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Ozudogru Celik T, Yalcin E, Keskin HL, Koymen I, Koca N, Demir A. The relationship between low back pain, pelvic tilt, and lumbar lordosis with urinary incontinence using the DIERS formetric 4D motion imaging system. Int Urogynecol J 2024; 35:189-198. [PMID: 38032376 DOI: 10.1007/s00192-023-05688-x] [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: 08/03/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary incontinence (UI) is a common public health problem and postural changes may be crucial in women presenting with UI. This study was aimed at evaluating the relationship between low back pain (LBP), pelvic tilt (PT), and lumbar lordosis (LL) in women with and without UI using the DIERS formetric 4D motion imaging system. To date no study has to our knowledge compared postural changes and LBP in women with UI using the DIERS 4D formetric system. METHODS This was a case-control study. We included 33 women with UI and 33 without incontinence. The severity of urogenital symptoms was assessed by the IIQ-7 (Incontinence Impact Score) and UDI-6 (Urogenital Distress Inventory), and disability owing to LBP was evaluated using the Oswestry Disability Index (ODI). Posture and movement assessment, LL angle, thoracic kyphosis, and PT assessment were performed with the DIERS Formetric 4D motion imaging system. RESULTS The LL angle and pelvic torsion degree were higher in the incontinence group than in the control group (53.9 ± 9.5° vs 48.18 ± 8.3°; p = 0.012, 3.9 ± 4.1 vs 2.03 ± 1.8 mm; p = 0.018 respectively). The LBP visual analog scale value was also significantly higher in the incontinence group (5.09 ± 2.3 vs 1.7 ± 1.8 respectively, p < 0.0001). The LL angle showed a positive correlation with pelvic obliquity, (r = 0.321, p < 0.01) and fleche lombaire (r = 0.472, p < 0.01) and a negative correlation with lumbar range of motion measurements. Pelvic obliquity correlated positively with pelvic torsion (r = 0.649, p < 0.01), LBP (r = 0.369, p < 0.01), and fleche lombaire (r = 0.269, p < 0.01). CONCLUSIONS Women with UI were more likely to have lumbopelvic sagittal alignment changes and a higher visual analog scale for LBP. These findings show the need for assessment of lumbopelvic posture in women with UI.
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Affiliation(s)
- Tugba Ozudogru Celik
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Turkey, Ankara Bilkent City Hospital, 06800, Ankara, Turkey.
| | - Elif Yalcin
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Turkey, Ankara Bilkent City Hospital, 06800, Ankara, Turkey
| | - Huseyin Levent Keskin
- Department of Obstetrics and Gynecology, Ankara Bilkent City Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Ipek Koymen
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Turkey, Ankara Bilkent City Hospital, 06800, Ankara, Turkey
| | - Nadide Koca
- Department of Physical Medicine and Rehabilitation, Ankara Education and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - Ayten Demir
- Faculty of Health Sciences, Ankara University, Ankara, Turkey
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Cha E, Park JH. Spinopelvic Alignment as a Risk Factor for Poor Balance Function in Low Back Pain Patients. Global Spine J 2023; 13:2193-2200. [PMID: 35220778 PMCID: PMC10538310 DOI: 10.1177/21925682221076417] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
STUDY DESIGN Retrospective, observational study. OBJECTIVES This study aimed to examine the association between spinopelvic parameters and balance function in low back pain (LBP). METHODS Among patients in the rehabilitation medicine department, the data of 182 patients (mean age, 47.8 years; M/F = 64/118) was obtained retrospectively. Spinopelvic parameters were measured through a whole-body low-dose biplanar radiography using the EOS imaging system, and balance function was evaluated by the center of pressure (COP) movement using the Zebris treadmill system. Pearson correlations were used to determine the relationship between radiographic and balance function. Stepwise multiple linear regression analyses were conducted with the balance function as a dependent variable and age and spinopelvic parameters as independent variables. RESULTS Increased age, knee flexion (KF), pelvic tilt (PT), C7-central sacral line (C7-CSL) and C7 sagittal vertical axis (SVA), and decreased spino-sacral angle (SSA) were associated with both poor static and dynamic balance. Moreover, increased Cobb's angle and decreased thoracic kyphosis (TK) and lumbar lordosis (LL) was associated with poor static balance. Increased pelvic incidence (PI) was related to poor dynamic balance. Increased age, Cobb's angle, SVA, and decreased TK were risk factors for poor static balance. For dynamic balance, increased age, C7-CSL, and PT were risk factors for poor sagittal balance, whereas increased CAM-plumb line and PT were risk factors for poor coronal balance. CONCLUSIONS Balance function was associated with spinopelvic parameters in patients with LBP. Increased SVA, followed by increased PT, was the strongest independent factor associated with poor static and dynamic balance.
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Affiliation(s)
- Eunsil Cha
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Hyun Park
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea
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Engkananuwat P, Kanlayanaphotporn R. Gluteus medius muscle strengthening exercise effects on medial longitudinal arch height in individuals with flexible flatfoot: a randomized controlled trial. J Exerc Rehabil 2023; 19:57-66. [PMID: 36910682 PMCID: PMC9993003 DOI: 10.12965/jer.2244572.286] [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: 12/16/2022] [Accepted: 01/14/2023] [Indexed: 02/25/2023] Open
Abstract
This study aimed to compare the effects of 8 weeks of foot plus hip exercise to foot exercise alone on medial longitudinal arch (MLA) parameters; navicular drop (ND), arch height index (AHI), plantar pressure, static balance, and dynamic balance were measured at baseline, 4 weeks, and 8 weeks. A total of 52 healthy participants with bilateral flatfoot were randomly assigned into foot exercise (n=26) and foot plus hip exercise (n=26) group. At 4 weeks, the foot plus hip exercise group showed significantly less ND (P=0.002), plantar pressure at the medial forefoot (P=0.002), and mediolateral displacement (P=0.001) while showing a greater AHI (P=0.019) than the foot exercise group. At 8 weeks, there was also significantly less plantar pressure at the medial hindfoot (P=0.017) and less anteroposterior displacement (P=0.002) in the foot plus hip exercise group than in the foot exercise group. No significant differences between groups were found in dynamic balance. The addition of gluteus medius muscle strengthening exercise to foot exercise was more effective in supporting the MLA than performing foot exercise alone.
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Affiliation(s)
- Phoomchai Engkananuwat
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Rotsalai Kanlayanaphotporn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Azevedo N, Ribeiro JC, Machado L. Balance and Posture in Children and Adolescents: A Cross-Sectional Study. SENSORS 2022; 22:s22134973. [PMID: 35808468 PMCID: PMC9269686 DOI: 10.3390/s22134973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 02/04/2023]
Abstract
Balance and posture are two topics that have been extensively studied, although with some conflicting findings. Therefore, the aim of this work is to analyze the relationship between the postural angles of the spine in the sagittal plane and the stable static balance. A cross-sectional study was conducted with children and adolescents from schools in northern Portugal in 2019. An online questionnaire was used to characterize the sample and analyze back pain. Spinal postural angle assessment (pelvic, lumbar, and thoracic) was performed using the Spinal Mouse®, while stabilometry assessment was performed using Namrol® Podoprint®. Statistical significance was set as α = 0.05. The results showed that girls have better balance variables. There is a weak correlation between the anthropometric variables with stabilometry variables and the postural angles. This correlation is mostly negative, except for the thoracic spine with anthropometric variables and the lumbar spine with BMI. The results showed that postural angles of the spine are poor predictors of the stabilometric variables. Concerning back pain, increasing the postural angle of the thoracic spine increases the odds ratio of manifestation of back pain by 3%.
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Affiliation(s)
- Nelson Azevedo
- CICS, ISAVE, Faculdade de Desporto da Universidade do Porto, 4200-450 Porto, Portugal;
| | - José Carlos Ribeiro
- CIAFEL, ITR, Faculdade de Desporto da Universidade do Porto, 4200-450 Porto, Portugal;
| | - Leandro Machado
- CIFI2D, LABIOMEP, Faculdade de Desporto da Universidade do Porto, 4200-450 Porto, Portugal
- Correspondence:
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Zmyślna A, Żurawski A, Rosiński T, Pogorzelska J, Śliwiński Z, Śliwiński G, Kiebzak W. The Relationship Between the Shape of the Spine and the Width of Linea Alba in Children Aged 6-9 Years. Case-Control Study. Front Pediatr 2022; 10:839171. [PMID: 35601410 PMCID: PMC9114469 DOI: 10.3389/fped.2022.839171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 04/14/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Civilization development coupled with contemporary lifestyle leads to a systematic increase in postural disorders. An analysis of factors that may provoke postural disorders indicates that such a stimulus may be the diastasis of the rectus abdominis muscles. Moreover, abnormal activity of the rectus abdominis muscles may affect balance disorders through reduced spinal stabilization and disturbed body statics. There is an increase in body posture abnormalities between the ages of 6 and 9 related to new school duties. PURPOSE OF THE STUDY The purpose of the study was to evaluate the relationship between the shape of the spine and the width of the linea alba in children aged 6-9 years. MATERIAL AND METHOD The study was designed to evaluate parameters determining the shape of the spine, and the width of the linea alba in healthy children aged 6-9 years. The study participants were divided into two groups based on the width of the linea alba. The study group with the width of the linea alba >10 mm and the control group with the width of the linea alba ≤ 10 mm. The study group were included 37 children and the control group 24 children. The examination of the linea alba width was performed by a radiology specialist using a linear transducer and SAOTE- My Lab Classc-type ultrasound at rest and during contraction of the rectus abdominis muscles. Parameters describing the shape of the spine were measured using the Diers Formetric 4D system: trunk inclination, trunk imbalance, pelvis tilt, pelvic torsion, kyphotic apex, lordotic apex, kyphotic angle, lordotic angle, rotation angle, trunk torsion, lateral deviation. The obtained results were statistically analyzed using a Paired t test for comparison of differences between the results in the study and control groups and Pearson's test to assess the correlation between the width of the linea alba and parameters describing spinal alignment. RESULTS In both groups, the parameters describing the shape of the spine did not differ from the norms accepted as typical for the age norm. The only statistically significant difference between the study and control group concerned the trunk inclination, which was negative in the study group, signifying a shift of the entire spine axis backwards beyond the vertical. CONCLUSIONS There is a correlation between the shape of spine and the width of the linea alba in terms of selected parameters determining the body posture in the sagittal plane, which concern: the position of the lumbar lordotic apex, trunk inclination and the depth of the lumbar lordotic angle. The width of the linea alba is not explicitly related to abnormalities of pelvic and spinal alignment in the frontal and transverse planes.
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Affiliation(s)
- Anna Zmyślna
- Collegium Medicum, Institute of Health Sciences, Jan Kochanowski University of Kielce, Kielce, Poland.,Swietokrzyskie Paediatrics Centre, Regional Hospital Complex in Kielce, Kielce, Poland
| | - Arkadiusz Żurawski
- Collegium Medicum, Institute of Health Sciences, Jan Kochanowski University of Kielce, Kielce, Poland.,Swietokrzyskie Paediatrics Centre, Regional Hospital Complex in Kielce, Kielce, Poland
| | - Tomasz Rosiński
- Collegium Medicum, Institute of Health Sciences, Jan Kochanowski University of Kielce, Kielce, Poland.,Swietokrzyskie Paediatrics Centre, Regional Hospital Complex in Kielce, Kielce, Poland
| | - Justyna Pogorzelska
- Collegium Medicum, Institute of Health Sciences, Jan Kochanowski University of Kielce, Kielce, Poland.,Swietokrzyskie Paediatrics Centre, Regional Hospital Complex in Kielce, Kielce, Poland
| | - Zbigniew Śliwiński
- Collegium Medicum, Institute of Health Sciences, Jan Kochanowski University of Kielce, Kielce, Poland.,Multispecialist Hospital-Independent Public Health Care Centre in Zgorzelec, In-patient Rehabilitation Centre, Nowa Sól, Poland
| | - Grzegorz Śliwiński
- Collegium Medicum, Institute of Health Sciences, Jan Kochanowski University of Kielce, Kielce, Poland.,TU Dresden, Faculty of Electrical and Computer Engineering, Institute of Biomedical Engineering, Dresden, Germany
| | - Wojciech Kiebzak
- Collegium Medicum, Institute of Health Sciences, Jan Kochanowski University of Kielce, Kielce, Poland.,Swietokrzyskie Paediatrics Centre, Regional Hospital Complex in Kielce, Kielce, Poland
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