Influence of Global Spine Sagittal Balance and Spinal Degenerative Changes on Locomotive Syndrome Risk in a Middle-Age and Elderly Community-Living Population.

Masaaki Machino,Naoki Ishiguro,Shinya Ishizuka,Taro Inoue,Kazuyoshi Kobayashi,Sadayuki Ito,Shunsuke Kanbara,Yasuhiko Takegami,Hiroyuki Koshimizu,Hiroaki Nakashima,Shiro Imagama,Taisuke Seki,Hidetoshi Yamaguchi,Kei Ando,Yukiharu Hasegawa

doi:10.1155/2020/3274864

Masaaki Machino, Naoki Ishiguro + Show 13 more

Open Access

https://doi.org/10.1155/2020/3274864

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Abstract

Purpose The aim of this study was to describe the characteristics of each locomotive syndrome (LS) risk stage, including global spine sagittal alignment, spinal degenerative changes evident on plain radiographs, low back pain (LBP), muscle strength, and physical ability in middle-aged and elderly people in a health checkup. Methods This study included 211 healthy Japanese volunteers (89 men and 122 women; mean age, 64.0 years) who underwent assessment with both radiographs and Spinal Mouse. Spinal sagittal parameters included thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), sagittal vertical axis, and spinal inclination angle (SIA). Lumbar disc height (LDH) and lumbar osteophyte formation (LOF) at each level were evaluated as the spinal degenerative changes. The LS assessment comprised three tests: stand-up test, two-step test, and 25-question Geriatric Locomotive Function Scale (GLFS-25). The subjects were divided into three groups (no risk, stage 1 LS, or stage 2 LS) according to LS risk test criteria. The prevalence of LBP was investigated with a visual analogue scale (VAS), and physical performances were also compared among the groups. Results Of the participants, 122 had no risk of LS, 56 had stage 1 LS risk, and 29 had stage 2 LS risk. With increasing LS risk stage, the prevalence of and VAS score for LBP increased significantly, and back muscle strength and physical abilities decreased significantly. The TKA did not differ among the three groups. The LLA decreased gradually with LS risk stage (P = 0.0001). At each level except L1–L2 and L5–S1, LDH decreased gradually with LS risk stage. The prevalence of LOF increased significantly with increasing LS risk stage. The SIA increased significantly with LS risk stage (P = 0.0167). Conclusions Participants with LS had higher prevalence of spinal degeneration, small LLA, and global spinal imbalance by anterior spinal inclination.

Highlights

Human locomotion is a fundamental activity that greatly affects quality of life (QOL)
The aim of this study was to describe the characteristics of each locomotive syndrome (LS) risk stage, including global spine sagittal alignment, spinal degenerative changes evident on plain radiographs, as well as low back pain (LBP), muscle strength, and physical ability in middle-aged and elderly people in a health checkup
No differences were found among the three groups with regard to age, sex, body height, body weight, or body mass index (BMI) (Table 1)

Summary

Introduction

Human locomotion is a fundamental activity that greatly affects quality of life (QOL). With aging, this function declines as a result of the degeneration of various organs. For middle-aged persons, it is very important to maintain motor function and prevent a decrease in it for a long and healthy life. In addition to a significantly poorer QOL, the risk for falling is increased in the elderly population with LS [6, 7]. Prevention of LS has long been advocated for maintaining and BioMed Research International improving motor function of middle-aged and elderly people [8,9,10]. According to methods for evaluating the LS risk, LS is categorized into three stages [11]: at stage 1, interventions such as exercise training are needed; at stage 2, the patient requires a medical checkup to determine the underlying pathologic process for the problem to be resolved

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