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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

Lateral bending movement represented in frontal plane (C1, T1, T6, L1, L3, S1, LASI and RASI trajectories) for the different groups. On the left (Figure 5A) the "hourglass" shape of a normal subject, in the center (Figure 5B) the "cone" shape of a representative obese subject and on the right the "wider cone" shape of a cLBP subject.
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Figure 5: Lateral bending movement represented in frontal plane (C1, T1, T6, L1, L3, S1, LASI and RASI trajectories) for the different groups. On the left (Figure 5A) the "hourglass" shape of a normal subject, in the center (Figure 5B) the "cone" shape of a representative obese subject and on the right the "wider cone" shape of a cLBP subject.

Mentions: The qualitative analysis of lateral bending by locating the CoR showed different trajectories among groups: subjects in C showed an "hourglass" shape (Figure 5A), while O and cLBP showed a "cone" shape (Figure 5B and Figure 5C). CoR was located between L1 and L3 in C (CoR Zone: 2) and between S1 and ASIS in O and cLBP (CoR Zone: 5; Mann-Whitney p = 0.007 and p = 0.012 respectively).


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)

Lateral bending movement represented in frontal plane (C1, T1, T6, L1, L3, S1, LASI and RASI trajectories) for the different groups. On the left (Figure 5A) the "hourglass" shape of a normal subject, in the center (Figure 5B) the "cone" shape of a representative obese subject and on the right the "wider cone" shape of a cLBP subject.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Lateral bending movement represented in frontal plane (C1, T1, T6, L1, L3, S1, LASI and RASI trajectories) for the different groups. On the left (Figure 5A) the "hourglass" shape of a normal subject, in the center (Figure 5B) the "cone" shape of a representative obese subject and on the right the "wider cone" shape of a cLBP subject.
Mentions: The qualitative analysis of lateral bending by locating the CoR showed different trajectories among groups: subjects in C showed an "hourglass" shape (Figure 5A), while O and cLBP showed a "cone" shape (Figure 5B and Figure 5C). CoR was located between L1 and L3 in C (CoR Zone: 2) and between S1 and ASIS in O and cLBP (CoR Zone: 5; Mann-Whitney p = 0.007 and p = 0.012 respectively).

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