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Ludwig O, Dindorf C, Kelm J, Simon S, Nimmrichter F, Fröhlich M. Reference Values for Sagittal Clinical Posture Assessment in People Aged 10 to 69 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054131. [PMID: 36901144 PMCID: PMC10001505 DOI: 10.3390/ijerph20054131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/01/2023]
Abstract
Poor posture is a well-known problem in all age groups and can lead to back pain, which in turn can result in high socio-economic costs. Regular assessment of posture can therefore help to identify postural deficits at an early stage in order to take preventive measures and can therefore be an important tool for promoting public health. We measured the posture of 1127 symptom-free subjects aged 10 to 69 years using stereophotogrammetry and determined the sagittal posture parameters flèche cervicale (FC), flèche lombaire (FL), and kyphosis index (KI) as well as the values standardized to the trunk height (FC%, FL%, KI%). FC, FC%, KI, and KI% showed an increase with age in men but not in women, and a difference between the sexes. FL remained largely constant with age, although FL% had significantly greater values in women than men. Postural parameters correlated only moderately or weakly with body mass index. Reference values were determined for different age groups and for both sexes. Since the parameters analyzed can also be determined by simple and non-instrumental methods in medical office, they are suitable for performing preventive checks in daily medical or therapeutic practice.
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Affiliation(s)
- Oliver Ludwig
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
| | - Carlo Dindorf
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
| | - Jens Kelm
- Chirurgisch-Orthopädisches Zentrum, 66557 Illingen, Germany
| | - Steven Simon
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
| | - Felix Nimmrichter
- Institute of Sport Science, Universität des Saarlandes, 66041 Saarbrücken, Germany
| | - Michael Fröhlich
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
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Ohlendorf D, Avaniadi I, Adjami F, Christian W, Doerry C, Fay V, Fisch V, Gerez A, Goecke J, Kaya U, Keller J, Krüger D, Pflaum J, Porsch L, Loewe C, Scharnweber B, Sosnov P, Wanke EM, Oremek G, Ackermann H, Holzgreve F, Keil F, Groneberg DA, Maurer-Grubinger C. Standard values of the upper body posture in healthy adults with special regard to age, sex and BMI. Sci Rep 2023; 13:873. [PMID: 36650216 PMCID: PMC9845304 DOI: 10.1038/s41598-023-27976-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
In order to classify and analyze the parameters of upper body posture in clinical or physiotherapeutic settings, a baseline in the form of standard values with special regard to age, sex and BMI is required. Thus, subjectively healthy men and women aged 21-60 years were measured in this project. The postural parameters of 800 symptom-free male (n = 397) and female (n = 407) volunteers aged 21-60 years (Ø♀: 39.7 ± 11.6, Ø ♂: 40.7 ± 11.5 y) were studied. The mean height of the men was 1.8 ± 0.07 m, with a mean body weight of 84.8 ± 13.1 kg and an average BMI of 26.0 ± 3.534 kg/m2. In contrast, the mean height of the women was 1.67 ± 0.06 m, with a mean body weight of 66.5 ± 12.7 kg and an average BMI of 23.9 ± 4.6 kg/m2. By means of video rasterstereography, a 3-dimensional scan of the upper back surface was measured when in a habitual standing position. The means or medians, confidence intervals, tolerance ranges, the minimum, 2.5, 25, 50, 75, 97.5 percentiles and the maximum, plus the kurtosis and skewness of the distribution, were calculated for all parameters. Additionally, ANOVA and a factor analyses (sex, BMI, age) were conducted. In both sexes across all age groups, balanced, symmetrical upper body statics were evident. Most strikingly, the females showed greater thoracic kyphosis and lumbar lordosis angles (kyphosis: Ø ♀ 56°, Ø♂ 51°; lordosis: Ø ♀ 49°, Ø♂ 32°) and lumbar bending angles (Ø ♀ 14°, Ø♂ 11°) than the males. The distance between the scapulae was more pronounced in men. These parameters also show an increase with age and BMI, respectively. Pelvic parameters were independent of age and sex. The upper body postures of women and men between the ages of 21 and 60 years were found to be almost symmetrical and axis-conforming with a positive correlation for BMI or age. Consequently, the present body posture parameters allow for comparisons with other studies, as well as for the evaluation of clinical (interim) diagnostics and applications.
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Affiliation(s)
- D Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany.
| | - I Avaniadi
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - F Adjami
- Department of Orthodontics, School of Dentistry, Goethe University Frankfurt/Main, Frankfurt, Germany
| | - W Christian
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - C Doerry
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - V Fay
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - V Fisch
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - A Gerez
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - J Goecke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - U Kaya
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - J Keller
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - D Krüger
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - J Pflaum
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - L Porsch
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - C Loewe
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - B Scharnweber
- Department of Orthodontics, School of Dentistry, Goethe University Frankfurt/Main, Frankfurt, Germany
| | - P Sosnov
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - E M Wanke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - G Oremek
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - H Ackermann
- Institute of Biostatistics and Mathematical Modeling, Goethe-University, Frankfurt/Main, Germany
| | - F Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - F Keil
- Institute of Neuroradiology, Goethe-University, Frankfurt/Main, Germany
| | - D A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - C Maurer-Grubinger
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
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Comparison of three validated systems to analyse spinal shape and motion. Sci Rep 2022; 12:10222. [PMID: 35715438 PMCID: PMC9205914 DOI: 10.1038/s41598-022-13891-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/30/2022] [Indexed: 11/17/2022] Open
Abstract
The assessment of spinal shape and mobility is of great importance for long-term therapy evaluation. As frequent radiation should be avoided, especially in children, non-invasive measurements have gained increasing importance. Their comparability between each other however stays elusive. Three non-invasive measurement tools have been compared to each other: Idiag M360, raster stereography and Epionics SPINE. 30 volunteers (15 females/15 males) have each been assessed by each system, investigating lumbar lordosis, thoracic kyphosis and spinal range-of-motion in the sagittal plane. Lumbar lordosis differed significantly (p < 0.001) between measurement devices but correlated significant to each other (Pearson’s r 0.5–0.6). Regarding thoracic kyphosis no significant difference and a high correlation (r = 0.8) could be shown between Idiag M360 and raster stereography. For lumbar mobility resulting measurements differed significantly and correlated only moderate between Idiag M360 and Epionics SPINE. Although the different measurement systems are moderate to high correlated to each other, their absolute agreement is limited. This might be explained by differences in their angle definition for lordotic and kyphotic angle, their measurement placement, or their capturing of mobility (static vs. dynamic assessment). Therefore, for long-term evaluation of the back profile, inter-modal comparison of values between different non-invasive devices should be avoided.
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Ohlendorf D, Krüger D, Christian W, Ackermann H, Keil F, Oremek G, Maurer-Grubinger C, Groneberg DA. Standard reference values of the upper body posture in healthy male adults aged between 51 and 60 years in Germany. Sci Rep 2022; 12:6961. [PMID: 35484316 PMCID: PMC9051089 DOI: 10.1038/s41598-022-10917-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/31/2022] [Indexed: 12/12/2022] Open
Abstract
Comparative values are essential for the classification of orthopedic abnormalities and the assessment of a necessary therapy. At present, reference values for the upper body posture for healthy, male adults exist for the age groups of 18-35, 31-40 and 41-50 years. However, corresponding data on the decade of 51 to 60 year-old healthy men are still lacking. 23 parameters of the upper body posture were analyzed in 102 healthy male participants aged 51-60 (55.36 ± 2.78) years. The average height was 180.76 ± 7.81 cm with a weight of 88.22 ± 14.57 kg. The calculated BMI was 26.96 ± 3.92 kg/m2. In the habitual, upright position, the bare upper body was scanned three-dimensionally using video raster stereography. Mean or median values, confidence intervals, tolerance ranges and group comparisons, as well as correlations of BMI and physical activity, were calculated for all parameters. The spinal column parameters exhibited a good exploration of the frontal plane in the habitual standing position. In the sagittal plane, a slight, ventral inclination of the trunk with an increased kyphosis angle of the thoracic spine and increased thoracic bending angle was observed. The parameters of the pelvis showed a pronounced symmetry with deviations from the 0° axis within the measurement error margin of 1 mm/1°. The scapula height together with the scapula angles of the right and left side described a slightly elevated position of the left shoulder compared to the right side. The upper body posture is influenced by parameters of age, height, weight and BMI. Primarily there are significant correlations to measurements of trunk lengths D (age: p ≤ 0.02, rho = -0.23; height: p ≤ 0.001, rho = 0.58; weight: p ≤ 0.001, rho = 0.33), trunk lengths S (age: p ≤ 0.01, rho = -0.27; height: p ≤ 0.001, rho = 0.58; weight: p ≤ 0.001, rho = 0.32), pelvic distance (height: p ≤ 0.01, rho = 0.26; weight: p ≤ 0.001, rho = 0.32; BMI: p ≤ 0.03, rho = 0.22) and scapula distance (weight: p ≤ 0.001, rho = .32; BMI: p ≤ 0.01, rho = 0.27), but also to sagittal parameters of trunk decline (weight: p ≤ 0.001, rho = -0.29; BMI: p ≤ 0.01, rho = -0.24), thoracic bending angle (height: p ≤ 0.01, rho = 0.27) and kyphosis angle (BMI: p ≤ 0.03, rho = 0.21). The upper body posture of healthy men between the ages of 51 and 60 years was axially almost aligned and balanced. With the findings of this investigation and the reference values obtained, suitable comparative values for use in clinical practice and for further scientific studies with the same experimental set-up have been established.
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Affiliation(s)
- Daniela Ohlendorf
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9a, 60596, Frankfurt/Main, Germany.
| | - Dominik Krüger
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9a, 60596, Frankfurt/Main, Germany
| | - Wolfgang Christian
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9a, 60596, Frankfurt/Main, Germany
| | - Hanns Ackermann
- Institute of Biostatistics and Mathematical Modeling, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, Building 11A, 60596, Frankfurt/Main, Germany
| | - Fee Keil
- Institute of Neuroradiology, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, Building 95, 60596, Frankfurt/Main, Germany
| | - Gerhard Oremek
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9a, 60596, Frankfurt/Main, Germany
| | - Christian Maurer-Grubinger
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9a, 60596, Frankfurt/Main, Germany
| | - David A Groneberg
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9a, 60596, Frankfurt/Main, Germany
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Haimerl M, Nebel I, Linkerhägner A, Konradi J, Wolf C, Drees P, Betz U. Comprehensive visualization of spinal motion in gait sequences based on surface topography. Hum Mov Sci 2022; 81:102919. [PMID: 34979480 DOI: 10.1016/j.humov.2021.102919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 10/26/2021] [Accepted: 12/21/2021] [Indexed: 11/19/2022]
Abstract
Analysis of spinal motion is considered to be important to assess function of the human spine. Surface topography (ST) is a method to record the vertebral orientation in 3D. Such measurements can be performed in static but also in dynamic situations like gait or other motion tasks. However, dynamic ST measurements are hard to interpret due to their complexity. The main goal of this paper is to provide comprehensive visualization tools which allow a more intuitive and comprehensive interpretation n of such measurements. In particular, juxtaposition and superimposition techniques are utilized to emphasize differences in motion characteristics. The method was applied to a test series of 12 healthy volunteers walking on a treadmill at various speed levels. It could be shown that the visualization tools are helpful to compare different motion sequences including an analysis of intra- and interindividual variation. Based on these techniques, it could be shown that the profiles of vertebral orientation remain considerable constant when one person was walking at different speed levels whereas they differed substantially between the different individuals. In contrast, the motion amplitudes contained high intra- and interindividual variation, i.e. between speed levels and different test persons. In summary, the paper demonstrates that appropriate visualization tools are helpful to interpret ST measurements and cope with the complexity of these data sets. In particular, they can be used to compare different motion sequences in a more comprehensive way.
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Affiliation(s)
- Martin Haimerl
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Kronenstraße 16, 78532 Tuttlingen, Germany.
| | - Iman Nebel
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Kronenstraße 16, 78532 Tuttlingen, Germany
| | - Alina Linkerhägner
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Kronenstraße 16, 78532 Tuttlingen, Germany
| | - Jürgen Konradi
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany.
| | - Claudia Wolf
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany.
| | - Philipp Drees
- Department of Orthopedics and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany.
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany.
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Ohlendorf D, Kaya U, Goecke J, Oremek G, Ackermann H, Groneberg DA. Standard reference values of the upper body posture in healthy male adults aged between 31 and 40 years in Germany-an observational study. J Physiol Anthropol 2021; 40:17. [PMID: 34715907 PMCID: PMC8557038 DOI: 10.1186/s40101-021-00266-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background In order to classify and analyze the parameters of upper body posture, a baseline in the form of standard values is demanded. To this date, standard values have only been published for healthy men aged 18–35 and 41–50 years. Data for male adults aged between 31 and 40 years are lacking. Methods The postural parameters of 101 symptom-free male volunteers aged 31–40 (35.58 ± 2.88) years were studied. The mean height of the men was 179.89 ± 7.38 cm, with a mean body weight of 86.36 ± 11.58 kg and an average BMI of 26.70 ± 3.35 kg/m2. By means of video rasterstereography, a 3-dimensional scan of the upper back surface was measured in a habitual standing position. The means or medians, confidence interval, tolerance range, and group comparisons and correlations of BMI and physical activity were calculated for all parameters. Results The habitual standing position was found to be almost symmetrical and the axis aligned in the spine, pelvis, and shoulder region, while the spine position was marginally inclined ventrally. The kyphosis angle of the thoracic spine was greater than the lordosis angle of the lumbar spine. All deviations fell under the measurement error margin of 1 mm/1°. The greater the BMI, the greater was the pelvic and scapular distance. The lower the BMI, the further caudally positioned was the right shoulder. The pelvic and scapular distances were also lower with the increasing athleticism of the participants. Conclusion The upper body posture of men between the ages of 31 and 40 years was found to be almost symmetrical and axis-conforming, with the kyphosis angle, pelvic distance, and shoulder distance enlarging with increasing BMI. Consequently, postural parameters presented in this survey allow for comparisons with other studies, as well as the evaluation of clinical diagnostics and applications.
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Affiliation(s)
- Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany.
| | - Ugur Kaya
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - Julian Goecke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - Gerhard Oremek
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - Hanns Ackermann
- Institute of Biostatistics and Mathematical Modeling, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, Building 11A, 60596, Frankfurt/Main, Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
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Huppert F, Betz W, Maurer-Grubinger C, Holzgreve F, Fraeulin L, Filmann N, Groneberg DA, Ohlendorf D. Influence of design of dentist's chairs on body posture for dentists with different working experience. BMC Musculoskelet Disord 2021; 22:462. [PMID: 34011319 PMCID: PMC8136039 DOI: 10.1186/s12891-021-04334-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Musculoskeletal disorders (MSD) are a common health problem among dentists. Dental treatment is mainly performed in a sitting position. The aim of the study was to quantify the effect of different ergonomic chairs on the sitting position. In addition, it was tested if the sitting position of experienced workers is different from a non-dental group. METHODS A total of 59 (28 m/31f) subjects, divided into two dentist groups according to their work experience (students and dentists (9 m/11f) < 10 years, dentists (9 m/10f) ≥ 10 years) and a control group (10 m/10f) were measured. A three-dimensional back scanner captured the bare back of all subjects sitting on six dentist's chairs of different design. Initially, inter-group comparisons per chair, firstly in the habitual and secondly in the working postures, were carried out. Furthermore, inter-chair comparison was conducted for the habitual as well as for the working postures of all subjects and for each group. Finally, a comparison between the habitual sitting posture and the working posture for each respective chair (intra-chair comparison) was conducted (for all subjects and for each group). In addition, a subjective assessment of each chair was made. For the statistical analysis, non-parametric tests were conducted and the level of significance was set at 5%. RESULTS When comparing the three subject groups, all chairs caused a more pronounced spinal kyphosis in experienced dentists. In both conditions (habitual and working postures), a symmetrical sitting position was assumed on each chair. The inter-chair comparisons showed no differences regarding the ergonomic design of the chairs. The significances found in the inter-chair comparisons were all within the measurementerror and could, therefore, be classified as clinically irrelevant. The intra-chair comparison (habitual sitting position vs. working sitting position) illustrated position-related changes in the sagittal, but not in the transverse, plane. These changes were only position-related (forward leaned working posture) and were not influenced by the ergonomic sitting design of the respective chair. There are no differences between the groups in the subjective assessment of each chair. CONCLUSIONS Regardless of the group or the dental experience, the ergonomic design of the dentist's chair had only a marginal influence on the upper body posture in both the habitual and working sitting postures. Consequently, the focus of the dentist's chair, in order to minimize MSD, should concentrate on adopting a symmetrical sitting posture rather than on its ergonomic design.
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Affiliation(s)
- F Huppert
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - W Betz
- Institute of Dentistry, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - C Maurer-Grubinger
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - F Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany.
| | - L Fraeulin
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - N Filmann
- Institute of Biostatistics and Mathematical Modeling, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, Building 11, 60590, Frankfurt/Main, Germany
| | - D A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - D Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
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Ohlendorf D, Sosnov P, Keller J, Wanke EM, Oremek G, Ackermann H, Groneberg DA. Standard reference values of the upper body posture in healthy middle-aged female adults in Germany. Sci Rep 2021; 11:2359. [PMID: 33504851 PMCID: PMC7840933 DOI: 10.1038/s41598-021-81879-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 01/04/2021] [Indexed: 12/25/2022] Open
Abstract
In order to classify and analyze the parameters of upper body posture, a baseline in form of standard values is demanded. To this date, standard values have only been published for healthy young women. Data for female adults between 51 and 60 years are lacking. 101 symptom-free female volunteers aged 51–60 (55.16 ± 2.89) years. The mean height of the volunteers was 1.66 ± 0.62 m, with a mean body weight of 69.3 ± 11.88 kg and an average BMI of 25.02 ± 4.55 kg/m2. By means of video raster stereography, a 3D-scan of the upper back surface was measured in a habitual standing position. The confidence interval, tolerance range and ICCs were calculated for all parameters. The habitual standing position is almost symmetrical in the frontal plane the most prominent deviation being a slightly more ventral position of the left shoulder blade in comparison to the right. The upper body (spine position) is inclined ventrally with a minor tilt to the left. In the sagittal plane, the kyphosis angle of the thoracic spine is greater than the lordosis angle of the lumbar spine. The pelvis is virtually evenly balanced with deviations from an ideal position falling under the measurement error margin of 1 mm/1°. There were also BMI influenced postural variations in the sagittal plane and shoulder distance. The ICCs are calculated from three repeated measurements and all parameters can be classified as "almost perfect". Deflections from an ideally symmetric spinal alignment in women aged 51–60 years are small-scaled, with a minimal frontal-left inclination and accentuated sigmoidal shape of the spine. Postural parameters presented in this survey allow for comparisons with other studies as well as the evaluation of clinical diagnostics and applications.
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Affiliation(s)
- Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany.
| | - Polyna Sosnov
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - Julia Keller
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - Eileen M Wanke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - Gerhard Oremek
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - Hanns Ackermann
- Institute of Biostatistics and Mathematical Modeling, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, Building 11A, 60596, Frankfurt/Main, Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
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9
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Maurer-Grubinger C, Avaniadi I, Adjami F, Christian W, Doerry C, Fay V, Fisch V, Gerez A, Goecke J, Kaya U, Keller J, Krüger D, Pflaum J, Porsch L, Wischnewski C, Scharnweber B, Sosnov P, Oremek G, Groneberg DA, Ohlendorf D. Systematic changes of the static upper body posture with a symmetric occlusion condition. BMC Musculoskelet Disord 2020; 21:636. [PMID: 32979920 PMCID: PMC7520031 DOI: 10.1186/s12891-020-03655-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022] Open
Abstract
Background Temporary occlusal changes and their influence on the upper body statics are still controversially discussed. Furthermore, concrete statements on whether age- or gender-specific differences in neurophysiological reactions exist are missing. Therefore, it is the aim of this study to evaluate the immediate effects of a symmetrical occlusion blocking on the upper body posture. These effects shall be investigated for both genders and for a larger age range. Methods In this study, 800 (407f/393 m) subjects volunteered aged from 21 to 60 years. Both genders were divided into four age groups according to decades. The three-dimensional upper body posture was measured by using the rasterstereography (ABW-Bodymapper). The habitual static posture was measured in two dental occlusion conditions (a) in rest position and (b) symmetrical blocking in the bicuspid region by cotton rolls. Results A significant reduction of the trunk length (0.72 mm; p < 0.001), an increase of the lumbar (0.30°; p < 0.001) and the thoracic bending angle (0.14°; p = 0.001), a reduction of the spinal forward decline (0.16°; p < 0.001) and a reduction of the scapular distance (0.36 mm; p = 0.001) was found. Gender-specific reactions can only be recorded in scapular distance, in that regard men reduce this distance while over all age groups women did not show a significant change. Discussion Slight gender- and age-independent reactions due to a symmetric occlusion blockade are shown: A gender independent reaction of the spinal related variables in the sagittal plane (thoracic and lumbar flexion angle, trunk length, spinal forward decline). In addition, a gender specific change of the shoulder blade distance could be observed, where men reduced the distance while female did not show a change. However, since these reactions are of a minimum amount, it can be concluded that neurophysiological compensation mechanisms work equally well regardless of age and sex, and the upper body posture of healthy people changes only very slightly due to a temporarily symmetrical altered bite position.
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Affiliation(s)
- C Maurer-Grubinger
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - I Avaniadi
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - F Adjami
- Department of Orthodontics, School of dentistry "Carolinum", Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 29, 60590, Frankfurt/Main, Germany
| | - W Christian
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - C Doerry
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - V Fay
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - V Fisch
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - A Gerez
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - J Goecke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - U Kaya
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - J Keller
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - D Krüger
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany.,Department of Orthodontics, School of dentistry "Carolinum", Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 29, 60590, Frankfurt/Main, Germany
| | - J Pflaum
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - L Porsch
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - C Wischnewski
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - B Scharnweber
- Department of Orthodontics, School of dentistry "Carolinum", Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, Building 29, 60590, Frankfurt/Main, Germany
| | - P Sosnov
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - G Oremek
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - D A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany
| | - D Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt/Main, Germany.
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10
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Scheidt S, Ossendorf R, Prangenberg C, Wirtz DC, Burger C, Kabir K, Welle K. The Impact of Lead Aprons on Posture of Orthopaedic Surgeons. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2020; 160:56-63. [PMID: 32854126 DOI: 10.1055/a-1219-8453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Surgeons working in orthopedics and trauma surgery are frequently exposed to repetitive actions and non-ergonomic positions in their operative activities with the regular use of lead aprons. Musculoskeletal complaints of the neck and back among surgeons are reported in the literature as up to 80%. In this study, the effects of lead aprons on the posture of surgeons are examined using videorasterstereography, foot pressure measurement and questionnaires. METHODOLOGY All subjects (n = 31) were examined before and after exposure to wearing lead aprons during surgery using videorasterstereography and pedography. In addition, a survey with a separately created questionnaire and the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was carried out. RESULTS An average duration of lead apron use of 102.6 min showed an increase in forefoot load (p = 0.002) especially in the elderly subjects and thoracic kyphosis (p < 0.001) especially in the younger doctors with a significant lateral deviation (p = 0.006). In addition, the lateral deviation was shown to correlate with an increasing body size or a shorter period of employment (p = 0.008; r = 0.51/p = 0.026; r = - 0.44). Significantly fewer surgeons experienced back complaints on working days without lead apron use in the operating room compared to days in the OR (p = 0.011). CONCLUSION The impact of wearing front covered lead aprons during operations in the field of orthopaedics and trauma surgery leads to more frequent back complaints, even among young and healthy doctors. Under an average duration of surgery of 102 min a temporary postural deviation occurs that can be demonstrated by means of videorasterstereography and foot pressure measurement. The subjects showed a shifted weight distribution on the forefoot, a gain in thoracic kyphosis and an increase in lateral deviation, which also correlated with an increasing height and shorter length of employment.
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Affiliation(s)
- Sebastian Scheidt
- Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, Germany
| | - Robert Ossendorf
- Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, Germany
| | | | | | - Christof Burger
- Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, Germany
| | - Koroush Kabir
- Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, Germany
| | - Kristian Welle
- Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, Germany
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11
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Scheidt S, Winnewisser J, Leichtle C, Gesicki M, Hofmann UK. The Value of Video Rasterstereography in the Detection of Alterations in Posture as a Marker of Pain Relief after Targeted Infiltrations of the Lumbar Spine. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2020; 159:496-502. [PMID: 32434258 DOI: 10.1055/a-1161-9633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Targeted infiltrations to the lumbar spine are used to identify the correct scope for surgery in patients with chronic lumbar back pain (CLBP) and multi-segmental pathologies, where radiologic imaging and clinical presentation do not match. Conclusions from that method have so far been based on individual statements of pain relief. The main principle for the infiltrations is the assumption that by locally administering an analgesic agent to possible surgical target areas, the effect of surgery can be temporarily simulated. The aim was to investigate the use of rasterstereographic posture measurements to substantiate reported pain reduction after infiltrations. METHODS In this case-control study (Level II), rasterstereography was performed on 57 patients and 28 reference subjects to evaluate changes in posture during 1 week of injections under fluoroscopic guidance and correlated with changes in the Numeric Pain Rating Scale (NRS). Statistical analysis was performed with SPSS (α = .05, two-sided) and presented in the form of box, scatter, and Bland-Altman plots. RESULTS AND CONCLUSION The CLBP patients' trunk inclination (median 6°) and absolute lateral tilt were significantly increased (p < .01 each) compared to the reference group. No significant difference was observed for trunk length, kyphotic/lordotic angle, or lateral deviation. During infiltration, no significant difference in posture could be observed. A subgroup analysis of patients reporting the highest pain improvement indicated no significant difference. No correlation was observed with pain improvement reported by the patients during injections. Subsequent rasterstereography does not seem to be able to verify results of injections in the diagnostics of lumbar spine pathologies, as patients' reported pain relief does not correlate with a relevant alteration in posture. The short-term effect of the targeted infiltrations may not suffice to change false posture being developed over years.
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Affiliation(s)
- Sebastian Scheidt
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
| | | | | | - Marco Gesicki
- Orthopädische Klinik, Universitätsklinikum Tübingen.,Orthopädie und Unfallchirurgie, Praxis Dres. Falck und Gesicki, Tübingen
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