Age and activity but not lumbar spinal stenosis and muscle fatigue affect sagittal spinal alignment: A pilot study

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-06-01 DOI:10.1016/j.clinbiomech.2025.106577

David Koch , Corina Nüesch , Dominika Ignasiak , Stefan Schären , Stephen J. Ferguson , Annegret Mündermann , Cordula Netzer

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引用次数: 0

Abstract

Background

Ageing is associated with changes in spinal alignment. Lumbar spinal stenosis may alter spinal alignment due to pain, muscle atrophy and fatigue. While spinal alignment and motion are crucial in lumbar spinal stenosis, the effects of age, activity, and muscle fatigue on spinal alignment remain unclear. This study investigates these factors using motion capture analysis.

Methods

In 11 patients with lumbar spinal stenosis (5 M/6 W; age, 71 ± 9 years; body mass index, 29 ± 5 kg/m²), 10 older controls (5 M/5F; 65 ± 5 years; 25 ± 6 kg/m²), and 10 young controls (5 M/5F; 26 ± 2 years; 22 ± 2 kg/m²), spinal alignment was assessed during standing and walking before and after a modified Biering-Sørensen test using reflective markers. The curvature of the thoracic and lumbar spine was modelled using a cubic polynomial. Spine inclination, thoracic kyphosis, lumbar lordosis and pelvic tilt were used to describe spinal alignment. The effects of group, activity and paraspinal muscle fatigue were investigated using bootstrapped mixed-effect models.

Findings

Patients and older controls had greater spine inclination than young controls. Spinal alignment did not differ between patients and older controls. Dynamic activity increased spine inclination, thoracic kyphosis, and pelvic tilt across all groups. Compared to non-fatigued conditions, significant spine inclination increases and lumbar lordosis decreases occurred with fatigue. A significant interaction effect for group and activity was found between patients and young controls.

Interpretation

Our findings suggest that age and activity, rather than lumbar spinal stenosis and muscle fatigue, play a critical role in spinal alignment. Further studies are warranted to investigate the underlying mechanisms. ClinicalTrials.gov ID NCT05309447.

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年龄和活动，但不腰椎管狭窄和肌肉疲劳影响矢状脊柱对齐：一项初步研究

衰老与脊柱排列的改变有关。腰椎管狭窄可因疼痛、肌肉萎缩和疲劳而改变脊柱排列。虽然脊柱对齐和运动对腰椎管狭窄至关重要，但年龄、活动和肌肉疲劳对脊柱对齐的影响尚不清楚。本研究使用动作捕捉分析来调查这些因素。方法11例腰椎管狭窄症患者(5 M/6 W；年龄：71±9岁；体重指数，29±5 kg/m2)， 10名老年对照(5 M/5F；65±5岁；25±6 kg/m2)， 10个年轻对照(5 M/5F；26±2岁；22±2 kg/m2)，在biering - s - ørensen试验前后使用反射标记评估站立和行走时脊柱对齐。胸椎和腰椎的曲度采用三次多项式建模。脊柱倾斜、胸后凸、腰椎前凸和骨盆倾斜被用来描述脊柱排列。采用自举混合效应模型研究了组、运动和棘旁肌疲劳的影响。研究发现，患者和老年对照组的脊柱倾斜度高于年轻对照组。脊柱排列在患者和老年对照组之间没有差异。动态运动增加了所有组的脊柱倾斜、胸椎后凸和骨盆倾斜。与非疲劳状态相比，明显的脊柱倾斜增加和腰椎前凸减少发生疲劳。在患者和年轻对照组之间发现了显著的群体和活动相互作用效应。我们的研究结果表明，年龄和活动，而不是腰椎管狭窄和肌肉疲劳，在脊柱对齐中起关键作用。有必要进一步研究其潜在机制。ClinicalTrials.gov编号NCT05309447。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.