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Huang H, Yang M, Fu Z, Hu H, Wu C, Tan L. Predicting and analysing of the unfavourable outcomes of early applicated percutaneous endoscopic interlaminar discectomy for lumbar disc herniation: development and validation based nomogram. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:906-914. [PMID: 38342841 DOI: 10.1007/s00586-024-08141-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/13/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVE To predict and analyse the unfavourable outcomes of early applicated percutaneous endoscopic interlaminar discectomy for lumbar disc herniation. METHODS Information of 426 patients treated by early applicated percutaneous endoscopic interlaminar discectomy (PEID) for lumbar disc herniation (LDH) at our hospital from June 2017 to October 2021 in addition to 17 other features was collected. The risk factors were selected by the least absolute shrinkage and selection operator method (LASSO) regression. Then, a prediction model (nomogram) was established to predict the unfavourable outcomes of using the risk factors selected from LASSO regression. Bootstrap (n = 1000) was used to perform the internal validation, and the performance of the model was assessed by the concordance index (C-index), receiver operating characteristic curve, and calibration curve. The decision curve analysis (DCA) and clinical impact curve (CIC) were used to assess the clinical utility of the model, respectively. RESULTS Finally, 53 of 426 patients showed unfavourable outcomes. Five potential factors, Modic change, Calcification, Lumbar epidural steroid injection preoperative, Articular process hyperplasia and cohesion, and Laminoplasty technique, were selected according to the LASSO regression, that identified the predictors to establish nomogram model. Meanwhile, the C-index of the prediction nomogram was 0.847, the area under the receiver operating characteristic curve value was 0.847, and the interval bootstrapping (n = 1000) validation C-index was 0.809. The model has good practicability for clinics according to the DCA and CIC. CONCLUSION This nomogram model has good predictive performance and clinical practicability, which could provide a certain basis for predicting unfavourable outcomes of early applicated PEID for LDH.
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Affiliation(s)
- Huiyu Huang
- Emergency Department, Zigong Fourth People's Hospital, Zigong, China.
| | - Min Yang
- Neurology Department, Zigong First People's Hospital, Zigong, China
| | - Zhaojun Fu
- Emergency Department, Zigong Fourth People's Hospital, Zigong, China
| | - Haigang Hu
- Orthopaedic Center, Zigong Fourth People's Hospital, Zigong, China
| | - Chao Wu
- Orthopaedic Center, Zigong Fourth People's Hospital, Zigong, China
- Digital Medical Center, Zigong Fourth People's Hospital, Zigong, China
| | - Lun Tan
- Orthopaedic Center, Zigong Fourth People's Hospital, Zigong, China
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Asahi R, Nakamura Y, Koike Y, Kanai M, Watanabe K, Yuguchi S, Kamo T, Azami M, Ogihara H, Asano S. Does locomotive syndrome severity predict future fragility fractures in community-dwelling women with osteoporosis? Mod Rheumatol 2023; 33:1036-1043. [PMID: 36029035 DOI: 10.1093/mr/roac101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/28/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES We investigated whether the locomotive syndrome (LS) severity affects future fragility fractures in osteoporosis patients. METHODS In this retrospective cohort study, 315 women with osteoporosis (mean follow-up period, 2.8 years) were reviewed, of whom 244 were included in the analysis. At baseline, we obtained medical information, bone mineral density of the lumbar spine and femoral neck, and sagittal vertical axis. Additionally, LS risk was assessed using the two-step test, stand-up test, and 25-question geriatric locomotive function scale scores. The LS risk test results were used to classify LS severity, which was rated on a 4-point scale from stage 0 (robust) to 3 (worsening). Cox proportional hazards regression analysis was used to determine the association of the severity with future fragility fracture. RESULTS Fragility fractures occurred in 37 of 315 participants (11.8%). This study showed that sagittal vertical axis (hazard ratio = 1.014; 95% confidence interval, 1.005-1.023; p value = 0.003) and LS severity (hazard ratio =1.748; 95% confidence interval, 1.133-2.699; p = 0.012) were independent risk factors for incidence of fragility fracture. CONCLUSIONS This study revealed the LS severity to predicted fragility fractures. We suggested that the progression of LS associated with osteoporosis increases the fracture risk.
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Affiliation(s)
- Ryoma Asahi
- School of Health Sciences, Japan University of Health Sciences, Saitama, Japan
| | - Yutaka Nakamura
- Saitama Spine Center, Higashi Saitama General Hospital, Saitama, Japan
| | - Yoshinao Koike
- Saitama Spine Center, Higashi Saitama General Hospital, Saitama, Japan
| | - Masayoshi Kanai
- Saitama Spine Center, Higashi Saitama General Hospital, Saitama, Japan
| | - Kento Watanabe
- Department of Rehabilitation, Kawaguchi Sakura Hospital, Saitama, Japan
| | - Satoshi Yuguchi
- School of Health Sciences, Japan University of Health Sciences, Saitama, Japan
| | - Tomohiko Kamo
- Department of Rehabilitation, Gunma Paz University, Gunma, Japan
| | - Masato Azami
- School of Health Sciences, Japan University of Health Sciences, Saitama, Japan
| | - Hirofumi Ogihara
- Division of Physical Therapy, Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
| | - Satoshi Asano
- Saitama Spine Center, Higashi Saitama General Hospital, Saitama, Japan
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Ohba T, Goto G, Oda K, Tanaka N, Yokomichi H, Haro H. Comparative Study for Characteristics of Locomotive Syndrome in Patients with Lumbar Stenosis and Adult Spinal Deformity. J Clin Med 2023; 12:4345. [PMID: 37445379 DOI: 10.3390/jcm12134345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/09/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
INTRODUCTION The differential diagnoses of lumbar spinal stenosis (LSS) and adult spinal deformity (ASD) have been demonstrated primarily using sagittal radiographic spinopelvic parameters. However, it is more important to know the differences in the characteristic clinical symptoms to make accurate treatment decisions. Recently, the relationship between spinal disease and Locomotive Syndrome (LS) has been reported. Additionally, the Geriatric Locomotive Function Scale-25 (GLFS-25) was reported to be a useful scale to evaluate disease severity and characteristic clinical symptoms in spinal disease. METHODS Sixty-nine consecutive patients with ASD and 196 patients with LSS who underwent spinal surgery were included. Locomotive dysfunction was evaluated using the GLFS-25 questionnaire and physical performance tests including the two-step test and the stand-up test, measured preoperatively. The correlations between sagittal spinopelvic parameters of ASD and LS were examined. RESULTS All subjects with lumbar degenerative disease in the present study were diagnosed with LS preoperatively. The severity of LS in patients with LSS and ASD were statistically similar. GLFS-25 scores in the mobility and community domain were similarly poor in both groups. Several scores in the domestic life and self-care domains were significantly worse in the ASD group. Question 20 of the GLFS-25, related to load-bearing tasks and housework, was significantly associated with a large pelvic incidence in ASD patients. CONCLUSIONS Lumbar degenerative disease requiring surgery severely affects the LS of older people. ASD patients had more difficulty with load-bearing tasks and housework such as cleaning the yard, carrying heavy bedding, dressing, and bathing compared to LSS patients.
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Affiliation(s)
- Tetsuro Ohba
- Department of Orthopaedics, University of Yamanashi, Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Go Goto
- Department of Orthopaedics, University of Yamanashi, Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Kotaro Oda
- Department of Orthopaedics, University of Yamanashi, Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Nobuki Tanaka
- Department of Orthopaedics, University of Yamanashi, Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Hiroshi Yokomichi
- Department of Health Sciences, University of Yamanashi, Shimokato, Chuo 409-3898, Yamanashi, Japan
| | - Hirotaka Haro
- Department of Orthopaedics, University of Yamanashi, Shimokato, Chuo 409-3898, Yamanashi, Japan
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Kobayashi T, Morimoto T, Shimanoe C, Ono R, Otani K, Mawatari M. Clinical characteristics of locomotive syndrome categorised by the 25-question Geriatric Locomotive Function Scale: a systematic review. BMJ Open 2023; 13:e068645. [PMID: 37192799 DOI: 10.1136/bmjopen-2022-068645] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVES The purpose of this study was to compile the currently available evidence on the clinical characteristics of the locomotive syndrome (LS) categorised by the 25-question Geriatric Locomotive Function Scale (GLFS-25) and clarify its clinical usefulness for assessing mobility function. DESIGN Systematic review. DATA SOURCES The PubMed and Google Scholar were searched for the relevant studies on 20 March 2022. ELIGIBILITY CRITERIA We included relevant peer-reviewed articles, available in English language, on clinical LS characteristics categorised with the GLFS-25. DATA EXTRACTION AND SYNTHESIS Pooled ORs or mean differences (MDs) of the LS groups were calculated and compared with the non-LS groups for each clinical characteristic. RESULTS In total, 27 studies that involve 13 281 participants (LS, n=3385; non-LS, n=9896) were examined in this analysis. Older age (MD 4.71; 95% (CI) 3.97 to 5.44; p<0.00001), female gender (OR 1.54; 95% CI 1.38 to 1.71; p<0.00001), higher body mass index (MD 0.78; 95% CI 0.57 to 0.99; p<0.00001), osteoporosis (OR 1.68; 95% CI 1.32 to 2.13; p<0.0001), depression (OR 3.14; 95% CI 1.81 to 5.44; p<0.0001), lower lumbar lordosis angle (MD -7.91; 95% CI -10.08 to -5.74; p<0.00001), higher spinal inclination angle (MD 2.70; 95% CI 1.76 to 3.65; p<0.00001), lower grip strength (MD -4.04; 95% CI -5.25 to -2.83; p<0.00001), lower back muscle strength (MD -15.32; 95% CI -23.83 to -6.81; p=0.0004), lower maximum stride (MD -19.36; 95% CI -23.25 to -15.47; p<0.00001), higher timed up-and-go (MD 1.36; 95% CI 0.92 to 1.79; p<0.00001), lower one-leg standing time (MD -19.13; 95% CI -23.29 to -14.97; p<0.0001) and slower normal gait speed (MD -0.20; 95% CI -0.22 to -0.18; p<0.0001) were found to be associated with LS. No significant differences were noted in other clinical characteristics between the two groups. CONCLUSIONS GLFS-25 is clinically useful for assessing mobility function according to the evidence available on the clinical characteristics of LS categorised by the GLFS-25 questionnaire items until.
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Affiliation(s)
- Takaomi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Tadatsugu Morimoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | | | - Rei Ono
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Koji Otani
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masaaki Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
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Temporiti F, Adamo P, Mandelli A, Buccolini F, Viola E, Aguzzi D, Gatti R, Barajon I. Test-retest reliability of a photographic marker-based system for postural examination. Technol Health Care 2023:THC220155. [PMID: 36970916 DOI: 10.3233/thc-220155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND The BHOHB system (Bhohb S.r.l., Italy) is a portable non-invasive photographic marker-based device for postural examination. OBJECTIVE To assess the test-retest reliability of the BHOHB system and compare its reliability with an optoelectronic system (SMART-DX 700, BTS, Italy). METHODS Thirty volunteers were instructed to stand upright with five markers on the spinous processes of C7, T6, T12, L3 and S1 vertebrae to define the dorsal kyphosis and lumbar lordosis (sagittal plane) angles. Three markers were placed on the great trochanter, apex of iliac crest and lateral condyle of the femur to detect pelvic tilt. Finally, to define angles between the acromion and the spinous processes (frontal plane), two markers were placed on the right and left acromion. Postural angles were recoded simultaneously with BHOHB and optoelectronic systems during two consecutive recording sessions. RESULTS The BHOHB system revealed excellent reliability for all the angles (ICCs: 0.92-0.99, SEM: 0.78∘-3.33∘) as well as a shorter processing time compared to the optoelectronic system. Excellent reliability was also found for all the angles detected through the optoelectronic system (ICCs: 0.91-0.99, SEM: 0.84∘-2.80∘). CONCLUSION The BHOHB system resulted as a reliable non-invasive and user-friendly device to monitor spinal posture, especially in subjects requiring repeat examinations.
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Affiliation(s)
- Federico Temporiti
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Paola Adamo
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
| | - Andrea Mandelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | | | | | - Roberto Gatti
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Isabella Barajon
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Sheppard WL, Chiou D, Upfill-Brown A, Shah A, Edogun E, Sassoon A, Park DY. Spondylolisthesis and mismatch deformity affect outcomes after total knee arthroplasty. J Orthop Surg Res 2023; 18:157. [PMID: 36864440 PMCID: PMC9979472 DOI: 10.1186/s13018-023-03605-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 02/10/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Little published data currently exist regarding the potential relationships between spondylolisthesis, mismatch deformity, and clinical outcomes following total knee arthroplasty (TKA). We hypothesize that preexisting spondylolisthesis will result in decreased functional outcomes after TKA. METHODS This retrospective cohort comparison of 933 TKAs was performed between January 2017 and 2020. TKAs were excluded if they were not performed for primary osteoarthritis (OA) or if preoperative lumbar radiographs were unavailable/inadequate to measure the degree of spondylolisthesis. Ninety-five TKAs were subsequently available for inclusion and divided into two groups: those with spondylolisthesis and those without. Within the spondylolisthesis cohort, pelvic incidence (PI) and lumbar lordosis (LL) were calculated on lateral radiographs to determine the difference (PI-LL). Radiographs with PI-LL > 10° were then categorized as having mismatch deformity (MD). The following clinical outcomes were compared between the groups: need for manipulation under anesthesia (MUA), total postoperative arc of motion (AOM) both pre-MUA or post-MUA/revision, incidence of flexion contracture, and a need for later revision. RESULTS Forty-nine TKAs met the spondylolisthesis criteria, while 44 did not have spondylolisthesis. There were no significant differences in gender, body mass index, preoperative knee range of motion (ROM), preoperative AOM, or opiate use between the groups. TKAs with spondylolisthesis and concomitant MD were more likely to have MUA (p = 0.016), ROM < 0-120 (p < 0.014), and a decreased AOM (p < 0.02) without interventions. CONCLUSION Preexisting spondylolisthesis by itself may not have adverse effect clinical results following TKA. However, spondylolisthesis increases the likelihood of developing MD. In those with both spondylolisthesis and concomitant mismatch deformities, patients had statistically and clinically significantly decreased in postoperative ROM/AOM and increased need for MUA. Surgeons should consider clinical/radiographic assessments of patients with chronic back pain who present for total joint arthroplasty. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- William L. Sheppard
- grid.19006.3e0000 0000 9632 6718Department of Orthopedic Surgery, University of California, Los Angeles, 1250 16th St Suite 2100, Santa Monica, CA 90404 USA
| | - Daniel Chiou
- grid.19006.3e0000 0000 9632 6718Department of Orthopedic Surgery, University of California, Los Angeles, 1250 16th St Suite 2100, Santa Monica, CA 90404 USA
| | - Alexander Upfill-Brown
- grid.19006.3e0000 0000 9632 6718Department of Orthopedic Surgery, University of California, Los Angeles, 1250 16th St Suite 2100, Santa Monica, CA 90404 USA
| | - Akash Shah
- grid.19006.3e0000 0000 9632 6718Department of Orthopedic Surgery, University of California, Los Angeles, 1250 16th St Suite 2100, Santa Monica, CA 90404 USA
| | - Eghosa Edogun
- grid.19006.3e0000 0000 9632 6718David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave, Los Angeles, CA 90095 USA
| | - Adam Sassoon
- grid.19006.3e0000 0000 9632 6718Department of Orthopedic Surgery, University of California, Los Angeles, 1250 16th St Suite 2100, Santa Monica, CA 90404 USA ,grid.19006.3e0000 0000 9632 6718David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave, Los Angeles, CA 90095 USA
| | - Don Y. Park
- grid.19006.3e0000 0000 9632 6718Department of Orthopedic Surgery, University of California, Los Angeles, 1250 16th St Suite 2100, Santa Monica, CA 90404 USA ,grid.19006.3e0000 0000 9632 6718David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave, Los Angeles, CA 90095 USA
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Spiegl UJ, Jarvers JS, Osterhoff G, Kobbe P, Hölbing PL, Schnake KJ, Heyde CE. Effect of subsequent vertebral body fractures on the outcome after posterior stabilization of unstable geriatric fractures of the thoracolumbar spine. BMC Musculoskelet Disord 2022; 23:1064. [PMID: 36471332 PMCID: PMC9721076 DOI: 10.1186/s12891-022-06031-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/25/2022] [Indexed: 12/09/2022] Open
Abstract
PURPOSE The purpose of this study was analyzing the effect of subsequent vertebral body fractures on the clinical outcome in geriatric patients with thoracolumbar fractures treated operatively. METHODS Retrospectively, all patients aged ≥ 60 with a fracture of the thoracolumbar spine included. Further inclusion parameters were acute and unstable fractures that were treated by posterior stabilization with a low to moderate loss of reduction of less than 10°. The minimal follow-up period was 18 months. Demographic data including the trauma mechanism, ASA score, and the treatment strategy were recorded. The following outcome parameters were analyzed: the ODI score, pain level, satisfaction level, SF 36 score as well as the radiologic outcome parameters. RESULTS Altogether, 73 patients were included (mean age: 72 years; 45 women). The majority of fractures consisted of incomplete or complete burst fractures (OF 3 + 4). The mean follow-up period was 46.6 months. Fourteen patients suffered from subsequent vertebral body fractures (19.2%). No trauma was recordable in 5 out of 6 patients; 42.8% of patients experienced a low-energy trauma (significant association: p < 0.01). There was a significant correlation between subsequent vertebral body fracture and female gender (p = 0.01) as well as the amount of loss of reduction (p = 0.02). Thereby, patients with subsequent vertebral fractures had significant worse clinical outcomes (ODI: 49.8 vs 16.6, p < 0.01; VAS pain: 5.0 vs 2.6, p < 0.01). CONCLUSION Patient with subsequent vertebral body fractures had significantly inferior clinical midterm outcome. The trauma mechanism correlated significantly with both the rate of subsequent vertebral body fractures and the outcome. Another risk factor is female gender.
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Affiliation(s)
- U. J. Spiegl
- grid.411339.d0000 0000 8517 9062Department of Orthopaedics, Trauma Surgery and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - J.-S. Jarvers
- grid.411339.d0000 0000 8517 9062Department of Orthopaedics, Trauma Surgery and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - G. Osterhoff
- grid.411339.d0000 0000 8517 9062Department of Orthopaedics, Trauma Surgery and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - P. Kobbe
- grid.1957.a0000 0001 0728 696XDepartment of Trauma and Reconstructive Surgery, University of Aachen, Aachen, Germany
| | - P.-L. Hölbing
- grid.411339.d0000 0000 8517 9062Department of Orthopaedics, Trauma Surgery and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - K. J. Schnake
- Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, Erlangen, Germany ,Department of Orthopedics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany
| | - C.-E. Heyde
- grid.411339.d0000 0000 8517 9062Department of Orthopaedics, Trauma Surgery and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
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Associations Between Neck and Shoulder Pain and Neuropathic Pain in a Middle-aged Community-living Population. Spine (Phila Pa 1976) 2022; 47:632-639. [PMID: 34431834 DOI: 10.1097/brs.0000000000004207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A cross-sectional study. OBJECTIVE The present study aimed to investigate the prevalence of NeP in subjects suffering from NSP to reveal the impact of NeP on the health-related QOL (HRQOL) in middle-aged and elderly people with NSP in a health checkup. SUMMARY OF BACKGROUND DATA No previous studies have established the relationship between NSP and NeP as potential risk factors contributing to a decreased QOL in the general population. METHODS The present study involved 203 participants (men: 84, women: 119; mean age: 63.3 yr). For each subject, anthro-pometric measurements, physical function examinations, and blood testing were performed. A cut-off score of >0 on the short-form spine painDETECT questionnaire defined the presence of NeP. Subsequently, the NSP (+) subjects were divided into 2 sub-groups: the NeP (+) and NeP (-) groups. For the assessment of QOL, the short form 36 health survey and the EuroQol 5 dimension 5 level version (EQ-5D-5L) tool were used. RESULTS The study included 100 NSP (+) and 103 NSP (-) subjects. Among the NSP (+) subjects, 46 and 54 subjects were found to be NeP (+) and NeP (-), respectively. For the short form 36 health survey, the multivariate regression analysis revealed that the prevalence of NeP was associated with a lower physical QOL (OR 3.56) and lower mental QOL (OR 4.04). Similarly, the NeP prevalence was found to be the predictor for low QOL scores in EQ-5D-5L (EQ-5D-5L index value <0.875; OR 3.61). CONCLUSION The prevalence of NeP was reported to be 46.0% in healthy middle-aged and elderly population suffering from NSP, where it was associated with poor HRQOL. Therefore, strategies aimed at alleviating NeP may contribute significantly to the improvement of QOL in middle-aged and elderly people with NSP.Level of Evidence: 2.
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Relationship between the locomotive syndrome and kinetic and kinematic parameters during static standing and level walking. Gait Posture 2022; 93:146-152. [PMID: 35151196 DOI: 10.1016/j.gaitpost.2022.01.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/08/2022] [Accepted: 01/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals experiencing age-related decline in locomotor functions are at high-risk of developing locomotive syndrome (LS). LS requires long-term care and greatly influences the quality of life and activities of daily living. The LS risk test was established as a diagnostic criterion by the Japanese Orthopedic Association. Although the relationship between the test and motor function has been established, few studies have reported on the characteristics of LS kinematically and kinetically. RESEARCH QUESTION Do elderly with LS show different kinetic and kinematic characteristics compared with healthy elderly during static standing and level walking? METHODS Forty-four Participants were divided into an LS group and a non-LS group based on the scores of the LS risk test. The standing posture and walking of the participants were measured using a three-dimensional motion capture system. The results of the groups were compared using an unpaired t-test, and then the characteristics of the LS group were extracted using logistic regression analysis. RESULTS LS group exhibited trunk flexion during both standing and gait. A higher intervertebral disc compressive force, which is the index of the low-back mechanical stress, during standing and an increase in ankle plantarflexion angle during walking were observed in LS group. SIGNIFICANCE This study determined the kinematic and kinetic features of elderly with LS. The findings suggest that parameters related to the trunk and ankle could be associated with LS. Further studying the characteristics of LS in older adults via motion analysis can help develop prevention and intervention methods for LS.
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Associations between potentially modifiable clinical factors and sagittal balance of the spine in older adults from the general population. Spine Deform 2022; 10:433-441. [PMID: 34741754 DOI: 10.1007/s43390-021-00435-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/23/2021] [Indexed: 01/01/2023]
Abstract
PURPOSE Spinal sagittal balance is associated with back pain and quality of life. Enhancing understanding of the clinical factors associated with sagittal balance is essential for guiding the development of effective non-operative treatment. We aimed to evaluate the associations between spinal sagittal balance and potentially modifiable clinical factors and interactions between current back pain and the evaluated clinical factors. METHODS We conducted a cross-sectional study where sagittal alignment, measured radiographically by EOS, was defined by sagittal vertical axis (SVA). The clinical factors included non-radiographic (NR) lumbar lordosis angle, balance (Berg balance scale), hip and back extension range of motion (ROM) and extensor strength, and back pain. Pearson's correlation coefficients and multivariable regression analyses were conducted in 63 adult participants (70% female, mean age 73 (SD 8.6) years) from the general population. RESULTS We identified correlations between SVA and age (r = 0.4, p < 0.001), body mass index (BMI) (r = 0.3, p = 0.008), balance (r = - 0.5, p < 0.001) and NR lumbar lordosis angle (r = - 0.5, p < 0.001). The final model (R2 = 58%) identified that, after controlling for age and BMI, larger SVA was associated with lower NR lumbar lordosis (R2 = 15%, p < 0.001), poorer balance (R2 = 7%, p = 0.02), greater hip extensor strength (R2 = 4%, p = 0.053), and among people with back pain, NR lumbar extension ROM (R2 = 3%, p = 0.034). Hip ROM and lumbar strength were not significant. CONCLUSION Reduced NR lumbar lordosis magnitude and ROM, balance and hip strength are associated with SVA; however, it is unclear if these factors are compensatory, contributing, or modifiable. Hence, future longitudinal studies are needed.
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Kobayashi T, Morimoto T, Otani K, Mawatari M. Locomotive Syndrome and Lumbar Spine Disease: A Systematic Review. J Clin Med 2022; 11:jcm11051304. [PMID: 35268395 PMCID: PMC8911455 DOI: 10.3390/jcm11051304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/21/2022] [Accepted: 02/25/2022] [Indexed: 02/04/2023] Open
Abstract
Locomotive syndrome (LS) is defined based on the Loco-Check, 25-question Geriatric Locomotive Function Scale (GLFS-25), 5-question Geriatric Locomotive Function Scale (GLFS-5), Stand-Up Test, Two-Step Test, or a total assessment (i.e., positive for one or more of the GLFS-25, Stand-Up Test, and Two-Step Test). Lumbar spine disease has been reported to be one of the most common musculoskeletal disorders leading to LS. We therefore conducted a systematic review via PubMed, Google Scholar, Cochrane Library, Web of Science, and MEDLINE, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 26 studies were considered to be eligible for inclusion in this systematic review. The GLFS-25 showed an association with low back pain, sagittal spinopelvic malalignment, and lumbar spinal stenosis but not vertebral fracture. The GLFS-5 showed an association with low back pain and lumbar spinal stenosis. The Loco-Check and Two-Step Test showed an association with low back pain, sagittal spinopelvic malalignment, and lumbar spinal stenosis. The Stand-Up Test showed no association with lumbar spinal stenosis. The total assessment showed an association with low back pain and lumbar spinal stenosis. Furthermore, the GLFS-25, Two-Step Test, and total assessment were improved by spinal surgery for lumbar spinal stenosis. The current evidence concerning the relationship between LS and lumbar spine disease still seems insufficient, so further investigations are required on this topic.
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Affiliation(s)
- Takaomi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (T.K.); (M.M.)
| | - Tadatsugu Morimoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (T.K.); (M.M.)
- Correspondence: ; Tel.: +81-952-34-2343; Fax: +81-952-34-2059
| | - Koji Otani
- Department of Orthopaedic Surgery, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan;
| | - Masaaki Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (T.K.); (M.M.)
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Morita T, Tanishima S, Yamashita E, Katou M, Fukada M. Physical Function and Low Back Pain in Leek Farmers: A Comparison with Non-Farmers. Yonago Acta Med 2022; 65:200-206. [DOI: 10.33160/yam.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/31/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Tetsuji Morita
- Department of Rehabilitation, Daisen Rehabilitation Hospital, Hoki-cho 689-4102, Japan
| | - Shinji Tanishima
- Division of Orthopedic Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Eijiro Yamashita
- Division of Clinical Radiology, Tottori University Hospital, Yonago 683-8504, Japan
| | - Minako Katou
- Tottori Prefecture Chubu Regional Office, Agriculture and Forestry Bureau, Agricultural Promotion Division, Kurayoshi 682-0802, Japan
| | - Mika Fukada
- School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
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Asahi R, Nakamura Y, Kanai M, Watanabe K, Yuguchi S, Kamo T, Azami M, Ogihara H, Asano S. Stand-up test predicts occurrence of non-traumatic vertebral fracture in outpatient women with osteoporosis. J Bone Miner Metab 2021; 39:883-892. [PMID: 33988756 DOI: 10.1007/s00774-021-01229-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 04/08/2021] [Indexed: 01/30/2023]
Abstract
INTRODUCTION The purpose of this retrospective study was to clarify the incidence of non-traumatic vertebral fracture among outpatient women with osteoporosis and to determine whether the stand-up test predicted the occurrence of non-traumatic vertebral fracture. MATERIALS AND METHODS A total of 242 postmenopausal women over 60 years of age who received outpatient osteoporosis treatment at our hospital between November 2013 and July 2020 were longitudinally evaluated in this study. We obtained medical information and radiographic parameters, including sagittal vertical axis, thoracic kyphosis, pelvic incidence, lumbar lordosis, pelvic tilt, and sacral slope at baseline. Additionally, we measured physical parameters, including height, weight, body mass index, lumbar bone mineral density, visual analog scale score for pain, and the stand-up test. RESULTS Vertebral fractures occurred in 20 of 242 participants (8.3%), and accounted for 48.8% the 41 total fractures in the study group. Among vertebral fractures, eight (40.0%) were traumatic, resulting from falls, and 12 (60.0%) were non-traumatic. Cox multivariate logistic regression analysis adjusted for age, body mass index, lumbar bone mineral density, and the time to non-traumatic vertebral fracture showed that the sagittal vertical axis (HR = 1.013, 95% CI 1.001-1.026), stand-up test score (HR = 3.977, 95% CI 1.156-13.683), and presence of difficulty with standing from a 20-cm-high seat using both legs (HR = 3.329, 95% CI 1.625-6.82) were independent risk factors for the occurrence of non-traumatic vertebral fracture. CONCLUSION The stand-up test may be useful as a simple screening tool for non-traumatic vertebral fracture in patients with osteoporosis.
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Affiliation(s)
- Ryoma Asahi
- School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte City, Saitama, 340-0145, Japan.
| | - Yutaka Nakamura
- Saitama Spine Center, Higashi Saitama General Hospital, 517-5, Yoshino, Satte City, Saitama, 340-0153, Japan
| | - Masayoshi Kanai
- Saitama Spine Center, Higashi Saitama General Hospital, 517-5, Yoshino, Satte City, Saitama, 340-0153, Japan
| | - Kento Watanabe
- Saitama Spine Center, Higashi Saitama General Hospital, 517-5, Yoshino, Satte City, Saitama, 340-0153, Japan
| | - Satoshi Yuguchi
- School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte City, Saitama, 340-0145, Japan
| | - Tomohiko Kamo
- School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte City, Saitama, 340-0145, Japan
| | - Masato Azami
- School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte City, Saitama, 340-0145, Japan
| | - Hirofumi Ogihara
- School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte City, Saitama, 340-0145, Japan
| | - Satoshi Asano
- Saitama Spine Center, Higashi Saitama General Hospital, 517-5, Yoshino, Satte City, Saitama, 340-0153, Japan
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Impact of Neck and Shoulder Pain on Health-Related Quality of Life in a Middle-Aged Community-Living Population. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6674264. [PMID: 34212040 PMCID: PMC8208860 DOI: 10.1155/2021/6674264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 06/02/2021] [Indexed: 12/24/2022]
Abstract
Purpose Neck and shoulder pain (NSP) is very common in the general population. However, scarce information exists on the relationship between NSP and health-related quality of life (HRQOL) outcomes in this population. The present study described NSP prevalence and its impact on the HRQOL of middle-aged and older persons undergoing a routine medical checkup. Methods This study recruited 318 subjects (125 males and 193 females; average age, 63.4 years) in good health, collected underwent anthropometric measurements, physical function examinations, and blood testing. This study defined NSP as the presence of muscle tension, stiffness, pressure, or dull pain in areas between the neck and the arch of the scapular. Study subjects were divided into two groups (NSP (+) and NSP (-) groups). The subjects completed questions on the Medical Outcomes Study 36-item short-form health survey (SF-36) and the EuroQol 5-dimension, 5-level version (EQ-5D-5L) tool. Results Of the patients, 150 and 168 were NSP (+) and NSP (-), respectively. The NSP complaint rate was 47.2%. The NSP (+) group had younger and more female participants than the NSP (-) group. In the multivariate regression analysis, the NSP (+) group had lower physical QOL based on the SF-36 physical component summary (odds ratio (OR), 2.45) and lower mental QOL based on the SF-36 mental component summary (OR, 2.05). Overall, the NSP (+) group had a higher risk of having low QOL scores (EQ-5D-5L index; OR, 1.76). Conclusions The NSP (+) rate in healthy middle-aged and older persons was 47.2%. Furthermore, NSP (+) status was directly related poor HRQOL. NSP is a predictor of suboptimal physical and mental QOL. Therefore, NSP prevention or intervention for NSP may improve middle-aged and older adults' QOL.
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Bioelectrical Impedance Analysis and Manual Measurements of Neck Circumference Are Interchangeable, and Declining Neck Circumference Is Related to Presarcopenia. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6622398. [PMID: 33860044 PMCID: PMC8024069 DOI: 10.1155/2021/6622398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/26/2021] [Accepted: 03/20/2021] [Indexed: 02/07/2023]
Abstract
Purpose Preventive medicine is important in an aging society. Presarcopenia is the preliminary stage of sarcopenia. Recent advances in bioelectrical impedance analysis (BIA) devices have enabled automatic estimation of neck circumference (NC). However, the agreement between and interchangeability of NC measured manually and that calculated with BIA have not been evaluated. We performed these analyses in the context of health checkups and investigated their associations with presarcopenia. Methods We enrolled 318 participants who underwent anthropometric measurements, including NC measured manually and by BIA; assessment of physical function; and blood testing. We used Bland-Altman analysis to calculate the agreement between and interchangeability of NC measurements by BIA and by the manual method. We then statistically compared normal participants and those with presarcopenia. Using multivariable analysis, we subsequently investigated significant risk factors for presarcopenia. We defined presarcopenia according to the appendicular skeletal muscle index (aSMI; the ratio of arm and leg skeletal muscle mass to height2). Results Bland-Altman analysis showed that bias (BIA-manual) was negative overall (−1.07), for male participants (−1.23), and for female participants (−0.96). This finding suggests that BIA measurement is an underestimate in comparison with manual measurement. NC measurement by BIA was found to be interchangeable with that by manual methods, inasmuch as the percentage error was less than 5% overall (4.38%), for male participants (3.81%), and for female participants (4.58%). Univariable analysis revealed that NC was significantly smaller in the participants with presarcopenia than in those without. Multivariable analysis, adjusted for confounding factors, revealed that a decrease in NC was significantly correlated with presarcopenia. Conclusions BIA measurements of NC are interchangeable within about 95% with manual measurements. The decrease in NC measured by BIA was significantly associated with presarcopenia in both genders. NC measurement can be used for early detection of presarcopenia.
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