Sway-back Posture Research Articles

Dear DrDr Omid Massah Thank you very much for submitting your manuscript to Physical Treatments Journal. Your Manuscript with the code "A-10-263-1" and entitled " Is Opium Smoking A Cause of Sway Back Posture and Spinal Musculoskeletal Disorders? What is the Relation?", has been reviewed by PTJ international reviewers and their comments are included at the bottom of this letter

Cultural care in nursing is an essential component of holistic healthcare that recognizes the importance of cultural diversity in patient care. As societies become increasingly multicultural, the healthcare system must adapt to meet the diverse needs of its patient population [1]. Nurses, often at the frontline of patient care, play a critical role in providing culturally competent care that respects and responds to their patients' cultural backgrounds. This article explores cultural care's significance in nursing, its challenges, and strategies for effective implementation [2].

The comparison of the psoas muscle thickness and strength, and sagittal lumbopelvic alignment in female gymnasts with sway-back posture and normal posture

The comparison of the psoas muscle thickness and strength, and sagittal lumbopelvic alignment in female gymnasts with sway-back posture and normal posture

The Relationship between Posture and Muscle Tensive Dysphonia in Teachers: A Systematic Scoping Review.

Teachers usually present work-related pain such as neck pain. Their posture could be the cause of these problems; indeed, it is often a sway-back posture. Furthermore, teachers can also experience problems with their voice such as dysphonia, specifically muscle tension dysphonia (MTD). This scoping review aims to find the correlation between teachers' posture and MTD. It also studies how a posture-based treatment can influence this disorder. Randomized controlled trials, controlled clinical trials, prospective cohort studies, and cross-sectional studies that considered the relationship between posture and MTD and that included teachers in their sample. The search led to an initial number of 396 articles; after the screening process, a final number of eight articles were included. A total of 303 patients were analyzed and all showed altered alignment of the head around the cervical spine with hypertonus of the cricothyroid, suprahyoid, and sternocleidomastoid muscles. Although MTD is a disorder with a multifactorial etiology, the articles revealed a correlation between posture and MTD related to a forward protraction of the cervical spine with a hypertonus of the laryngeal and hyoid musculature. This study also detected that an intervention in posture could reduce vocal disorders.

Assessing the effects of sway-back posture on global and regional spinal sagittal angles using inertial measurement units.

Sway-back posture in the sagittal profile is a commonly adopted poor standing posture. Although the terms, definitions, and adverse health problems of sway-back posture are widely used clinically, few studies have quantified sway-back posture. To investigate spinal sagittal alignment in sway-back posture while standing based on global and regional angles using inertial measurement units (IMUs). This cross-sectional study recruited 30 asymptomatic young adults. After measuring the sway angle while standing, the participants were divided into sway-back and non-sway-back groups (normal thoracic group). Each participant stood in a comfortable posture for 5 seconds with IMUs at the T1, T7, T12, L3, and S2 levels. Then, we measured the global and regional lumbar and thoracic angles and sacral inclination in the standing position. Although there was no difference in the global lumbar angle, there was a difference in regional lumbar angles between the two groups. The normal thoracic group had balanced lumbar lordosis between the upper and lower lordotic arcs, whereas the sway back group tended to have a flat upper lumbar angle and increased lower lumbar angle. It is useful to assess the global and regional angles in the spinal sagittal assessment of individuals with sway-back posture.

Changes in Trunk Muscle Activity during Unilateral Weight Bearing and Abnormal Postural Gait in Healthy Individuals.

Background and Objectives: Many people tend to carry their bags or baggage on only one side of their body. Due to smartphone use, people also tend to walk bent forward in a kyphotic posture. In this study, we aimed to assess trunk muscle activity changes due to weight-bearing, carried in the left or right hand, and using three different gait postures. Materials and Methods: We recruited 27 healthy participants (aged 19−75 years) with no history of LBP within the last 6 months before study participation. Electromyographic activities of the lower back and the abdominal muscles of the participants were evaluated using four-channel surface electromyography (EMG). Surface EMG recordings were obtained from four trunk muscles, including the flexor (rectus abdominis (RA), external oblique (EO)) and extensor muscles (lumbar erector spinae (LE), and the superficial lumbar multifidus (LM)), during unilateral weight-bearing tasks and with different gait postures (normal gait, with a sway back, and thoracic kyphosis). Results: In the “unilateral weight-bearing task”, there was a significant difference in the activity of all the trunk muscles between the weight-bearing limb side and the opposite side (p < 0.05). The activation of the left trunk muscle was greater than that of the right trunk muscle when the dumbbell was lifted using the right hand. The other side showed the same result. In the “gait posture task” performed by the participants using a sway-back posture, the RA and EO had a higher level of activity in the stance and swing phases compared with that in a neutral gait (p < 0.05). Moreover, in the participants with a thoracic kyphosis posture, the LE and LM had a higher level of activity compared with that in a neutral gait (p < 0.05). Conclusions: Our results indicate that abnormal gait posture and unilateral weight-bearing tasks may impair the balance of trunk muscles, increasing the incidence of LBP. However, further large-scale, prospective, controlled studies are warranted to corroborate our results.

Method for co-registration of high resolution 3Tmagnetic resonance imaging with standing 0.5T magnetic resonance imagingto investigate weight bearing joints

Method for co-registration of high resolution 3Tmagnetic resonance imaging with standing 0.5T magnetic resonance imagingto investigate weight bearing joints

Kinematic Analysis of the Musculoskeletal System Diabetic Type I

This study aimed to apply the principles of biomechanics science correctly, also to be is nested in the treatment of diabetics, and establish kinematic record for musculoskeletal diabetics. In order to improve the quality of life and care for diabetics. To achieve this, the researchers used the kinematic analysis of the musculoskeletal system for (8) mail patients with type1 diabetes, purposive selected and belonging to Jordanian team of Diabetes (age: 21±0.7years, height: 164± 4 cm, mas:58± 0.2 kg, the experience of the disease, 13.3±0.8 years). The study sample was filmed by using video camera (Sony HDR-CX220E) reached speed (50) frame/s. The study results showed that musculoskeletal system for Diabetic Type I differences in their shape of musculoskeletal the rest of the population, consequently people with Type 1 Diabetes have a swayback posture and a lower chest forward posture. and the average of sample study in the flexion spine(77)° and (15)°for extension spine. Where it formed 81% from natural flexion spine and 45% from natural extension spine. The researchers recommend: the necessity informed Diabetic Type I on kinematic analysis of the musculoskeletal system.

Effect of standing postural deviations on trunk and hip muscle activity

[Purpose] It is very important to consider effects that postural deviations has on muscle activity when treating low back pain. Therefore, activities of trunk and hip joint muscles in healthy adults while they attempted three postural conditions of neutral, sway-back, and lordosis was compared and evaluated in this study. [Subjects and Methods] The subjects comprised 17 healthy adult male volunteers. The muscle activity and spinal curve were measured while the subjects attempted different postural conditions (neutral, sway-back, and lordosis) as defined in the text. [Results] Activity of trunk and hip inner muscles was decreased in sway-back posture, and only activity of the trunk back muscles was increased in lordosis. [Conclusion] This results were suggested that postural deviations affected muscle control in the lumbo-pelvic area.

Muscle activity patterns in different standing postures in people with recurrent lower back pain

Background: Excessive lordosis or kyphosis of the spine is thought to be a cause of lower back pain (LBP), and reportedly creates irregularities in lumbar extensor activity (Shirado, 1995). The iliopsoas (ILIO) is thought to play a role in LBP in patients with recurrent LBP (RLBP) (Lee, 2013). Recent research has shown that activity of local muscles deep in the trunk is important in preventing LBP (Hodges, 2009), althoughmany details of this remain unclear. There have been no reports on differences in lumbar extensor activity related to different postures between people with and without RLBP. Purpose: To clarify differences in lumbar extensor activity between people with and without RLBP with respect to different standing postures, and to elucidate how the trunk and hip flexors used in lumbar extension are responsible for controlling lower back and spinal alignment. Methods: Subjects included 11 adults with RLBP (RLBP group), and nine healthy adults with no history of orthopedic diseases in the legs or trunk (pain-free group). We measured activity of the ILIO, multifidus (MF), iliocostalis lumborum (IL), and iliocostalis thoraces (IT) muscles using an MQ16 (Kissei Comtec). Each subject stood in a relaxed standing posture, a flat posture, a swayback posture, and a lordosis posture. Subjects maintained the postures for ten seconds with the help of pictures, verbal instructions, and manual guidance while we measuredmuscle activity. Additionally, we placedmarkers in eleven locations, including T1, T7, T12, L3, S2, ASIS, PSIS, the greater trochanter, and the knee joint lateral epicondyle. We took pictures of each posture with a digital camera, and defined each posture by calculating the alignment of the thoracic vertebra, the lumbar, and the pelvis based on the angle change at each. Differences in muscle activity between the two groups were assessed by an independent t-test using SPSS 12.0J. A P-value < 0.05 was considered significant. Results: In the standing posture, there were no significant differences in muscle activity between the two groups. In the flat posture, MF and IT muscle activity was greater in the RLBP group than in the pain-free group (P< 0.05). In the swaybackposture, ITmuscle activitywas greater in theRLBP group than in the pain-free group (P< 0.05). In the lordosis posture, MF muscle activity was greater in the RLBP group than in the pain-free group (P< 0.05). Conclusion(s): Muscle activity increased in global muscles and decreased in local muscles in people with RLBP. However, muscle activity in the upright and lordosis postures suggested that hyperkinesia in the MF, which is a local muscle, plays a role in lumbar lordosis. Furthermore, in the RLBP group, maintenance of vertical stability in the spine seems to be attained not only by the lumbar extensors, but also due to hyperkinesia in the IT,which plays a role in lumbar extension. Implications:This studywill lead to newdevelopments in physical therapy for people with RLBP by clarifying posture control patterns in these patients.

The impact of faulty posture on rotator cuff tears with and without symptoms

We hypothesized that the prevalence of rotator cuff tears would be higher among individuals with poor posture, regardless of the presence of symptoms. The study initially comprised 525 residents of a mountain village who participated in an annual health check. Participants completed a background questionnaire, and physical examinations were performed to evaluate shoulder function. Ultrasonographic examinations were also performed to identify rotator cuff tears, and participants were grouped according to the presence or absence of tears. Posture was classified by 2 observers into 4 types according to the classification of Kendall, as follows: ideal alignment, kyphotic-lordotic posture, flat-back posture, and sway-back posture. Univariate analyses were performed to compare differences in background characteristics between groups, then multivariate analysis was performed to identify those factors associated with rotator cuff tears. Final analysis was performed for 379 participants (135 men, 244 women; mean age, 62.0 years; range, 31-94 years) showing the same posture classification from both observers. Of these, 93 (24.5%) showed rotator cuff tear in one shoulder and 45 (11.9%) showed tears in both. Prevalence of rotator cuff tears was 2.9% with ideal alignment, 65.8% with kyphotic-lordotic posture, 54.3% with flat-back posture, and 48.9% with sway-back posture. Logistic regression analysis identified increased age, abnormal posture, and past pain as factors associated with rotator cuff tears. Postural abnormality represented an independent predictor of both symptomatic and asymptomatic rotator cuff tears. These results may help define preventive measures for rotator cuff tears and in design ing rehabilitation therapies for shoulder disease.

Effect of posture on hip angles and moments during gait

Anterior hip pain is common in young, active adults. Clinically, we have noted that patients with anterior hip pain often walk in a swayback posture, and that their pain is reduced when the posture is corrected. The purpose of this study was to investigate a potential mechanism for the reduction in pain by testing the effect of posture on movement patterns and internal moments during gait in healthy subjects. Fifteen subjects were instructed to walk while maintaining three postures: 1) natural, 2) swayback, and 3) forward flexed. Kinematic and force data were collected using a motion capture system and a force plate. Walking in the swayback posture resulted in a higher peak hip extension angle, hip flexor moment and hip flexion angular impulse compared to natural posture. In contrast, walking in a forward flexed posture resulted in a decreased hip extension angle and decreased hip flexion angular impulse. Based on these results, walking in a swayback posture may result in increased forces required of the anterior hip structures, potentially contributing to anterior hip pain. This study provides a potential biomechanical mechanism for clinical observations that posture correction in patients with hip pain is beneficial.

Classification System of the Normal Variation in Sagittal Standing Plane Alignment

Cohort study. To construct a sagittal standing alignment classification system in which the clinical significance of identified subgroups was considered with spinal pain measures. Numerous grading systems for the categorization of sagittal standing alignment have been devised. However, no common consensus exists about which typology should be adopted. Furthermore, the clinical significance of proposed classification schemes has rarely been assessed in terms of their relationship with spinal pain. Given the importance of the adolescent period for musculoskeletal development, research within a young adolescent population is required. The study population consisted of 639 prepeak height velocity boys (mean age, 12.6 yr [standard deviation, 0.54 yr]). Sagittal posture was quantified during habitual standing; data were used to develop a classification system according to 3 gross postural and 5 lumbopelvic characteristics. Prevalence rates of spinal pain measures (pain and seeking care) were compared between postural subgroups. Cluster analysis indicated 3 types of characteristic overall sagittal profiles: neutral global alignment (n = 266 [41.6%]), sway-back (n = 199 [31.1%]), and leaning-forward (n = 174 [27.2%]). Within each of these categories, postural subgroups could be established according to specific lumbopelvic features. Logistic regression revealed that prevalence (lifetime and month) of low back pain and neck pain was significantly higher in boys classified as having sway-back posture than in those classified as having neutral global alignment. Spinal pain measures did not differ between groups of the lumbopelvic subclassification. Meaningful classifications exist for sagittal plane posture in young adolescent boys, both on gross body segment and lumbopelvic level. In terms of clinical importance, that is, low back pain and neck pain prevalence, postural subgrouping strategies based on the orientation of gross body segments are suggested to be superior when compared with lumbopelvic grading.

Fat infiltration in the lumbar multifidus and erector spinae muscles in subjects with sway-back posture.

Decreased activity of the lumbar stabilizer muscles has been identified in individuals with sway-back posture. Disuse can predispose these muscles to atrophy, which is characterized by a reduced cross-sectional area (CSA) and by fat infiltration. The aim of this study was to evaluate the amount of fat infiltration in the lumbar multifidus and lumbar erector spinae muscles as a sign of the muscle atrophy in individuals with sway-back posture, with and without low back pain. Forty-five sedentary individuals between 16 and 40years old participated in this study. The sample was divided into three groups: symptomatic sway-back (SSBG) (n=15), asymptomatic sway-back (ASBG) (n=15), and control (CG) (n=15). The individuals were first subjected to photographic analysis to classify their postures and were then referred for a magnetic resonance imaging (MRI) examination of the lumbar spine. The total (TCSA) and functional (FCSA) cross-sectional areas of the lumbar erector spinae together with lumbar multifidus and isolated lumbar multifidus muscles were measured from L1 to S1. The amount of fat infiltration was estimated as the difference between the TCSA and the FCSA. Greater fat deposition was observed in the lumbar erector spinae and lumbar multifidus muscles of the individuals in the sway-back posture groups than in the control group. Pain may have contributed to the difference in the amount of fat observed in the groups with the same postural deviation. Similarly, sway-back posture may have contributed to the tissue substitution relative to the control group independently of low back pain. The results of this study indicate that individuals with sway-back posture may be susceptible to morphological changes in their lumbar erector spinae and lumbar multifidus muscles, both due to the presence of pain and as a consequence of their habitual posture.

Abdominal Muscle Endurance and its Association with Posture and Low Back Pain: An initial investigation in male and female élite gymnasts

Low back pain is a common consequence of gymnastic training. Potential aetiological factors include postural muscle weakness and abnormal posture. This study assessed the incidence of, and relationship between, reduced postural muscle endurance, posture type and low back pain in 12 male and 10 female élite gymnasts and matched controls. Postural muscle endurance was assessed using a pressure biofeedback unit (PBU). Posture was categorised subjectively by observation. History of low back pain was determined by questionnaire. Postural muscle endurance was non-significantly reduced (P > 0.05) in all gymnasts. The most common postures reported were sway-back (male gymnasts 100%; male controls 62.5%), lordosis (female gymnasts 80%) and normal (female controls 70%). Low back pain was reported in two female gymnasts, two female controls, nine male gymnasts and two male controls. Postural muscle endurance tended to reduce (P > 0.05) in those subjects with low back pain and lordotic postures. Low back pain was slightly more prevalent in those subjects with a sway-back posture. There is some evidence of a link between low back pain, posture and postural muscle endurance in gymnasts although no cause-and-effect relationships can be determined. These data should be further investigated and the practical implications for gymnasts and their training should be evaluated. Low back pain is a common consequence of gymnastic training. Potential aetiological factors include postural muscle weakness and abnormal posture. This study assessed the incidence of, and relationship between, reduced postural muscle endurance, posture type and low back pain in 12 male and 10 female élite gymnasts and matched controls. Postural muscle endurance was assessed using a pressure biofeedback unit (PBU). Posture was categorised subjectively by observation. History of low back pain was determined by questionnaire. Postural muscle endurance was non-significantly reduced (P > 0.05) in all gymnasts. The most common postures reported were sway-back (male gymnasts 100%; male controls 62.5%), lordosis (female gymnasts 80%) and normal (female controls 70%). Low back pain was reported in two female gymnasts, two female controls, nine male gymnasts and two male controls. Postural muscle endurance tended to reduce (P > 0.05) in those subjects with low back pain and lordotic postures. Low back pain was slightly more prevalent in those subjects with a sway-back posture. There is some evidence of a link between low back pain, posture and postural muscle endurance in gymnasts although no cause-and-effect relationships can be determined. These data should be further investigated and the practical implications for gymnasts and their training should be evaluated.