Impact of Standing and Sitting Postures on Spinal Curvature and Muscle Mechanical Properties in Young Women: A Photogrammetric and MyotonPro Analysis.

BACKGROUND This study aimed to evaluate the effect of standing and sitting positions on spinal curvatures evaluated using projection moire and muscle tone and stiffness using the MyotonPRO hand-held device in young women. MATERIAL AND METHODS Thirty-three healthy women, aged 21 to 23 years, volunteered in the study. We used the projection moire method to examine spinal curvatures in both positions and the MyotonPRO device to measure the tone and stiffness of muscles in 3 regions. We evaluated the effects of positions (standing vs sitting), regions (cervical, thoracic, and lumbar), and side factor (right vs left) using multivariate analysis. RESULTS The sitting position significantly decreased the lumbosacral and thoracolumbar angles (P<0.001), but had no effect on the superior thoracic angle. Muscle tension and stiffness were the highest (P<0.001) in the cervical region and did not differ between positions (P>0.05) in this region. We found significantly higher muscle tone and stiffness in the thoracic and lumbar regions during sitting than during standing (P<0.001). There was symmetry in the muscle tone and the stiffness between the right and left sides of the spine. CONCLUSIONS The sitting posture decreased lumbosacral and thoracolumbar angles but increased muscle tension and stiffness in the lumbar and thoracic regions only. The symmetry of muscle tone and transverse stiffness in both positions was the normative value. This study provides insight into the adaptive physiological changes in spinal curvature and muscle mechanical properties in young women and serves as an important reference point for clinical studies of women.

Frontal Plane Body Posture as a Predictor of Musculoskeletal Injuries in Amateur Athletes: A Comprehensive Study of 89 Participants Over 12 Months.

BACKGROUND This study aimed to evaluate frontal plane body posture parameters as injury risk factors during physical activity in the previous 12 months. MATERIAL AND METHODS The study sample consisted of 41 males aged 21.3±1.1 years old and 48 females aged 20.8±0.6. To evaluate body posture, we assessed differences in the height of the acromion process (SSA) and differences in the height of the shoulder blades (LSAS), differences in the distance of the lower angles of the shoulder blades and spine (LSPD), differences in the height of the posterior superior iliac spine (PSIS), and the maximum deflection of spinous process line from the line C7-S1 (PTA). The Injury History Questionnaire was used for injury data collection from the previous 12 months. The parameters were assessed for their ability to distinguish between injured and non-injured individuals using the receiver operating characteristic (ROC) method. RESULTS The results suggest that LSPD is a significantly (P=0.028) better predictor of injury than other body posture parameters. The cut-off points for risk of injury based on the assessed body posture parameters demonstrated a diagnostic accuracy higher than chance, except for LSAS and PTA (AUC >0.5). In addition, there were no sex differences in the predictive potential of detecting injuries between males and females. CONCLUSIONS The LSPD has the greatest predictive value for musculoskeletal injuries. Our results suggest that body posture parameters, irrespective of sex, independently influence injury risk, emphasizing the need for preventive strategies targeting athletes' trunk and shoulder regions.

Associated Risk Factors with Low Back Pain in White-Collar Workers-A Cross-Sectional Study.

Objective: The purpose of the study was to compare the pressure pain threshold (PPT) of soft tissue and the curvatures of the spine in a sitting position and to estimate associated physical risk factors with low back pain (LBP) in young adults. Subjects: White-collar workers (n= 139), both women (n = 51) and men (n = 88) were separated into a control group (n = 82) and a low-intensity LBP (NRS < 3) (n = 57). Methods: The PPTs were tested utilizing the Wagner algometer. The curvatures of the spine were measured employing the photogrammetric method. In the logistic regression model, the odds ratio (OR) was estimated with ±95% confidence interval (CI) indicating the probability of the reported LBP. Results: The PPTs of soft tissue (OR = 1.1; CI = 1.02−1.19; p < 0.05) and the angle of the thoracolumbar spine in the everyday, habitual sitting position (OR = 1.19; CI = 1.05−1.34; p < 0.05) were associated with low-intensity LBP in female subjects. Additionally, the low intensity LBP were associated with the angles of the torso (OR = 1.14; CI = 1.01−1.29; p < 0.05) and the lumbosacral spine in the corrected sitting position (OR = 1.06; CI = 0.98−1.15; p > 0.05) and BMI (OR = 1.56; CI = 0.84−2.90; p > 0.05) in male subjects. Conclusion: Individual risk factors were associated with the low-intensity LBP only in females utilizing the PPT and the thoracolumbar angle in the habitual sitting position study factors. Men from the LBP group did not effectively correct the lumbosacral angle. Therefore, re-educated, self-corrected posture with specific postural training would be expected to improve proprioception in postural control capacity and result in decreasing pain.

Acute effects of proprioceptive neuromuscular facilitation exercises on the postural strategy in patients with chronic low back pain.

INTRODUCTION: Active treatments focused on improvement in motor function are postulated in chronic low back patients (CLBP). OBJECTIVE: to establish the acute effects of PNF exercise on the postural control strategy. METHODS: The sway of the body was tested before intervention in fifty-three CLBP patients and after that participants were randomly assigned into the intervention PNF group (n = 25). Mean velocity (VEL) and sample entropy (SEn), over the center of pressure in the mediolateral (ML) and anterior-posterior (AP) planes served to estimate the postural strategy and automaticity levels in the neuromuscular controller. Tandem and one-leg standing tests (OLST) with eyes open and eyes closed were used. RESULTS: Pain intensity decreased after the intervention. The VEL was no longer vision-dependent in both planes. The SEn decreased immediately after the exercise and either returned to or even exceeded the baseline values in the OLST ML plane. CONCLUSION: A single session of PNF exercise may have a beneficial effect on pain and postural control in CLBP patients. The statistically significant pain relief combined with newly acquired better control of posture may have encouraged the PNF group participants to a subconscious exploration of the stability area. Postural movements were more automatized in OLST in the delayed test.

Lumbar Spine Kinematics in Asymptomatic People When Changing Body Position From Sitting to Standing.

OBJECTIVE: The purpose of this study was to assess the lumbar spine kinematics in 3 movement axes in asymptomatic individuals in the sit-to-stand (STS) movement performed in a habitual, flexion, or extension manner. METHODS: There were 30 participants (16 women, 14 men), aged 23 to 37 years. Each participant performed an STS test. We registered the total time of the STS movement and the maximum acceleration of the lumbar spine in the vertical, anteroposterior, and mediolateral axes. The examination of the movement pattern was performed with the use of a BTS G-sensor device. RESULTS: The highest movement dynamics in the lumbar spine were observed during the STS performed in a habitual manner in the 3 axes (P < .01). The lowest movement dynamics ere associated with the extension STS pattern. The flexion pattern differed from the habitual one in total performance time in both groups (P < .01). There were no significant differences in kinematic lumbar spine between sexes. CONCLUSION: The kinematics of the STS movement for asymptomatic individuals were characterized by significant variability in the maximum acceleration in the 3 axes. The highest movement dynamics were observed during the STS performed in a habitual manner, and the lowest dynamics with the extension pattern of STS.

Effect of Sacroiliac Joint Mobilization on the Level of Soft Tissue Pain Threshold in Asymptomatic Women.

OBJECTIVE: This study aimed to evaluate the effect of sacroiliac joint (SIJ) mobilization and/or self-mobilization on the level of soft tissue pain threshold in 21- to 23-year-old asymptomatic women (n = 20). METHODS: The FPIX Wagner Algometer was applied to compute the pressure pain threshold (PPT) over the right and left side of the iliolumbar ligament and lumbar erector spinae (L3). Measurements were taken of the right SIJ before and after a randomized protocol of oscillating mobilization, self-mobilization, and placebo treatment. RESULTS: A main effect of intervention (mobilization, self-mobilization, placebo) was confirmed by analysis of variance, with increases in PPT over the iliolumbar ligament (F = 13.04, P < .05) and erector spinae (F = 12.28, P < .05) on the mobilized side. The Wilcoxon test indicated that SIJ mobilization increased PPT over the iliolumbar ligament (P < .05) and erector spinae (P < .05) on both sides. Self-mobilization increased erector spinae PPT on the exercised side (P < .05), whereas the placebo did not cause any changes in PPT (P > .05). CONCLUSION: The study provides evidence of local and global pain modulation resulting from oscillatory mobilization of the SIJ in women without pain symptoms. Self-mobilization of the SIJ has limited analgesic application.

Active self-correction of spinal posture in pain-free women in response to the command "straighten your back".

Evidence is limited regarding the regional changes in spinal posture after self-correction. The aim of the present study was to evaluate whether active self-correction improved standing and sitting spinal posture. Photogrammetry was used to assess regional spinal curvatures and vertical global spine orientation (GSO) in 42 asymptotic women aged 20-24 years. Upper thoracic spine angle and GSO increased in response to self-correction, while the thoracolumbar and lumbosacral angles decreased. Self-correction in the standing position resulted in decreased inclination of the upper thoracic and thoracolumbar spinal angles. Correction of sitting posture reduced the angle of the upper thoracic spine and GSO. The effects of active self-correction on spinal curvature and GSO were different for the standing versus sitting position; the greatest effects of active correction were noted in the thoracic spine. Balanced and lordotic postures were most prevalent in the habitual and actively self-corrected standing positions, whereas the kyphotic posture was most prevalent in the habitual sitting position, indicative that self-correction back posture in the standing position could be an important health-related daily activity, especially during prolonged sitting.

The Effect of Chronic Pain Intensity on Sit-to-Stand Strategy in Patients With Herniated Lumbar Disks.

OBJECTIVE: Recurrent symptoms of low back pain and its transition to a chronic state are associated with specific motor strategies used by people to avoid pain. The aim of the study was to determine the impact of chronic pain intensity on sit-to-stand (STS) strategy in chronic low back pain (CLBP) patients with herniated disks. METHOD: Vertical ground reaction forces (counter, peak, and postpeak rebound) and their respective times of occurrence were measured on 2 Kistler force plates. Thirty-two healthy persons served as a control group. People with CLBP (n = 40) were divided into 2 subgroups according to the reported pain intensity at rest as measured by the numeric pain rating scale (NRS): low pain (NRS ≤ 3) and high pain (HP; NRS > 3). RESULTS: Both CLBP subgroups achieved shorter time to counter force but longer time to postpeak rebound force (P < .01). The time to peak force was extended in HP on the right side (P < .01). HP presented lower peak force on the right and lower postpeak rebound force on the left side (P < .001) compared with controls. CONCLUSION: Patients with CLBP were characterized by an individual, compensatory STS movement strategy with shorter preparation and longer stabilization times. Avoidance behavior in STS execution was presented in HP individuals only, indicating that intensity of chronic pain was a significant factor in decreasing ground reaction peak force and increasing time to peak force.

The effect of chronic pain intensity on the stability limits in patients with low back pain.

OBJECTIVE: The purpose of this study was to evaluate if the intensity of recurrent chronic pain would modify postural performance in reaching the functional limits of stability (LOS) in chronic low back pain (CLBP) patients. METHODS: Three groups of subjects were investigated. Healthy persons comprised the asymptomatic group (n = 32) while CLBP patients (n = 36) were divided into 2 subgroups, according to the reported intensity of resting pain on a numerical rating scale: patients with low (LP) and high pain (HP) levels. The maximal displacement of the center of pressure (COP) indexing the LOS magnitude and the COP mean velocity indexing the performance in reaching LOS were calculated on a Kistler force plate during forward and backward voluntary body lean with eyes open (EO) or closed (EC). RESULTS: The forward LOS was lower in both the LP (P < .01) and HP (P < .01) subgroups than in the asymptomatic under EO and EC conditions, while no differences between the LP and HP groups were found. The backward LOS was lower in the HP group than in asymptomatic but only with EC (P = .01). Eye closure caused an increase in forward (P = .02) and backward (P = .001) COP velocity in the LP group and forward COP velocity in the asymptomatic (P = .04) only. With EC, the only intergroup difference was lower forward COP velocity in the HP than LP group (P = .04). CONCLUSION: Subjects with CLBP had reduced forward LOS regardless the pain level. However, the higher level of pain was associated with slower execution of voluntary leaning tasks, with EC only.

Anterioposterior spinal curvatures and magnitude of asymmetry in the trunk in musicians playing the violin compared with nonmusicians.

OBJECTIVE: Playing an instrument often requires a certain posture and asymmetric position that may affect the anteroposterior spinal curvatures and may lead to postural asymmetry. The aim of the study was to evaluate the spinal curvatures in the sagittal plane and the magnitude of asymmetries in the trunk in the frontal plane in a group of music students in comparison with a control group. METHODS: The group of 67 students aged 20 to 26 years was made up of 2 subgroups: the musicians (violin playing students of the Academy of Music in Wroclaw) and the control group (physical therapy students who played no instruments). The examination included an interview, measuring of somatic characteristics, and evaluation of body posture by means of the photogrammetric method. RESULTS: The spinal curvatures of the instrumentalists in the sagittal plane differ from the control group mainly in terms of length and depth parameters. Compared with the control group, the musicians were characterized by statistically more significantly longer and deeper thoracic kyphosis (P < .01) and more shallow lumbar lordosis (P < .05), a greater angle of thoracic kyphosis (P < .005), and a smaller inclination angle of the thoracolumbar and lumbosacral section of the spine (P < .01). CONCLUSION: In the group of musicians, the asymmetries in the area of shoulders and waist triangles as well as the distance of the spinous processes from the C7 to S1 line were more frequent.

The occurrence of strain symptoms in the lumbosacral region and pelvis during pregnancy and after childbirth.

OBJECTIVE: The etiology and pathology of pain in the lumbosacral region and pelvis of pregnant women during and after pregnancy have not been fully determined. This study evaluated if lower back pain during pregnancy and after childbirth is connected with static alterations in the alignment of the pelvis, dysfunction of sacroiliac joints, and irritation of the pelvic ligaments and spine in the lumbosacral region. METHODS: This study was carried out on a group of 30 women in their eighth month of pregnancy and through 3 months after childbirth. Techniques of manual examination were used to determine the strain. Static alteration of the pelvis was evaluated in both the sitting and standing positions on the basis of alignment of the posterior superior iliac spines. Irritation of the iliolumbar ligaments, sacrotuberous, sacroiliac, and interspinous ligaments was evaluated by means of pressure palpation. Disorders of sacroiliac joint function were evaluated with the Patrick FABERE test, the standing Gillet test, and the standing and sitting flexion tests. RESULTS: The most frequently irritated ligaments in the lumbar region are interspinous (60%), iliolumbar (40%), and sacroiliac (36%). CONCLUSIONS: In women, in their eighth month of pregnancy and after childbirth, disorders of static alterations in pelvis alignment and sacroiliac joint dysfunction may occur. The state of pregnancy may result in strain symptoms in the lumbosacral region and pelvis with variable pain intensifying in various static positions.

Postural control in patients with lumbar disc herniation in the early postoperative period.

Chronic spinal disc disease leads to disorders in postural movement coordination. An incorrect asymmetrical movement pattern for the lower limbs loading impairs proprioception and deteriorates postural stability, particularly when the vision is occluded. The standard surgical treatment improves biomechanical conditions in the lumbar spine, reduces pain, yet does it reduce the stability deficit in the upright position? An answer to the latter question would help work out targeted therapy to improve postural stability. We hypothesized that the standard surgical treatment would improve postural stability reflected by decreased sway variability accounting for better use of proprioceptive inputs postoperatively. Thirty-nine patients with lumbar disc herniation participated in the study. Their postural sway was recorded in anterior/posterior and medial/lateral planes with their eyes open or closed (EC) before and after surgery. The variability, range, mean velocity of the recorded time series and the area of the ellipse enclosed by the statokinesiogram were used as measures of postural stability. Preoperatively, EC condition resulted in an increased variability and mean velocity of postural sway, while postoperatively it caused an increase in sway mean velocity and sway area only with no effect on sway variability and range. The comparison of the balance before and after the surgery in the EC condition showed significant decrease in all parameters. In the early postoperative period, the patients recover the ability to control their postural sway in EC within normal limits, however, at the expense of significantly increased frequency of corrective torques. It is probably a transient short-term strategy needed to compensate for the recovery phase when the normal weighting factors for all afferents are being reestablished. We propose that this transient postoperative period may be the best timing of therapeutic intervention targeted at facilitating and reinforcing the acquisition of correct motor patterns.

Postural balance in the early post-operative period in patients with intervertebral disk disease following surgery.

BACKGROUND: The authors assumed that advanced lumbar disk disease contributes to disorders of body balance and asymmetry of foot pressure force on the ground. Surgery improves biomechanical relations in the lumbar spine, thus decreasing the disturbance of postural balance and foot load. MATERIAL AND METHODS: The study was carried out among 40 patients treated in Military Clinical Hospital in Wroclaw due to a herniated nucleus pulposus in the lumbar region of the spine. Patients were examined prior to lumbar intervertebral disc surgery and 3 days following the procedure. A PEL 38 MEDICAPTEURS platform was used to measure foot pressure forces on the ground. RESULTS: Examinations of body posture balance based on plumb line tests before the operation indicated transposition of pelvis both to the left and the right side. The correct position of the pelvis was reported only in 25% of the patients. Examinations of lower limb load indicated asymmetry in the distribution of foot pressure forces on the ground. CONCLUSIONS: Herniated disk disease in the lumbar spine causes disturbances of body posture balance, such as transposition of pelvis to the left or right and asymmetry of foot pressure forces on the ground due to pain radiating to one of the lower limbs. Surgery for herniated disk reduces the abnormal position of the pelvis and alleviates the pain, but it does not improve the lower limb load disorders.

Mobility of cervical spine and postural equilibrium in patients with spinal overload syndrome.

BACKGROUND: The spinal overload syndrome develops as a result of the gradual wearing away of the structural elements of the spine due to loads exceeding their endurance strength in the setting of reduced adaptability. The aim of the investigation was to study the limitation of mobility in the cervical spine and determine the effect of the spinal overload syndrome on postural equilibrium. MATERIAL AND METHODS: The study enrolled 27 patients with signs of overload of the cervical spine. Postural equilibrium was measured by stabilography. Range of motion in the cervical spine was also evaluated. CONCLUSIONS: The investigations of spinal mobility indicate a disturbance of muscular equilibrium. Most of the patients suffered from Lewit's upper crossed syndrome. The disturbance of postural equilibrium is of functional origin.

Pseudoradicular symptoms in patients exhibiting the lumbar spinal disc disease.

INTRODUCTION: The goal is to describe occurrences of functional motion system disorders in patients who exhibit the lumbar spinal disc disease. It is assumed that the lower back pain- radicular and pseudoradicular is caused by the lumbar spinal disc disease. MATERIAL AND METHODS: Studies were performed in 19 patients who exhibited MRI determined hernia disc in the lumbar spine. Patients were 40-50 years old. Diagnosis of dysfunctions of motion system was determined by utilizing the following manual diagnostic tests: Kibler skin fold test, palpation of spine and pelvis ligaments exams, examination of painfulness processus spinosus, areas of active pain points in muscle tissue; and further examined the state of nerve irritation in accordance to Laseque test and cross Laseque test. RESULTS: The study results indicate symptoms of syndrom pseudoradiatic pain occurred in the majority of examined patients (40-60%). Examination of a localized irritation in the area of dermantom lead to the conclusion that skin pain occurred at L3-S1 levels (60-80% of examined patients) and Th5-Th7 (30-35% of examined patients). The analysis of pain occurrences in the area of pelvis ligaments , lead to the conclusion that all examined ligaments are susceptible for irritations. CONCLUSIONS: This particular group of examined patients experienced lower back pain as a result of radicular or/and pseudoradicular pain . Subsequently, any physical therapy treatments in patients who suffer from the lumbars spinal disc disease should be performed individually in each patient because of radicular or pseudoradicular symptoms.