Lumbar Flexibility Research Articles

The effect of transcutaneous electrical nerve stimulation on lumbar range of motion and lumbar fascia characteristics in healthy individuals

ObjectivesTo investigate the effect of Transcutaneous electrical nerve stimulation (TENS) on lumbar fascia thickness, lumbar flexion angle, and lumbar curvature in healthy people. DesignRandomized, clinical trial. Subjects100 healthy individuals. InterventionsParticipants were randomized into the active TENS group (n = 50) and placebo TENS group (n = 50). Subjects received 10 sessions of TENS in the lumbar region for 2 weeks. Main measuresLumbar fascia thickness, lumbar flexion angle, and lumbar curvature examined by ultrasonography, flexible ruler, and spinal mouse three times (before and after the intervention sessions, and two weeks after the last intervention session-follow up) ResultsSubjects in the TENS group showed a significant reduction in lumbar fascia thickness (P ≤ 0.002), an increase in lumbar flexion angle (P = 0.000), and an increase in lumbar curvature angle (P = 0.000) before and after the intervention sessions. The results of the follow-up evaluations showed the stability of the changes in the mentioned variables. ConclusionThe improvements in the lumbar fascia thickness and lumbar flexibility suggest that TENS may be effective in healthy subjects. Data indicate that biomechanical properties of lumbar fascia and lumbar flexibility are directly linked, and other mechanisms could be more influential in contributing to improvement.

Comparative analysis of two different physiotherapy intervention programs in individuals experiencing chronic lower back pain

Background and objectives. Physiotherapy programs in individuals experiencing chronic lower back pain (CLBP) aim to improve function, disabilities from worsening. As per clinical practice guidelines, many methods are applied, such as the McKenzie method, therapeutic exercises, transcutaneous electrical nerve stimulation (TENS), traction, thermotherapy etc. The effectiveness of these methods is supported by a wide range of evidence and studies, making them some of the most diverse and well-established approaches. These physiotherapeutic treatments are combined every day. Therefore, the aim of this research is to provide a comparative investigation on two different physiotherapy programs containing a combination of these treatment modalities in individuals with CLBP. Materials and methods. This research involved 60 patients who were separated into two groups. Group I received the McKenzie treatment method, passive modalities, lumbar traction, and a walking program. Group II received therapeutic exercises, passive modalities, lumbar traction, and a walking program. Both groups underwent treatment for six weeks. Subjects were tested using research instruments at the beginning, at the end of three weeks, and at the end of six weeks of treatment. The evaluation instruments used were the visual analog scale, Finger-to-Floor test, the Oswestry Low Back Pain Disability Questionnaire, and the Rosenberg self-esteem scale. Results. Pain intensity, functional disability, lumbar flexibility, and self-confidence showed greater improvement after six weeks of treatment in both programs (p <0.0001), without any significant statistical difference among the groups (p >0.05). Conclusions. The data obtained from both groups support the effectiveness of both treatment programs and suggest that they can be considered as options for viable programs treatment for patients with CLBP.

Preparation For Flight: The Physical Profile of Pre-Professional and Professional Circus Artists in the United States.

Established norms for fitness and performance measures are lacking in circus arts. These would assist healthcare professionals and coaches to screen for readiness to participate in training or performance, determine post-injury return to performance, and develop targeted conditioning programs. The purpose of this research was to establish norms for trunk and extremity physical exam and performance measures in circus artists by professional status, assigned sex at birth (ASAB), and age. Descriptive laboratory study. Circus artists (n=201; ages 13-69y; 172 females ASAB, 29 males ASAB) from 10 cities across the United States underwent a baseline physical examination including shoulder, hip and trunk measures of passive (PROM) and active (AROM) range of motion, measures of flexibility (shoulder and hip), strength (manual muscle tests, grip strength), cardiovascular fitness (3 minute-step test), balance (single limb and handstand), and performance, (pull-ups, and the closed kinetic chain upper extremity stability test [CKCUEST]). ANOVAs were used to determine between group differences by age and T-tests to discern differences by ASAB or professional status. Differences existed by professional status for shoulder external rotation PROM, hip PROM, hip flexibility, shoulder and abdominal strength, and cardiovascular fitness. Sex differences were seen in active scapular upward rotation, hip and shoulder PROM and flexibility, hip and grip strength, and for functional performance measures (pull-ups, CKCUEST). Differences by age were limited to active scapular upward rotation, shoulder PROM, flexibility and strength, cardiovascular fitness, and balance. Overall, professionals outperformed pre-professionals for lower abdominal strength, pull-ups, handstand balance, cardiovascular fitness, hamstring, and straddle flexibility. Generally, males ASAB demonstrated greater shoulder flexibility and upper body functional strength while females ASAB had greater hip and lumbar flexibility and hip strength. No measures showed consistent declines with increasing age, though some showed differences between adolescents and adults. These normative values for physical characteristics and functional performance in pre-professional and professional circus artists may be used to guide screening for readiness to participate in advanced training or performance, return to performance after injury, and the development of targeted strength and conditioning programs. 3.

Characteristics and standards of severe sagittal imbalance in adult patients with spinal deformities: a retrospective analysis

ObjectiveTo analyze the characteristics of “severe” dynamic sagittal imbalance (DSI) in patients with adult spinal deformity (ASD) and establish criteria for them.MethodsWe retrospectively analyzed 102 patients with ASD presenting four cardinal signs of lumbar degenerative kyphosis. All patients underwent deformity corrective surgery and were divided into three groups according to the diagnostic criteria based on the Oswestry disability index and dynamic features (△Timewalk: time until C7 sagittal vertical axis [C7SVA] reaches ≥ 20 cm after the start of walking) of sagittal imbalance. The paravertebral back muscles were analyzed and compared using T2-weighted axial imaging. We performed a statistically time-dependent spinopelvic sagittal parameter analysis of full standing lateral lumbar radiographs. Lumbar flexibility was analyzed using dynamic lateral lumbar radiography.ResultsThe patients were classified into the mild (△Timewalk ≥ 180 s, 35 patients), moderate (180 s > △Timewalk ≥ 30 s, 38 patients), and severe (△Timewalk < 30 s, 29 patients) groups. The back muscles in the severe group exhibited a significantly higher signal intensity (533.4 ± 237.5, p < 0.05) and larger area of fat infiltration (35.2 ± 5.4, p < 0.05) than those in the mild (223.8 ± 67.6/22.9 ± 11.9) and moderate groups (294.4 ± 214.7/21.6 ± 10.6). The analysis of lumbar flexibility revealed significantly lower values in the severe group (5.8° ± 2.5°, p < 0.05) than in the mild and moderate groups (14.2° ± 12.4° and 11.4° ± 8.7°, respectively). The severe group had significantly lower lumbar lordosis (LL, 25.1° ± 22.7°, p < 0.05) and Pelvic incidence-LL mismatch (PI-LL, 81.5° ± 26.6°, p < 0.001) than those of the mild (8.2° ± 16.3°/58.7° ± 18.8°) and moderate (14.3° ± 28.6°/66.8° ± 13.4°) groups. On receiver operating characteristic curve analysis, PI-LL was statistically significant, with an area under the curve of 0.810 (95% confidence interval) when the baseline was set at 75.3°. The severe group had more postoperative complications than the other groups.ConclusionsOur results suggest the following criteria for severe DSI: C7SVA > 20 cm within 30 s of walking or standing, a rigid lumbar curve < 10° on dynamic lateral radiographs, and a PI-LL mismatch > 75.3°.Level of evidence3.

Correlation between Hamstrings-quadriceps Strength Ratio and Lumbar Flexibility of College-going Students: A Pilot Study

Introduction: The concept of myofascial chains or meridians emphasises the interconnectedness of the musculoskeletal system. There is a correlation between the counteracting forces applied by the knee and lower back regions. Fatigue in the quadriceps femoris muscle can lead to increased activation of the lumbar muscles. Accelerated exhaustion of the lumbar muscles during isometric trunk extension correlates with heightened suppression of the quadriceps muscles. The strength of the quadriceps muscles sets a limit on the ability to lift objects or sustain back injuries. Aim: To establish relationship between hamstring-quadriceps strength ratio and lumbar flexibility among college going individuals. Materials and Methods: A pilot study was conducted in the Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India, from October 2023 to November 2023. The study comprised 15 volunteers, aged 18 to 25, who were regular college-going students with a normal Body Mass Index (BMI) and have no active cardiovascular or musculoskeletal conditions. An evaluation was made that included isokinetic dynamometer strength ratio (duration for strength ratio evaluation was 10 minutes for each subject) and Schober test (duration for flexibility evaluation was 5 minutes for each subject). Participants followed test thrice at the same time. Results: Normality of data was determined by using Shapiro–Wilk test which showed not normal distribution. The peak hamstringquadriceps ratio was generated from bilateral limb, which showed fair correlation to performance of composite score of Schober test in individuals going college regularly (r=-0.594; p&lt;0.05). Conclusion: Lumbar flexibility can be dependent on Hamstring and quadriceps strength ratio among healthy individuals. The clinical implication of the present study is improving strength ratio of Hamstring and quadriceps can be an effective measure to increase lumbar flexibility and reduce low back injuries.

Differences in the Effectiveness of Dynamic Stretching Exercise and Static Stretching Exercise on Lumbar Flexibility for Elderly

Differences in the Effectiveness of Dynamic Stretching Exercise and Static Stretching Exercise on Lumbar Flexibility for Elderly

Running, jumping, hunting, and scavenging: Functional analysis of vertebral mobility and backbone properties in carnivorans.

Carnivorans are well-known for their exceptional backbone mobility, which enables them to excel in fast running and long jumping, leading to them being among the most successful predators amongst terrestrial mammals. This study presents the first large-scale analysis of mobility throughout the presacral region of the vertebral column in carnivorans. The study covers representatives of 6 families, 24 genera and 34 species. We utilized a previously developed osteometry-based method to calculate available range of motion, quantifying all three directions of intervertebral mobility: sagittal bending (SB), lateral bending (LB), and axial rotation (AR). We observed a strong phylogenetic signal in the structural basis of the vertebral column (vertebral and joint formulae, length proportions of the backbone modules) and an insignificant phylogenetic signal in most characteristics of intervertebral mobility. This indicates that within the existing structure (stabilization of which occurred rather early in different phylogenetic lineages), intervertebral mobility in carnivorans is quite flexible. Our findings reveal that hyenas and canids, which use their jaws to seize prey, are characterized by a noticeably elongated cervical region and significantly higher SB and LB mobility of the cervical joints compared to other carnivorans. In representatives of other carnivoran families, the cervical region is very short, but the flexibility of the neck (both SB and LB) is significantly higher than that of short-necked odd-toed and even-toed ungulates. The lumbar region of the backbone in carnivorans is dorsomobile in the sagittal plane, being on average ~23° more mobile than in artiodactyls and ~38° more mobile than in perissodactyls. However, despite the general dorsomobility, only some representatives of Canidae, Felidae, and Viverridae are superior in lumbar flexibility to the most dorsomobile ungulates. The most dorsomobile artiodactyls are equal or even superior to carnivorans in their ability to engage in dorsal extension during galloping. In contrast, carnivorans are far superior to ungulates in their ability to engage ventral flexion. The cumulative SB in the lumbar region in carnivorans largely depends on the mode of running and hunting. Thus, adaptation to prolonged and enduring pursuit of prey in hyenas is accompanied by markedly reduced SB flexibility in the lumbar region. A more dorsostable run is also a characteristic of the Ursidae, and the peculiar maned wolf. Representatives of Felidae and Canidae have significantly more available SB mobility in the lumbar region. However, they fully engage it only occasionally at key moments of the hunt associated with the direct capture of the prey or when running in a straight line at maximum speed.

Effects of Breathing Exercise of Pilates on Dysfunction and Lumbar Flexibility in Patients with Chronic Non-Specific Low Back Pain

Effects of Breathing Exercise of Pilates on Dysfunction and Lumbar Flexibility in Patients with Chronic Non-Specific Low Back Pain

Effect of Self-Myofascial Release of the Lower Back on Myofascial Gliding, Lumbar Flexibility, and Abdominal Trunk Muscle Strength: A Crossover Study.

Roller massage has been recognized as an effective intervention for managing various conditions. However, data on the effects of roller massage on the dynamic mechanisms of the myofascial and soft tissues of the lower back are limited. This study aimed to examine the effect of the self-myofascial release of the lower back on myofascial gliding, lumbar flexibility, and abdominal trunk muscle strength using a roller massager. This crossover study included 24 college athletes who underwent three interventions-roller massage, static stretching, and control (rest). Before and after the intervention, lumbar and fascial gliding were evaluated using ultrasonography. Long-seat anteflexion (lumbar flexibility) and abdominal trunk muscle strength were assessed. The movement velocities of the subcutaneous tissue and the multifidus muscle over time were calculated using echo video analysis software, and gliding was estimated using the cross-correlation coefficient between the velocities. Gliding, lumbar flexibility, and abdominal trunk muscle strength showed significant intervention-by-time interactions. Roller massage significantly improved gliding, lumbar flexibility, and abdominal trunk muscle strength. The self-myofascial release of the lower back using a roller massager improved the lumbar/fascia gliding, lumbar flexibility, and abdominal trunk muscle strength compared to static stretching.

The Effect of Combined Treatment with Passive Therapy, Physical Exercises, Lumbar Traction, and Walking Program on Chronic Low Back Pain

Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders worldwide with far-reaching implications for social, economic, and public health. The study aimed to compare the effect of combined physiotherapy treatment in patients with CLBP. This observational retrospective randomized controlled study involved reviewing medical records of patients who were treated during a period of 6 weeks in the physiotherapy department of the Special Hospital for General Rehabilitation “Banja e Kllokotit,” Kllokot, Republic of Kosovo. The observational research was conducted for 60 patients, divided into two groups: Group 1: experimental group (n=30), with mean age of 41.7 years, average height of 1.68 cm, and average body mass index (BMI) of 71.7 for both sexes; Group 2: control group (n=30) with mean age of 43.1 years, average height of 1.66 cm, and average body mass index (BMI) of 71.5 for both sexes. In Group 1, combined treatment with passive therapy [thermotherapy and transcutaneous electrical nerve stimulation (TENS)], physical exercises, lumbar traction, and walking program was applied, while in Group 2, passive therapy like thermotherapy and TENS was applied. Outcome measurements included pain intensity, lumbar flexibility, revised Oswestry disability index (ODI), and self-confidence, which were assessed pre-treatment, at 3 weeks, and after 6 weeks of clinical treatment. The results showed significant improvement in both groups. However, the improvement was greater and with a significant difference only after 6 weeks in Group 1 compared to Group 2. The differences were observed in various outcome measures, including the visual analog scale for pain (VAS; p&lt;0.0001), fingertip-to-floor distance (FTF; p&lt;0.0001), ODI (p&lt;0.0001), and Rosenberg self-esteem scale (RSE; p=0.0002). According to our data, combined treatment with thermotherapy, therapeutic exercises, lumbar traction, TENS, and walking program was more effective and can be considered as a treatment protocol for patients with CLBP. However, further research is recommended on the efficacy of combined physiotherapy treatment, especially lumbar traction for longer periods.

Relationship between core muscles, leg arch, hamstring and lumbar flexibility on pop-up ability among surfers

Background: Surfing is a sport that requires alternating high, medium, and low intensity at one time. Surfing combines three phases, namely paddling, pop-up, and wave-ride. The surf pop-up phase is characterized by a change from a paddling position to a standing position on the surfboard in one dynamic motion. During this transition, a surfer must move 75% of his body weight in less than one second. Pop-up movement is a unique challenge for the human motor system because it must be done quickly, with sufficient strength, on a moving and unstable surface that requires the readiness of the bio motoric component to avoid injury. This study aimed to see the relationship between core muscles, leg arches, hamstring, and lumbar flexibility on pop-up ability among surfers.&#x0D; Methods: The research uses analytic observational with a cross-sectional approach. The number of samples was 80 people with inclusion criteria, men aged 20-40 years and at least one year of surfing experience. Core muscles were measured using the curl-up test, the footprint test measured leg arches, hamstring flexibility by the sit and reach test, lumbar flexibility by the modified Schober's test, and pop-up ability using the time to pop-up. The research was conducted in Badung regency.&#x0D; Results: This study showed a significant and strong relationship between core muscles (r= 0,57, p-value&lt; 0.001), leg arches (rs= 0.33-0.43, p-values= 0.009 - &lt;0.001), hamstring and lumbar flexibility (rs= 0.31-0.50, p-values= 0.013 - &lt;0.001) on pop-up ability among surfers.&#x0D; Conclusion: There were significant relationships between the core muscles, leg arches, hamstring and lumbar flexibility on pop-up ability among surfers.

Association of age and spinopelvic function in patients receiving a total hip arthroplasty

Restricted spinopelvic mobility received attention as a contributing factor for total hip arthroplasty (THA) instability. However, it is still unknown, how the spinopelvic function is influenced by age. In identifying the patients at highest risk for altered spinopelvic mechanics the study aimed to determine the association of age on the individual segments of the spinopelvic complex and global spinal sagittal alignment in patients undergoing THA. 197 patients were included in the prospective observational study conducting biplanar stereoradiography (EOS) in standing and sitting position pre-and postoperatively. Two independent investigators assessed C7-sagittal vertical axis (C7-SVA), cervical lordosis (CL), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), anterior plane pelvic tilt (APPT), and pelvic femoral angle (PFA). Key segments of the spinopelvic complex are defined as lumbar flexibility (∆ LL = LLstanding − LLsitting), pelvic mobility (∆ SS = SSstanding − SSsitting) and hip motion (∆ PFA = PFAstanding − PFAsitting). Pelvic mobility was further defined based on ∆ SS = SSstanding − SSsitting as stiff (∆ SS < 10°), normal (∆ SS ≥ 10°–30°) and hypermobile (∆ SS > 30°). The patient collective was classified into three groups: (1) < 60 years (n = 56), (2) ≥ 60–79 years (n = 112) and (3) ≥ 80 years (n = 29). Lumbar flexibility (∆ LL) was decreased with increasing age between all groups (36.1° vs. 23.1° vs. 17.2°/p1+2 < 0.000, p2+3 = 0.020, p1+3 < 0.000) postoperatively. Pelvic mobility (∆ SS) was decreased in the groups 2 and 3 compared to group 1 (21.0° and 17.9° vs. 27.8°/p1+2 < 0.000, p2+3 = 0.371, p1+3 = 0.001). Pelvic retroversion in standing position (APPT) was higher in group 2 and 3 compared to group 1 (1.9° and − 0.5° vs 6.9°/p1+2 < 0.000, p2+3 = 0.330, p1+3 < 0.000). Global sagittal spinal balance (C7-SVA) showed more imbalance in groups 2 and 3 compared to group 1 (60.4 mm and 71.2 mm vs. 34.5 mm/p1+2 < 0.000, p2+3 = 0.376, p1+3 < 0.000) postoperatively. The preoperative proportion of patients with stiff pelvic mobility in group 1 was distinctly lower than in group 3 (23.2% vs. 35.7%) and declined in group 1 to 1.8% compared to 20.7% in group 3 after THA. Changes after THA were reported for groups 1 and 2 representing spinopelvic complex key parameter lumbar flexibility (∆ LL), pelvic mobility (∆ SS) and hip motion (∆ PFA), but not for group 3. This is the first study to present age-adjusted normative values for spinopelvic mobility. The subgroups with increased age were identified as risk cohort for altered spinopelvic mechanics and enhanced sagittal spinal imbalance and limited capacity for improvement of mobility after THA. This valuable information serves to focus in the preoperative screening on the THA candidates with the highest risk for abnormal spinopelvic function.

Finger-Floor Distance Is Not a Valid Parameter for the Assessment of Lumbar Mobility

Low back pain (LBP) could be associated with a reduced lumbar mobility. For the evaluation of lumbar flexibility, parameters such as finger-floor distance (FFD) are historically established. However, the extent of the correlation of FFD to lumbar flexibility or other involved joint kinematics such as pelvic motion, as well as the influence of LBP, is not yet known. We conducted a prospective cross-sectional observation study with 523 participants included (167 with LBP > 12 weeks, 356 asymptomatic). LBP-participants were matched for sex, age, height, and body-mass-index with an asymptomatic control cohort, resulting in two cohorts with 120 participants each. The FFD in maximal trunk flexion was measured. The Epionics-SPINE measurement-system was used to evaluate the pelvic and lumbar Range-of-Flexion (RoF), and the correlation of FFD to pelvic- and lumbar-RoF was evaluated. In an asymptomatic sub-cohort of 12 participants, we examined the individual correlation of FFD to pelvic- and lumbar-RoF under gradual trunk flexion. Participants with LBP showed a significantly reduced pelvic-RoF (p < 0.001) and lumbar-RoF (p < 0.001) as well as an increased FFD (p < 0.001) compared to the asymptomatic control cohort. Asymptomatic participants exhibited a weak correlation of FFD to pelvic-RoF and lumbar-RoF (r < 0.500). LBP patients revealed a moderate correlation of FFD to pelvic-RoF (male: p < 0.001, r = -0.653, female: p < 0.001, r = -0.649) and sex-dependent to lumbar-RoF (male: p < 0.001, r = -0.604, female: p = 0.012, r = -0.256). In the sub-cohort of 12 participants, gradual trunk flexion showed a strong correlation of FFD to pelvic-RoF (p < 0.001, r = -0.895) but a moderate correlation to lumbar-RoF (p < 0.001, r = -0.602). The differences in FFD in an individual patient, assuming consistent hip function, may be attributed partially to the differences in lumbar flexibility. However, the absolute values of FFD do not qualify as a measure for lumbar mobility. Rather, using validated non-invasive measurement devices should be considered.

Comparison of Matrix Rhythm Therapy Versus Pilates on Pain, Lumbar Flexibility, Functional Impairments, and Pelvic Inclination in Chronic Low Back Pain

Comparison of Matrix Rhythm Therapy Versus Pilates on Pain, Lumbar Flexibility, Functional Impairments, and Pelvic Inclination in Chronic Low Back Pain

Core muscle strengths, lumbar flexibility and quality of life in lenke type 5 AIS patients treated with either Cobb to Cobb VBT versus fusion compared with healthy individuals

Core muscle strengths, lumbar flexibility and quality of life in lenke type 5 AIS patients treated with either Cobb to Cobb VBT versus fusion compared with healthy individuals

Spinal stability analysis of lumbar interbody fusion according to pelvic type and cage angle based on simplified spinal model with various pelvic indices.

Recently, the objectives of lumbar interbody fusion (LIF) have been extended to include the correction of broader/relative indications in addition to spinal fixation. Accordingly, LIF must be optimized for sagittal alignment while simultaneously achieving decompression. Therefore, a representative model classified into three pelvic types, i.e., neutral pelvis (NP), anterior pelvis (AP), and retroverted pelvis (RP), was selected according to the pelvic index, and LIF was performed on each representative model to analyze Lumbar lordosis (LL) and the corresponding equivalent stress. The finite element (FE) model was based on a sagittal 2D X-ray image. The calculation efficiency and convergence were improved by simplifying the modeling of the vertebral body in general and its posterior portion in particular. Based on the position of the pelvis, according to the pelvic shape, images of patients were classified into three types: AP, RP, and NP. Subsequently, representative images were selected for each type. The fixation device used in the fusion model was a pedicle screw and a spinal rod of a general type. PEEK was used as the cage material, and the cage shape was varied by using three different cage angles: 0°, 4°, and 8°. Spinal mobility: The pelvic type with the highest range of motion (ROM) for the spine was the NP type; the AP type had the highest LL. Under a combination load, the NP type exhibited the highest lumbar flexibility (LF), which was 2.46° lower on average compared to the case where a pure moment was applied. Equivalent stress on the spinal fixation device: The equivalent stress acting on the vertebrae was lowest when cage 0 was used for the NP and AP type. For the RP type, the lowest equivalent stress on the vertebrae was observed when cage 4 was used. Finally, for the L5 upper endplate, the stress did not vary significantly for a given type of cage. In conclusion, there was no significant difference in ROM according to cage angle, and the highest ROM, LL and LF were shown in the pelvic shape of NP type. However, when comparing the results with other pelvic types, it was not possible to confirm that LF is completely dependent on LL and ROM.

Spinopelvic Adaptations in Standing and Sitting Positions in Patients With Adult Spinal Deformity.

PurposeTo describe spinopelvic adaptations in the standing and sitting positions in patients with adult spinal deformity (ASD).MethodsNinety-five patients with ASD and 32 controls completed health-related quality of life (HRQOL) questionnaires: short form 36 (SF36), Oswestry Disability Index (ODI), and visual analog scale (VAS) for pain. They underwent biplanar radiography in both standing and sitting positions. Patients with ASD were divided into ASD-front (frontal deformity Cobb > 20°, n = 24), ASD-sag (sagittal vertical axis (SVA) > 50 mm, pelvic tilt (PT) > 25°, or pelvic incidence (PI)-lumbar lordosis (LL) > 10°, n = 40), and ASD-hyper thoracic kyphosis (TK >60°, n = 31) groups. Flexibility was defined as the difference (Δ) in radiographic parameters between the standing and sitting positions. The radiographic parameters were compared between the groups. Correlations between HRQOL scores were evaluated.ResultsAll participants increased their SVA from standing to sitting (ΔSVA<0), except for patients with ASD-sag, who tended to decrease their SVA (78-62 mm) and maximize their pelvic retroversion (27-40° vs 10-34° in controls, p<0.001). They also showed reduced thoracic and lumbar flexibility (ΔLL = 3.4 vs 37.1°; ΔTK = −1.7 vs 9.4° in controls, p<0.001). ASD-hyperTK showed a decreased PT while sitting (28.9 vs 34.4° in controls, p<0.001); they tended to decrease their LL and TK but could not reach values for controls (ΔLL = 22.8 vs 37.1° and ΔTK = 5.2 vs 9.4°, p<0.001). The ASD-front had normal standing and sitting postures. ΔSVA and ΔLL were negatively correlated with the physical component scale (PCS of SF36) and ODI (r = −0.39 and r = −0.46, respectively).ConclusionPatients with ASD present with different spinopelvic postures and adaptations from standing to sitting positions, with those having sagittal malalignment most affected. In addition, changes in standing and sitting postures were related to HRQOL outcomes. Therefore, surgeons should consider patient sitting adaptations in surgical planning and spinal fusion. Future studies on ASD should evaluate whether physical therapy or spinal surgery can improve sitting posture and QOL, especially for those with high SVA or PT.

Hip replacement improves lumbar flexibility and intervertebral disc height — a prospective observational investigation with standing and sitting assessment of patients undergoing total hip arthroplasty

PurposeThe pathogenic mechanism of the hip–spine syndrome is still poorly elucidated. Some studies have reported a reduction in low back pain after total hip arthroplasty (THA). However, the biomechanical mechanisms of THA acting on the lumbar spine are not well understood. The aim of the study is to evaluate the influence of THA on (1) the lumbar lordosis and the lumbar flexibility and (2) the lumbar intervertebral disc height.MethodsA total of 197 primary THA patients were prospectively enrolled. Pre- and post-operative biplanar stereoradiography was performed in standing and sitting positions. Spinopelvic parameters (lumbar lordosis (LL), pelvic tilt, sacral slope, pelvic incidence), sagittal spinal alignment (sagittal vertical axis, PI-LL mismatch (PI-LL)) and lumbar disc height index (DHI) for each segment (L1/2 to L5/S1) were evaluated. The difference between standing and sitting LL (∆LL = LLstanding − LLsitting) was determined as lumbar flexibility. Osteochondrosis intervertebralis was graded according to Kellgren and Lawrence (0–4), and patients were assigned to subgroups (mild: 0–2; severe: 3–4).ResultsLumbar flexibility increased significantly after THA (pre: 22.04 ± 12.26°; post: 25.87 ± 12.26°; p < 0.001), due to significant alterations in LL in standing (pre: 51.3 ± 14.3°; post: 52.4 ± 13.8°; p < 0.001) and sitting (pre: 29.4 ± 15.4°; post: 26.7 ± 15.4°; p = 0.01). ∆LL increased significantly in both subgroups stratified by osteochondrosis (pre/post: ΔLLmild: 25.4 (± 11.8)/29.4 ± 12.0°; p < 0.001; ΔLLsevere: 17.5 (± 11.4)/21.0 ± 10.9°; p = 0.003). The DHI increased significantly from pre-operatively to post-operatively in each lumbar segment. PI-LL mismatch decreased significantly after THA (pre: 3.5°; post: 1.4°; p < 0.001).ConclusionThe impact of THA on the spinopelvic complex was demonstrated by significantly improved lumbar flexibility and a gain in post-operative disc height. These results illustrate the close interaction between the pelvis and the vertebral column. The investigation provides new insights into the biomechanical patterns influencing the hip–spine syndrome.

Improvement Effort Of Lumbar Flexibility Through Pilates Exercise For Post -Partum Women

Post-partum atau nifas adalah periode yang dikenal dengan masa rehabilitasi setelah hamil dan melahirkan. Permasalahan pada ibu-ibu post partum setelah melahirkan adalah mengalami ketidaklenturan lumbal; fleksibilitas lumbal menurun, otot-otot yang menopang saat kehamilan kendor, dan lainnya. Salah satu upaya untuk mengembalikan oto-oto kehamilan kembali ke keadaan belum hamil adalah dnegan melakukan pilates exercise. Pelaksanaan senam atau latihan pilates ini sangat bermanfaat untuk meningkatkan fleksibilitas lumbal dan otot-otot serta ligament-ligament yang menopang beban saat kehamilan berlangsung. Tujuan dari pengabdian masyarakat ini adalah untuk meningkatkan kelenturan lumbal, sehingga otot-otot kehamilan tersebut bisa kembali ke keadaan sebelum hamil dengan segera. Metode yang digunakan adalah demonstrasi dan pengimplementasian piates pada 10 ibu nifas atau post partum pada tahun 2021. Hasil yang didapat setelah melakukan pilates exercise, didapatkan flexibilitas lumbar ibu post-partum meningkat di range 20-21 (30%) dan &gt; 21 (70%) dengan pengukuran Modifies Schober Test (MST). Kesimpulan bahwa flexibilitas lumbar ibu post partum meningkat setelah melakukan pilates exercise. Perlu disarankan latihan senam pilates pada ibu post partum setelah melahirkan, karena memberikan manfaat banyak tanpa efek samping, nyaman, ekonomi, dan mudah dilakukan

Immediate effects of muscle energy technique (post isometric relaxation) and static stretching in improving lumbar range of motion and iliopsoas flexibility on iliopsoas muscle tightness

Iliopsoas is a compound muscle which consists of the psoas major and iliacus. Shortening of the iliopsoas muscle was found to be the primary cause of lumbar hyper lordosis and excessive anterior pelvic tilt. iliopsoas is a muscle of lower extremity prone to tightness with prevelance of 83% in young and middle-aged adults leading to lower back pain. Aim of the study: The aim of the study was to compare the effect of static stretching and muscle energy technique to improve lumbar range of motion and iliopsoas flexibility. Study design: A Research with experimental design was performed in 2 groups that were selected from collage in Navsari. Methodology: Immediate effect comparative study to evaluate the effectiveness of MET versus Static Stretching techniques for iliopsoas tightness. One group was given MET and other group was given Static Stretchig. Modified Thomas test and schobers test was taken for lumbar flexibility and lumbar range of motion in iliopsoas tightness subject.Result: The MET (Group A) was associated with a statistically significant change in Lumbar flexibility than Static Stretching (Group B). There was no statistically significant change observed Lumbar range of motion in both the groups. Conclusion: The present study concluded that both MET and Static Stretching technique are shown to have an effect on improving lumbar range of motion and lumbar flexibility. The MET technique was found clinically more effective in improving lumbar range of motion and lumbar flexibility in iliopsoas tightness muscle. However, there is no significant difference found in lumbar flexibility between both the groups MET and Static stretching groups.