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Shalamzari MH, Henteh MA, Shamsoddini A, Ghanjal A. Comparison of the effects of core stability and whole-body electromyostimulation exercises on lumbar lordosis angle and dynamic balance of sedentary people with hyperlordosis: a randomized controlled trial. BMC Sports Sci Med Rehabil 2024; 16:91. [PMID: 38654368 PMCID: PMC11036689 DOI: 10.1186/s13102-024-00879-5] [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: 10/30/2023] [Accepted: 04/10/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Hyperlordosis is an excessive inward curvature of the lumbar spine that affects spinal function. The aim of this study was to compare the effects of core stability exercises (CSE), Whole-Body Electromyostimulation (WB-EMS), and CSE Plus on the Lumbar lordosis angle and dynamic balance in sedentary people with hyperlordosis. METHODS In a parallel randomized controlled trial study, seventy five untrained male adults with hyperlordosis, recruited from clinics of sports medicine and corrective exercise centers in Tehran, were randomly assigned to four groups: CSE (n = 19), WB-EMS (n = 18), CSE Plus (n = 18), and control Group (CG) (n = 20). The CSE group performed Core stability exercises, the WB-EMS group followed a Whole-body electromyostimulation combined training protocol, and the CSE Plus group engaged in a combined program protocol (CSE with the WB-EMS vest), and the control group only participated in activities of daily living. Anthropometric parameters and outcomes, including the lordosis angle and dynamic balance, were assessed before and after a six-week training program. A flexible ruler was used to measure the angle of lordosis, and the Y balance test was employed to evaluate the dynamic balance. RESULTS The results indicated that the lordosis angle improved in both the CSE and CSE Plus groups compared to the CG in the post-test (P = 0.017, P = 0.024). However, there were no significant differences observed between the other group pairs. Additionally, a significant difference in dynamic balance was found between the CSE Plus group and the CG in the post-test (P = 0.001), while no significant differences were observed between the other group pairs. Furthermore, within-group test results demonstrated that lumbar lordosis angle and dynamic balance variables significantly improved in the post-test compared to the pre-test stage (P < 0.05). CONCLUSIONS The two CSE and CSE Plus training protocols are effective as training methods for correcting certain parameters and physical deformities, including lumbar lordosis. Furthermore, the CSE Plus group demonstrated a positive impact on improving dynamic balance. Consequently, it is highly recommended that individuals with hyperlordosis can benefit from the exercises of the present study, especially CSE Plus exercises along with other rehabilitation exercises. TRIAL REGISTRATION The trial was registered at Thai Clinical Trials Registry (TCTR20221004011, registration date: 04/10/2022).
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Affiliation(s)
- Mohammad Hamzeh Shalamzari
- Department of Sports Injury and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
| | - Mohammad Amin Henteh
- Department of Sports Injury and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran
| | - Alireza Shamsoddini
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ali Ghanjal
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Passias PG, Segreto FA, Imbo B, Williamson T, Joujon-Roche R, Tretiakov P, Krol O, Naessig S, Bortz CA, Horn SR, Ahmad W, Pierce K, Ihejirika YU, Lafage V. Defining age-adjusted spinopelvic alignment thresholds: should we integrate BMI? Spine Deform 2022; 10:1077-1084. [PMID: 35657561 DOI: 10.1007/s43390-022-00522-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 05/02/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To develop age- and BMI-adjusted alignment targets to improve patient-specific management and operative treatment outcomes. METHODS Retrospective review of a single-center stereographic database. ASD patients receiving operative or non-operative treatment, ≥ 18y/o with complete baseline (BL) ODI scores and radiographic parameters (PT, SVA, PILL, TPA) were included. Patients were stratified by age consistent with US-Normative values (norms) of SF-36(< 35, 35-55, 45-54, 55-64, 65-74, ≥ 75y/o), and dichotomized by BMI (Non-Obese < 30; Obese ≥ 30). Linear regression analysis established normative age- and BMI-specific radiographic thresholds, utilizing previously published age-specific US-Normative ODI values converted from SF-36 PCS (Lafage et al.), in conjunction with BL age and BMI means. RESULTS 486 patients were included (Age: 52.5, Gender: 68.7%F, mean BMI: 26.2, mean ODI: 32.7), 135 of which were obese. Linear regression analysis developed age- and BMI-specific alignment thresholds, indicating PT, SVA, PILL, and TPA to increase with both increased age and increased BMI (all R > 0.5, p < 0.001). For non-obese patients, PT, SVA, PILL, and TPA ranged from 10.0, - 25.8, - 9.0, 3.1 in patients < 35y/o to 27.8, 53.4, 17.7, 25.8 in patients ≥ 75 y/o. Obese patients' PT, SVA, PILL, and TPA ranged from 10.5, - 7.6, - 7.1, 5.8 in patients < 35 y/o to 28.3, 67.0, 19.15, 27.7 in patients ≥ 75y/o. Normative SVA values in obese patients were consistently ≥ 10 mm greater compared to non-obese values, at all ages. CONCLUSION Significant associations exist between age, BMI, and sagittal alignment. While BMI influenced age-adjusted alignment norms for PT, SVA, PILL, and TPA at all ages, obesity most greatly influenced SVA, with normative values similar to non-obese patients who were 10 years older. Age-adjusted alignment thresholds should take BMI into account, calling for less rigorous alignment objectives in older and obese patients.
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Affiliation(s)
- Peter G Passias
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA. .,Division of Spinal Surgery, Department of Orthopaedic and Neurological Surgery, NYU School of Medicine, New York Spine Institute, 301 East 17th St, New York, NY, 10003, USA.
| | - Frank A Segreto
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA
| | - Bailey Imbo
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA
| | - Tyler Williamson
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA
| | - Rachel Joujon-Roche
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA
| | - Peter Tretiakov
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA
| | - Oscar Krol
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA
| | - Sara Naessig
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA
| | - Cole A Bortz
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA
| | - Samantha R Horn
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA
| | - Waleed Ahmad
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA
| | - Katherine Pierce
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA
| | - Yael U Ihejirika
- Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, Manhattan, NY, USA
| | - Virginie Lafage
- Department of Orthopaedics, Lenox Hill Hospital, Northwell Health, New York, NY, USA
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Body mass index and waist circumference in early adulthood are associated with thoracolumbar spine shape at age 60-64: The Medical Research Council National Survey of Health and Development. PLoS One 2018; 13:e0197570. [PMID: 29902185 PMCID: PMC6002244 DOI: 10.1371/journal.pone.0197570] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 05/04/2018] [Indexed: 12/12/2022] Open
Abstract
This study investigated associations between measures of adiposity from age 36 and spine shape at 60-64 years. Thoracolumbar spine shape was characterised using statistical shape modelling on lateral dual-energy x-ray absorptiometry images of the spine from 1529 participants of the MRC National Survey of Health and Development, acquired at age 60-64. Associations of spine shape modes with: 1) contemporaneous measures of total and central adiposity (body mass index (BMI), waist circumference (WC)) and body composition (android:gynoid fat mass ratio and lean and fat mass indices, calculated as whole body (excluding the head) lean or fat mass (kg) divided by height2 (m)2); 2) changes in total and central adiposity between age 36 and 60-64 and 3) age at onset of overweight, were tested using linear regression models. Four modes described 79% of the total variance in spine shape. In men, greater lean mass index was associated with a larger lordosis whereas greater fat mass index was associated with straighter spines. Greater current BMI was associated with a more uneven curvature in men and with larger anterior-posterior (a-p) vertebral diameters in both sexes. Greater WC and fat mass index were also associated with a-p diameter in both sexes. There was no clear evidence that gains in BMI and WC during earlier stages of adulthood were associated with spine shape but younger onset of overweight was associated with a more uneven spine and greater a-p diameter. In conclusion, sagittal spine shapes had different associations with total and central adiposity; earlier onset of overweight and prior measures of WC were particularly important.
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Ameer MAM, Abdel-Aziem AA. Relationship between anthropometric measures and sagittal spinal curvatures in adult male handball players. HUMAN MOVEMENT 2017. [DOI: 10.1515/humo-2017-0035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractPurpose. Increasing anthropometric measures bring considerable spinal loads during sports practice, which inversely affects the adaptation abilities of the spinal structures; this in turn influences the spinal curvatures. The study was conducted to explore the relationship between anthropometric measures and sagittal spinal curvatures in handball players. Method. The total of 83 male handball players were divided into 2 groups, depending on their body height: group 1 (age, 23.62 ± 2.07 years) consisted of 40 handball players with height above average, group 2 (age, 24.63 ± 2.58 years) consisted of 43 handball players with height below average. The thoracic and lumbar curvatures and trunk height were measured with the Formetric III 4D spine and posture analysis system. Results. The thoracic kyphosis of group 1 was significantly higher than that of group 2 (p = 0.038), without a significant difference in lumbar lordosis (p = 0.312), and significant difference in the coefficient of compensation between thoracic kyphosis and lumbar lordosis (p = 0.026). Group 1 showed strong positive correlation between body height and kyphotic angle (r = 0.897), and moderate positive correlation with lordosis angle (r = 0.496). In group 2, there was weak positive correlation with kyphotic angle (r = 0.381), and weak negative correlation with lumbar lordosis angle (r = -0.355). Conclusions. Increasing body height of handball players is associated with bigger kyphotic and lordotic angles. Owing to frequent sagittal asymmetric overloading of the spine during handball training, exercises that help maintain good posture and correct the thoracic kyphosis are required, especially for taller players.
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Kim B, Tsujimoto T, So R, Zhao X, Suzuki S, Kim T, Tanaka K. Weight loss may be a better approach for managing musculoskeletal conditions than increasing muscle mass and strength. J Phys Ther Sci 2015; 27:3787-91. [PMID: 26834353 PMCID: PMC4713792 DOI: 10.1589/jpts.27.3787] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 09/17/2015] [Indexed: 11/24/2022] Open
Abstract
To prevent or remedy musculoskeletal conditions, the relationship between obesity and the
characteristics of muscle mass and strength need to be clarified. [Subjects and Methods] A
total of 259 Japanese males aged 30–64 years were classified into 4 groups according to
the Japanese obesity criteria. Body composition was evaluated, and handgrip strength and
knee extensor strength were measured for the upper and lower extremities, respectively.
Physical performance was evaluated with a jump test. [Results] Obesity was positively
correlated with skeletal muscle mass index, percentage of whole-body fat, and leg muscle
strength and negatively correlated with the percentage of muscle mass index, body
weight-normalized handgrip strength, and knee extensor strength, and the jump test
results. [Conclusion] Weight loss may be a better approach than increasing muscle mass and
strength to improve musculoskeletal conditions in obese adult males.
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Affiliation(s)
- Bokun Kim
- Doctoral Program in Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan
| | | | - Rina So
- Faculty of Health and Sport Sciences, University of Tsukuba, Japan; Japan Society for the Promotion of Science, Japan
| | - Xiaoguang Zhao
- Doctoral Program in Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan
| | - Shun Suzuki
- Master's Program in Health and Sport Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan
| | - Taeho Kim
- Doctoral Program in Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan
| | - Kiyoji Tanaka
- Faculty of Health and Sport Sciences, University of Tsukuba, Japan
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