Isokinetic strength assessment of trunk muscle and its relationship with spinal-pelvic parameters in patients with degenerative spinal deformity.

BACKGROUND The incidence rate of degenerative spinal deformity (DSD) has gradually increased in the elderly. Currently, the relationship between the functional status of trunk muscle and the spinal-pelvic parameters of DSD patients remains unclear. OBJECTIVE This paper aims to explore the relationship between the two factors and provide new clues for exploring the mechanism of the occurrence and development of DSD. METHODS A total of 41 DSD patients treated in our hospital (DSD group) and 35 healthy volunteers (control group) were selected. Muscle strength was evaluated using an IsoMed-2000 isokinetic dynamometer, and the trunk flexor and extensor peak torque (PT) of subjects was measured at a low, medium, and high angular velocity of 30∘/s, 60∘/s, and 120∘/s, respectively. Hand grip strength (HGS) was assessed using an electronic grip dynamometer and Surgimap software was used to measure the spinal-pelvic parameters, including the sagittal vertical axis (SVA), thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), pelvic incidence rate (PI), and PI-LL, and the relationship between trunk muscle function and various parameters was analyzed. RESULTS Under the three angular velocities, the flexor and extensor PT values in the DSD group were lower than those in the control group, and only the extensor PT showed a statistically significant difference (P< 0.05). There was no significant difference in HGS between the two groups (P> 0.05). In the DSD group, the extensor PT at 30∘/s was significantly negatively correlated with SVA (P< 0.05). At 60∘/s and 120∘/s, the extensor PT was significantly negatively correlated with SVA and PT (P< 0.05). CONCLUSION Trunk extensor strength is significantly lower in DSD patients than in normal controls. The decline in trunk extensor strength in DSD patients is a type of local muscle dysfunction more closely related to the deformity, which is likely involved in the compensatory mechanism of DSD and may reflect the overall imbalance of the trunk.

[1]  P. Hodges,et al.  Paraspinal muscle imaging measurements for common spinal disorders: review and consensus-based recommendations from the ISSLS degenerative spinal phenotypes group , 2021, European Spine Journal.

[2]  F. Luo,et al.  Assessment of isokinetic trunk muscle strength and its association with health-related quality of life in patients with degenerative spinal deformity , 2020, BMC Musculoskeletal Disorders.

[3]  K. de Jesus,et al.  Evaluation isometric and isokinetic of trunk flexor and extensor muscles with isokinetic dynamometer: A systematic review. , 2020, Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine.

[4]  Z. Wang,et al.  Limited correction of lumbar lordosis in the treatment of degenerative scoliosis , 2020, Medicine.

[5]  Hiroshi Ito,et al.  Adult spinal deformity and its relationship with height loss: a 34-year longitudinal cohort study , 2020, BMC Musculoskeletal Disorders.

[6]  J. Cheung.  The importance of sagittal balance in adult scoliosis surgery. , 2020, Annals of translational medicine.

[7]  F. Luo,et al.  Reliability and validity of three isometric back extensor strength assessments with different test postures , 2019, The Journal of international medical research.

[8]  Haiying Liu,et al.  Association between back muscle degeneration and spinal-pelvic parameters in patients with degenerative spinal kyphosis , 2019, BMC Musculoskeletal Disorders.

[9]  Tetsuro Ohba,et al.  Potential Role of Paraspinal Musculature in the Maintenance of Spinopelvic Alignment in Patients With Adult Spinal Deformities , 2019, Clinical spine surgery.

[10]  Carl B Paulino,et al.  Adult spinal deformity , 2019, The Lancet.

[11]  G. S. Dangayach,et al.  Impact of posture and upper-limb muscle activity on grip strength , 2018, International journal of occupational safety and ergonomics : JOSE.

[12]  Ajlan Saç.  Correlation between the Q angle and the isokinetic knee strength and muscle activity. , 2018, Turkish journal of physical medicine and rehabilitation.

[13]  R. Holewijn,et al.  Sagittal radiographic parameters demonstrate weak correlations with pretreatment patient-reported health-related quality of life measures in symptomatic de novo degenerative lumbar scoliosis: a European multicenter analysis. , 2018, Journal of neurosurgery. Spine.

[14]  B. Fink,et al.  Handgrip Strength as a Darwinian Fitness Indicator in Men , 2018, Front. Psychol..

[15]  Melvin C. Makhni,et al.  Restoration of Sagittal Balance in Spinal Deformity Surgery , 2018, Journal of Korean Neurosurgical Society.

[16]  A. Schnider,et al.  Comparison of Neuroplastic Responses to Cathodal Transcranial Direct Current Stimulation and Continuous Theta Burst Stimulation in Subacute Stroke. , 2017, Archives of physical medicine and rehabilitation.

[17]  T. Pizzari,et al.  Isokinetic strength assessment offers limited predictive validity for detecting risk of future hamstring strain in sport: a systematic review and meta-analysis , 2017, British Journal of Sports Medicine.

[18]  J. Mecklin,et al.  Spinopelvic Changes Based on the Simplified SRS-Schwab Adult Spinal Deformity Classification: Relationships With Disability and Health-Related Quality of Life in Adult Patients With Prolonged Degenerative Spinal Disorders , 2017, Spine.

[19]  E. Wong,et al.  Adult Degenerative Lumbar Scoliosis. , 2017, Orthopedics.

[20]  R. Yu,et al.  Reference Values of Grip Strength, Prevalence of Low Grip Strength, and Factors Affecting Grip Strength Values in Chinese Adults. , 2017, Journal of the American Medical Directors Association.

[21]  H. Takashima,et al.  Magnetic resonance spectroscopic analysis of multifidus muscles lipid content and association with spinopelvic malalignment in chronic low back pain. , 2017, The British journal of radiology.

[22]  N. Passuti,et al.  Correlation between radiographic parameters and functional scores in degenerative lumbar and thoracolumbar scoliosis. , 2017, Orthopaedics & traumatology, surgery & research : OTSR.

[23]  Lars Donath,et al.  Absolute and relative reliability of isokinetic and isometric trunk strength testing using the IsoMed-2000 dynamometer. , 2017, Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine.

[24]  L. Lenke,et al.  Recent and Emerging Advances in Spinal Deformity , 2017, Neurosurgery.

[25]  Ji Hee Kim,et al.  The Effect of Lumbar Spinal Muscle on Spinal Sagittal Alignment: Evaluating Muscle Quantity and Quality. , 2016, Neurosurgery.

[26]  A. López-Valenciano,et al.  Isokinetic trunk flexion–extension protocol to assess trunk muscle strength and endurance: Reliability, learning effect, and sex differences , 2016, Journal of sport and health science.

[27]  M. McGee-Lawrence,et al.  Fatty Infiltration of Skeletal Muscle: Mechanisms and Comparisons with Bone Marrow Adiposity , 2016, Front. Endocrinol..

[28]  M. Matsumoto,et al.  The paravertebral muscle and psoas for the maintenance of global spinal alignment in patient with degenerative lumbar scoliosis. , 2016, The spine journal : official journal of the North American Spine Society.

[29]  Justin K Scheer,et al.  Defining Spino-Pelvic Alignment Thresholds: Should Operative Goals in Adult Spinal Deformity Surgery Account for Age? , 2016, Spine.

[30]  F. Schwab,et al.  Sagittal alignment of the spine: What do you need to know? , 2015, Clinical Neurology and Neurosurgery.

[31]  L. Lenke,et al.  Degenerative Spinal Deformity. , 2015, Neurosurgery.

[32]  D. Rothenfluh,et al.  Pelvic incidence-lumbar lordosis mismatch predisposes to adjacent segment disease after lumbar spinal fusion , 2015, European Spine Journal.

[33]  F. Schwab,et al.  Recruitment of Compensatory Mechanisms in Sagittal Spinal Malalignment Is Age and Regional Deformity Dependent: A Full-Standing Axis Analysis of Key Radiographical Parameters , 2015, Spine.

[34]  Christopher Ames,et al.  TheT1 pelvic angle, a novel radiographic measure of global sagittal deformity, accounts for both spinal inclination and pelvic tilt and correlates with health-related quality of life. , 2014, The Journal of bone and joint surgery. American volume.

[35]  Zhixiong Zhou,et al.  Muscular strength measurements indicate bone mineral density loss in postmenopausal women , 2013, Clinical interventions in aging.

[36]  Oheneba Boachie-Adjei,et al.  Radiographical Spinopelvic Parameters and Disability in the Setting of Adult Spinal Deformity: A Prospective Multicenter Analysis , 2013, Spine.

[37]  L. Ploutz-Snyder,et al.  Influence of muscle strength to weight ratio on functional task performance , 2013, European Journal of Applied Physiology.

[38]  J. Buchowski,et al.  Scoliosis Research Society—Schwab Adult Spinal Deformity Classification: A Validation Study , 2012, Spine.

[39]  Pierre Roussouly,et al.  Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms? , 2011, European Spine Journal.

[40]  M. Mullender,et al.  Spinal decompensation in degenerative lumbar scoliosis , 2010, European Spine Journal.

[41]  Ashish Patel,et al.  Pelvic Tilt and Truncal Inclination: Two Key Radiographic Parameters in the Setting of Adults With Spinal Deformity , 2009, Spine.

[42]  T. Fukunaga,et al.  Relationships Between Muscle Strength and Indices of Muscle Cross-Sectional Area Determined During Maximal Voluntary Contraction in Middle-Aged and Elderly Individuals , 2009, Journal of strength and conditioning research.

[43]  M. Takemitsu,et al.  A Prospective Study of De Novo Scoliosis in a Community Based Cohort , 2006, Spine.

[44]  Courtney W. Brown,et al.  Is There an Optimal Patient Stance for Obtaining a Lateral 36” Radiograph?: A Critical Comparison of Three Techniques , 2005, Spine.

[45]  V. Unnithan,et al.  Differences in Thoracic Kyphosis and in Back Muscle Strength in Women With Bone Loss due to Osteoporosis , 2005, Spine.

[46]  Danuta Roman-Liu,et al.  Maximum handgrip force in relation to upper limb posture--a meta-analysis. , 2003, AIHA journal : a journal for the science of occupational and environmental health and safety.

[47]  Virgil Mathiowetz,et al.  Comparison of Rolyan and Jamar dynamometers for measuring grip strength. , 2002, Occupational therapy international.

[48]  E. Berthonnaud,et al.  Sagittal morphology and equilibrium of pelvis and spine , 2002, European Spine Journal.

[49]  K. Lam,et al.  The importance of an intact abdominal musculature mechanism in maintaining spinal sagittal balance. Case illustration in prune-belly syndrome. , 1999, Spine.

[50]  E Itoi,et al.  Correlation of back extensor strength with thoracic kyphosis and lumbar lordosis in estrogen-deficient women. , 1996, American journal of physical medicine & rehabilitation.