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Effect of obesity and low back pain on spinal mobility: a cross sectional study in women.

Vismara L, Menegoni F, Zaina F, Galli M, Negrini S, Capodaglio P - J Neuroeng Rehabil (2010)

Bottom Line: A biomechanical model was developed in order to analyse kinematics and define angles of clinical interest. obesity was characterized by a generally reduced ROM of the spine, due to a reduced mobility at both pelvic and thoracic level; a static postural adaptation with an increased anterior pelvic tilt.Obesity with cLBP is associated with an increased lumbar lordosis.In lateral bending, obesity with cLBP is associated with a reduced ROM of the lumbar and thoracic spine, whereas obesity on its own appears to affect only the thoracic curve. obese individuals with cLBP showed higher degree of spinal impairment when compared to those without cLBP.The observed obesity-related thoracic stiffness may characterize this sub-group of patients, even if prospective studies should be carried out to verify this hypothesis.

View Article: PubMed Central - HTML - PubMed

Affiliation: Orthopaedic Rehabilitation Unit and Clinical Lab for Gait Analysis and Posture, Ospedale San Giuseppe, Istituto Auxologico Italiano, IRCCS, Via Cadorna 90, I-28824, Piancavallo (VB), Italy. lucavisma@libero.it

ABSTRACT

Background: obesity is nowadays a pandemic condition. Obese subjects are commonly characterized by musculoskeletal disorders and particularly by non-specific chronic low back pain (cLBP). However, the relationship between obesity and cLBP remains to date unsupported by an objective measurement of the mechanical behaviour of the spine and its morphology in obese subjects. Such analysis may provide a deeper understanding of the relationships between function and the onset of clinical symptoms.

Purpose: to objectively assess the posture and function of the spine during standing, flexion and lateral bending in obese subjects with and without cLBP and to investigate the role of obesity in cLBP.

Study design: Cross-sectional study

Patient sample: thirteen obese subjects, thirteen obese subjects with cLBP, and eleven healthy subjects were enrolled in this study.

Outcome measures: we evaluated the outcome in terms of angles at the initial standing position (START) and at maximum forward flexion (MAX). The range of motion (ROM) between START and MAX was also computed.

Methods: we studied forward flexion and lateral bending of the spine using an optoelectronic system and passive retroreflective markers applied on the trunk. A biomechanical model was developed in order to analyse kinematics and define angles of clinical interest.

Results: obesity was characterized by a generally reduced ROM of the spine, due to a reduced mobility at both pelvic and thoracic level; a static postural adaptation with an increased anterior pelvic tilt. Obesity with cLBP is associated with an increased lumbar lordosis.In lateral bending, obesity with cLBP is associated with a reduced ROM of the lumbar and thoracic spine, whereas obesity on its own appears to affect only the thoracic curve.

Conclusions: obese individuals with cLBP showed higher degree of spinal impairment when compared to those without cLBP. The observed obesity-related thoracic stiffness may characterize this sub-group of patients, even if prospective studies should be carried out to verify this hypothesis.

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Related in: MedlinePlus

Representation of markers and angles in frontal plane during lateral bending. On the left (Figure 3A) are shown: lateral trunk inclination (βLTI), pelvic obliquity (β1), proximal curvature (PC), distal curvature (βDC). On the right (Figure 3B) are represented: lumbar movement (β2), thoracic movement (β3), and angle of shoulders (β4).
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Figure 3: Representation of markers and angles in frontal plane during lateral bending. On the left (Figure 3A) are shown: lateral trunk inclination (βLTI), pelvic obliquity (β1), proximal curvature (PC), distal curvature (βDC). On the right (Figure 3B) are represented: lumbar movement (β2), thoracic movement (β3), and angle of shoulders (β4).

Mentions: The above mentioned angles were evaluated at the initial standing position (START) and at maximum forward flexion (MAX). The range of motion (ROM) between START and MAX was also computed. As for lateral bending, similar angles were considered (Figure 3): lateral trunk inclination (βLTI), pelvic obliquity (β1), lumbar curve (βDC), lumbar movement (β2), thoracic curve (βPC), thoracic movement (β3), and shoulders (β4).


Effect of obesity and low back pain on spinal mobility: a cross sectional study in women.

Vismara L, Menegoni F, Zaina F, Galli M, Negrini S, Capodaglio P - J Neuroeng Rehabil (2010)

Representation of markers and angles in frontal plane during lateral bending. On the left (Figure 3A) are shown: lateral trunk inclination (βLTI), pelvic obliquity (β1), proximal curvature (PC), distal curvature (βDC). On the right (Figure 3B) are represented: lumbar movement (β2), thoracic movement (β3), and angle of shoulders (β4).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2821381&req=5

Figure 3: Representation of markers and angles in frontal plane during lateral bending. On the left (Figure 3A) are shown: lateral trunk inclination (βLTI), pelvic obliquity (β1), proximal curvature (PC), distal curvature (βDC). On the right (Figure 3B) are represented: lumbar movement (β2), thoracic movement (β3), and angle of shoulders (β4).
Mentions: The above mentioned angles were evaluated at the initial standing position (START) and at maximum forward flexion (MAX). The range of motion (ROM) between START and MAX was also computed. As for lateral bending, similar angles were considered (Figure 3): lateral trunk inclination (βLTI), pelvic obliquity (β1), lumbar curve (βDC), lumbar movement (β2), thoracic curve (βPC), thoracic movement (β3), and shoulders (β4).

Bottom Line: A biomechanical model was developed in order to analyse kinematics and define angles of clinical interest. obesity was characterized by a generally reduced ROM of the spine, due to a reduced mobility at both pelvic and thoracic level; a static postural adaptation with an increased anterior pelvic tilt.Obesity with cLBP is associated with an increased lumbar lordosis.In lateral bending, obesity with cLBP is associated with a reduced ROM of the lumbar and thoracic spine, whereas obesity on its own appears to affect only the thoracic curve. obese individuals with cLBP showed higher degree of spinal impairment when compared to those without cLBP.The observed obesity-related thoracic stiffness may characterize this sub-group of patients, even if prospective studies should be carried out to verify this hypothesis.

View Article: PubMed Central - HTML - PubMed

Affiliation: Orthopaedic Rehabilitation Unit and Clinical Lab for Gait Analysis and Posture, Ospedale San Giuseppe, Istituto Auxologico Italiano, IRCCS, Via Cadorna 90, I-28824, Piancavallo (VB), Italy. lucavisma@libero.it

ABSTRACT

Background: obesity is nowadays a pandemic condition. Obese subjects are commonly characterized by musculoskeletal disorders and particularly by non-specific chronic low back pain (cLBP). However, the relationship between obesity and cLBP remains to date unsupported by an objective measurement of the mechanical behaviour of the spine and its morphology in obese subjects. Such analysis may provide a deeper understanding of the relationships between function and the onset of clinical symptoms.

Purpose: to objectively assess the posture and function of the spine during standing, flexion and lateral bending in obese subjects with and without cLBP and to investigate the role of obesity in cLBP.

Study design: Cross-sectional study

Patient sample: thirteen obese subjects, thirteen obese subjects with cLBP, and eleven healthy subjects were enrolled in this study.

Outcome measures: we evaluated the outcome in terms of angles at the initial standing position (START) and at maximum forward flexion (MAX). The range of motion (ROM) between START and MAX was also computed.

Methods: we studied forward flexion and lateral bending of the spine using an optoelectronic system and passive retroreflective markers applied on the trunk. A biomechanical model was developed in order to analyse kinematics and define angles of clinical interest.

Results: obesity was characterized by a generally reduced ROM of the spine, due to a reduced mobility at both pelvic and thoracic level; a static postural adaptation with an increased anterior pelvic tilt. Obesity with cLBP is associated with an increased lumbar lordosis.In lateral bending, obesity with cLBP is associated with a reduced ROM of the lumbar and thoracic spine, whereas obesity on its own appears to affect only the thoracic curve.

Conclusions: obese individuals with cLBP showed higher degree of spinal impairment when compared to those without cLBP. The observed obesity-related thoracic stiffness may characterize this sub-group of patients, even if prospective studies should be carried out to verify this hypothesis.

Show MeSH
Related in: MedlinePlus