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Chen C, Tang Y, Yang S, Dai W, Tan J, Yu X, Zhang C, Luo F. Relationship between paravertebral muscle function, pelvic incidence, and health-related quality of life in patients with degenerative spinal deformity. J Orthop Surg Res 2024; 19:102. [PMID: 38297329 PMCID: PMC10832213 DOI: 10.1186/s13018-024-04593-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/28/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Patients with degenerative spinal deformity often experience symptoms that seriously affect their quality of life, such as low back pain and dysfunction. This study aimed to investigate the relationship between paravertebral muscle function and pelvic incidence (PI) and their effect on health-related quality of life (HRQL) in patients with degenerative spinal deformity. METHODS A total of 112 patients with degenerative spinal deformity in Southwest Hospital (Chongqing, China) were enrolled. They were divided into groups according to PI angle: high (PI > 60°, n = 37), normal (PI 50°-60°, n = 31), and low (PI < 50°, n = 44). Paravertebral muscle strength and endurance were assessed using the prone external fixation test frame. The sagittal vertical axis (SVA) was measured on X-rays of the spine in an anterolateral position, and all subjects were assessed with the Oswestry Disability Index (ODI), Roland-Morris questionnaire (RMQ), and 36-Item Short Form Health Survey (SF-36). Pearson or Spearman coefficients were used to assess the relationship of paravertebral muscle function with SVA, PI, and health-related quality of life. RESULTS Maximal voluntary exercise (MVE) in the high-PI group was significantly lower than the MVE of both the normal- and low-PI groups (p < 0.05). There was no significant difference in MVE between the normal- and low-PI groups (p > 0.05). There was no significant difference in endurance time, SVA, ODI, RMQ, and SF-36 among the three groups. Paravertebral muscle MVE was negatively correlated with PI, SVA, ODI, and RMQ (r = - 0.193, - 0.210, - 0.283, - 0.277, p < 0.05). Endurance time of paravertebral muscle was also negatively correlated with SVA, ODI, and RMQ (r = - 0.200, - 0.420, - 0.348, p < 0.05) and positively correlated with SF-36 (r = 0.245, p < 0.05). In addition, paravertebral muscle MVE was positively correlated with the physical functioning score of the SF-36 (r = 0.251, p < 0.05), and the endurance time of paravertebral muscle was positively correlated with the physical functioning, physical role, bodily pain, and social function scores of the SF-36 (r = 0.342, 0.230, 0.209, 0.256, p < 0.05). CONCLUSIONS High PI may serve as a risk factor for decreased paraspinal muscle strength in patients with degenerative spinal deformities. Early and targeted exercises focusing on paraspinal muscle strength and endurance could potentially be of positive significance in slowing down the progression of sagittal imbalance, alleviating functional disorders, and increasing health-related quality of life in patients with degenerative spinal deformity.
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Affiliation(s)
- Can Chen
- Department of Orthopaedics, Southwest Hospital, Army Medical University (Third Military Medical University), 30 Gaotanyan Street, Shapingba, Chongqing, 400038, People's Republic of China
- Department for Combat Casualty Care Training, Training Base for Army Health Care, Army Medical University (Third Military Medical University), Chongqing, 400038, People's Republic of China
| | - Yong Tang
- Department of Orthopaedics, Southwest Hospital, Army Medical University (Third Military Medical University), 30 Gaotanyan Street, Shapingba, Chongqing, 400038, People's Republic of China
- Department of Orthopaedics, The 72nd Group Army Hospital, Huzhou University, Huzhou, 313000, Zhejiang, People's Republic of China
| | - Sen Yang
- Department of Orthopaedics, Southwest Hospital, Army Medical University (Third Military Medical University), 30 Gaotanyan Street, Shapingba, Chongqing, 400038, People's Republic of China
| | - Wei Dai
- Department of Orthopaedics, Southwest Hospital, Army Medical University (Third Military Medical University), 30 Gaotanyan Street, Shapingba, Chongqing, 400038, People's Republic of China
| | - Jiulin Tan
- Department of Orthopaedics, Southwest Hospital, Army Medical University (Third Military Medical University), 30 Gaotanyan Street, Shapingba, Chongqing, 400038, People's Republic of China
| | - Xueke Yu
- Department of Orthopaedics, Southwest Hospital, Army Medical University (Third Military Medical University), 30 Gaotanyan Street, Shapingba, Chongqing, 400038, People's Republic of China
| | - Chengmin Zhang
- Department of Orthopaedics, Southwest Hospital, Army Medical University (Third Military Medical University), 30 Gaotanyan Street, Shapingba, Chongqing, 400038, People's Republic of China.
| | - Fei Luo
- Department of Orthopaedics, Southwest Hospital, Army Medical University (Third Military Medical University), 30 Gaotanyan Street, Shapingba, Chongqing, 400038, People's Republic of China.
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Frota NT, Fidelis-de-Paula-Gomes CA, Pontes-Silva A, Pinheiro JS, de Jesus SFC, Apahaza GHS, da Silva Souza C, Avila MA, Dibai-Filho AV. 15-item Roland-Morris Disability Questionnaire (RMDQ-15): structural and criterion validity on patients with chronic low back pain. BMC Musculoskelet Disord 2022; 23:978. [PMID: 36371173 PMCID: PMC9652881 DOI: 10.1186/s12891-022-05953-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/06/2022] [Indexed: 11/15/2022] Open
Abstract
Background The Roland-Morris Disability Questionnaire (RMDQ) is one of the most used instruments to measure self-reported disability in patients with low back pain, however, the uncertainty on which version to use may lead to inadequate disability measurement and consequently, improper management of patients with chronic low back pain. Objective To propose a short version of the RMDQ, compare it with the other short versions presented by the specialized literature, and identify the best internal structure of the RMDQ for the Brazilian population. Methods This is a cross-sectional study in which we used confirmatory factor analysis to identify the best structure of the RMDQ. We assessed 545 participants, most of which were women, aged ≥ 30 years old, single, with mean low back pain intensity ~ 5 points, and mean pain chronicity ~ 72 months. We used lavaan and semPlot packages, with implementation of a tetrachoric matrix and the robust diagonally weighted least squares extraction method. We also used fit indices chi-square/degree of freedom, comparative fit index, Tucker-Lewis index, root mean square error of approximation, and standardized root mean squared residual. For the comparison between models, we considered the structure with the lowest values of the Akaike information criterion and Bayesian information criterion. In addition, we assessed criterion validity via Spearman’s correlation coefficient to correlate the long and short versions. In this study, the 15-item structure was created through the use of modification indices to identify redundant items (9 items were excluded). Results RMDQ structure with one domain and 15 items and the structure with two domains and 16 items showed all fit indices with adequate values, but the one-dimensional version showed the lowest Akaike information criterion and Bayesian information criterion values. Regarding criterion validity, correlation between the RMDQ with 24 items and 15 items is adequate (rho = 0.954, p < 0.001). Conclusion The RMDQ-15 is a short version of the RMDQ instrument with the most adequate internal structure and satisfactorily correlated with the long version of the instrument. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05953-y.
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