Functional Analysis of the Spine with the Idiag SpinalMouse System among Sedentary Workers Affected by Non-Specific Low Back Pain.

WHO describes "low back pain" (LBP) as the most common problem in overall occupational-related diseases. The aim of this study was to evaluate characteristics of spinal functionality among sedentary workers and determine usability of the SpinalMouse® skin-surface measurement device in workplace settings in a risk population for LBP. The spinal examination was implemented at National Instruments Corporations' Hungarian subsidiary, Debrecen in October, 2015, involving 95 white-collar employees as volunteers to assess spinal posture and functional movements. Data from the physical examination of 91 subjects (age: 34.22 ± 7.97 years) were analyzed. Results showed significant differences (p < 0.05) in posture and mobility of the spinal regions in sitting compared to standing position. Significant positive correlations were observed between values measured in standing and sitting positions in all observed regions and aspects of the spine (p < 0.05) except posture of lumbar extension (p = 0.07) and mobility of sacrum/hip in E-F (p = 0.818). Significant (p < 0.001) difference (5.70°) was found between the spinal inclination in sitting 6.47 ± 3.55° compared to standing 0.77 ± 2.53 position. Sitting position has a negative effect on the posture and mobility of the spine among white-collar employees. The SpinalMouse can be used effectively to determine spinal posture and mobility in cross-sectional studies and impact analysis of physical exercise interventions.

Trunk inclination and hip extension mobility, but not thoracic kyphosis angle, are related to 3D-accelerometry based gait alterations and increased fall-risk in older persons.

BACKGROUND: Only a portion of the increased variability in gait parameters observed in ageing can be explained by age and gait speed alone. Other factors, like musculoskeletal changes of the spine, might contribute to higher variability of gait parameters, slower walking speed and subsequently increased fall-risk in ageing. RESEARCH QUESTION: Are spinal posture and mobility related to 3D-accelerometry based gait analysis, functional performance and fall-risk in ageing? METHODS: Forty elderly presenting increased fall-risk (OFR, 80.6 ±â€¯5.4yrs), 41 old controls (OC, 79.1 ±â€¯4.9yrs), and 40 young controls (YC, 21.6 ±â€¯1.4yrs) were assessed for spinal posture and mobility (SpinalMouse®), gait analysis (DynaPort MiniMod), and functional performance (grip strength, grip work, timed-get-up-and-go-test, performance-oriented mobility assessment). RESULTS: Compared to OC, OFR showed significantly (p < .05) larger trunk inclination angle (INC), smaller sacral extension mobility, slower walking speed, and lower medio-lateral step and stride regularity. Thoracic kyphosis angle (TKA) was similar in all groups. INC and sacral extension mobility showed the highest correlation with walking speed, gait parameters, functional performance and fall-risk. INC (OR = 1.14) and sacral extension mobility (OR = 1.12) can moderately explain fall-risk in elderly participants and showed fair capacity to discriminate OFR from OC, the diagnostic value on fall-risk is however low (best probabilistic cut-off value, INC: -0.83° [sensitivity = 70%, specificity = 61%, PPV = 64%, NPV = 68%, LR+ = 1.79, LR- = 0.49, AUC = 0.71]; sacral extension mobility: 8.5° [sensitivity = 70%, specificity = 73%, PPV = 72%, NPV = 71%, LR+ = 2.61, LR -= 0.41, AUC = 0.71]). SIGNIFICANCE: Larger trunk inclination and smaller sacral extension mobility (i.e. hip extension mobility) are moderately related to increased fall-risk, gait alterations, lower muscle performance and worse functional mobility in ageing. Contrary to our hypothesis, TKA showed no relation with parameters of gait and/or fall-risk. INC and sacral extension mobility have fair discriminative power to distinguish older persons with increased fall-risk from those without and might be considered as therapeutic targets.

Progression of postural changes in Parkinson's disease: quantitative assessment.

Previous studies of posture in Parkinson's disease (PD) patients focused on the pathophysiology of severe deformities, using mainly subjective estimations or goniometric measures. The aim of this study was to investigate risk factors associated with flexed posture in PD and their effects on the course of posture variations. One hundred-ninety patients with definite PD were prospectively evaluated for angles of spinal inclination in upright position, extension, and flexion using a mechanical computer-assisted, hand-held device (SpinalMouse). Patients underwent clinical examination, including background data and bone mineral density. Motor function was evaluated with the UPDRS, and back pain with the RMDQ. Physical activity data were collected by self-report. Postural measurements were repeated after 10-17 months. Angle of upright inclination correlated with age (p = 0.0004), older age at disease onset (p = 0.0085), longer disease duration (p = 0.003), higher UPDRS motor and posture score (p = 0.0005 and 0.0001), the presence of back-pain (p = 0.0097), and osteoporosis (p = 0.027). There was no correlation between upright angle of inclination and gender, disease type, or side of disease onset. Re-evaluation of posture in 124 patients at 13.77 ± 4.4 months after the initial evaluation showed significant deterioration in forward bending (p < 0.0001) and was significantly associated with disease duration (p = 0.029), worsening of the UPDRS score (p = 0.016), right-side disease onset (p = 0.032), presence of vertebral fractures (p = 0.049), and the lack of physical activity (p = 0.0327). Older age, disease severity and duration, presence of back-pain and osteoporosis are associated with postural abnormalities in PD. Physical activity might slow the worsening of postural abnormalities in PD.

Relationship between spinal morphology and function and adolescent non-specific back pain: A cross-sectional study.

CONTEXT: Non-specific back pain has become a public health problem affecting adolescent health. OBJECTIVE: To examine the relationships between abnormalities in spinal morphology and non-specific back pain among adolescents. DESIGN: Cross-sectional study. SETTING: Junior and senior high schools. PATIENTS: Participants were screened using a questionnaire regarding back pain. Students in the pain group (n= 273, 121 boys and 152 girls) reported experiencing upper and/or lower back pain within the previous month, and those who did not report pain were assigned to the group without pain (n= 127, 63 boys and 64 girls). Participants who had experienced acute upper and/or lower back injuries within the previous month or received a definitive diagnose of disease were excluded. METHODS: The SpinalMouse® was used to measure the thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), sacrum/hip angle (SA), and incline angle (INA) in both the standing position and sitting position. The SpinalMouse® also was used to measure the sacral, thoracic, and lumbar range of motion (ROM) in the fully flexed position and fully extended position in the sagittal plane. The thoracic and lumbar ROM in left/right lateral flexion was recorded. The Matthiass test was used to assess changes in the measured angles upon loading. RESULTS: Among junior high school students, 47.0% of boys and 53% of girls had an abnormal TKA. Among senior high school students, 52.6% of boys and 46.99% of girls had an abnormal TKA. The incidence of LLA abnormality was significantly higher among junior high boys than girls (p< 0.05), as was the incidence of hypolordosis (p< 0.05). Significantly fewer senior high boys than girls had a normal LLA value (p< 0.05). An excessive TKA (p< 0.05, odds ratio = 1.236) and limited lumbar ROM (p< 0.01, odds ratio = 0.975) were correlated with back pain in adolescents. CONCLUSIONS: The incidences of TKA and LLA abnormality are high among Chinese adolescents, and an excessive TKA and insufficient total lumbar ROM may be risk factors for non-specific back pain in adolescents.

Beneficial effect of levodopa therapy on stooped posture in Parkinson's disease.

OBJECTIVE: This study was designated to quantitatively evaluate the effect of levodopa on spinal posture in patients with PD using a computer-assisted handheld SpinalMouse device. METHODS: Prospective case-study involving 48 patients with definite PD. All patients were recruited between September 2011 and September 2013 and included 22 dopa-naïve, evaluated before and 3 months after initiation of treatment, and 26 patients with response fluctuations studied during the "off" and "on" states. The SpinalMouse instrument, a computer-assisted mechanical hand-held device, designed to noninvasively assess the curvature of the spine was guided along the midline of the vertebral column in upright, full flexion, and full extension positions to objectively assess spinal posture. RESULTS: In the dopa-naïve patients, spinal incline in the upright position was 12.4±1.2° before and 7.6±1.3° after treatment; p=0.002. Corresponding area-under-the-curve (AUC) values were 131.7±8.0 cm(2) and 87.1±7.3 cm(2); p<0.0001. In the response fluctuations patients, spinal incline was 13.3±1.3° in the "off" and 9.3±1.2° in the "on" period; p=0.015. Corresponding AUC values were 144.6±9.2 cm(2) and 103.1±8.2 cm(2); p<0.0001. CONCLUSIONS: This is the first study that objectively measured and quantified abnormalities of spinal posture in patients with PD. Findings suggest that levodopa does have a beneficial effect on anterior flexion of the thoracolumbar spine, and thus indicate that the disorder of stooped posture in PD is mediated, at least in part, by dopamine deficiency.

Relation among the knee, sagittal spinal alignment, and the spinal range of motion: Investigation in local medical check-ups using the SpinalMouse.

BACKGROUND: This study was designed as an investigation in a local population to assess the relation between the knee joint and spinal alignment in a population-based study using the SpinalMouse. METHODS: Medical check-ups were conducted for residents of a mountain village in Japan. The study population included 107 men and 157 women (528 knees) with a mean age of 71.1 ± 6.8 years (range, 60-87 years). A questionnaire dealing with any current symptoms involving the knees was administered, and physical examinations dealing with the range of motion (ROM) of knee were conducted. The SpinalMouse was used to measure sagittal spinal alignment and spinal ROM. The parameters considered were thoracic kyphosis angle, lumbar lordosis angle (LLA), sacral inclination angle (SIA), and trunk angle of inclination (INC). The patients were divided into a group with knee flexion contracture (FC group) and a group without knee FC (non-FC group) to conduct a comparative study of both groups. RESULTS: With regard to static spinal alignment, LLA and SIA decreased significantly in the FC group (p < 0.05). With regard to spinal ROM, LLA and INC decreased significantly in the FC group (p < 0.05). CONCLUSION: Results suggested that the knee and the spine affect each other and that the spinal ROM is also involved. The current study may explain the development of knee-spine syndrome.