases using Korean Health Insurance Review & Assessment Service database from 2010 to 2019. All of the senile spinal diseases have gradually increased in the number of patients and cost over the last 10 years. In addition, the proportion of those aged 60 and over increased among those diagnosed. And fusion surgery and discectomy also increased in the last 10 years, and the treatment cost and ratio of over 60 years old increased. Korea has already become an aging society. So, in the future, senile diseases will increase further, and among them, senile spinal diseases will steadily increase. As a result, the frequency and cost of surgery will continue to increase. Efforts are needed to understand this trend and to prevent senile spinal diseases. For example, regular exercise, proper posture and habits, adequate nutrition, and efforts such as quitting smoking should be required. When these efforts are made, more healthy old life will be achieved.

Vertical and horizontal barbell kinematics indicate differences in mechanical advantage between using an arched or flat back posture in the barbell bench press exercise

Employing an arched back posture during the bench press exercise is increasingly popular. Vertical displacement of the barbell is commonly believed to be the key difference influencing strength performance between an arched and flat back bench press technique. However, comparisons between these back postures using a free weight barbell are lacking. Directly comparing performance between each posture is confounded by many variables such as proficiency and fatigue. This investigation aimed to investigate whether changing back posture alone can influence barbell kinematics, to indirectly assess potential performance differences. Twenty males performed one repetition of the bench press exercise using either an arched or flat back posture, at 25%, 50% and 75% of their one repetition maximum, in a repeated measures study design. Statistical significance was considered at p < 0.05. Changing back posture alone, reduced vertical displacement (approximately 11% average difference across all load conditions) and barbell to glenohumeral joint moment arm (approximately 20% difference) in the arched posture compared to the flat posture. These changes occurred without any specific cueing of the barbell motion and may increase the potential for lifting higher loads and decrease cumulative joint exposure. Additional cueing and training may be required to maximize the mechanical advantage available with each back posture. The arched posture appears to have an increased potential for further improvements in vertical displacement and moment arm through specific cueing. Future comparisons should consider if each back posture’s potential mechanical advantage has been maximized when assessing differences between techniques.