Comparative evaluation of a novel measurement tool to assess lumbar spine posture and range of motion

PurposeThe diagnosis of low back pain pathology is generally based upon invasive image-based assessment of structural pathology, but is limited in methods to evaluate function. The accurate and robust measurement of dynamic function may assist in the diagnosis and monitoring of therapy success. Epionics SPINE is an advanced strain-gauge measurement technology, based on the two sensor strips SpineDMS system, which allows the non-invasive assessment of lumbar and thoraco-lumbar motion for periods of up to 24 h. The aim of this study was to examine the reliability of Epionics SPINE and to collect and compare normative data for the characterisation of spinal motion in healthy subjects. Furthermore, the identification of parameters that influence lumbar range of motion (RoM) was targeted.MethodsSpinal shape was measured using Epionics SPINE in 30 asymptomatic volunteers during upright standing, as well as maximum flexion and extension, to check intra-rater reliability. Furthermore, back shape was assessed throughout repeated maximum flexion and extension movements in 429 asymptomatic volunteers in order to collect normative data of the lordosis angle and RoM in different gender and age classes.ResultsThe lordosis angle during standing in the healthy collective measured with Epionics SPINE was 32.4° ± 9.7°. Relative to this standing position, the average maximum flexion angle was 50.8° ± 10.9° and the average extension angle 25.0° ± 11.5°. Comparisons with X-ray and Spinal Mouse data demonstrated good agreement in static positions. Age played a larger role than gender in influencing lumbar posture and RoM.ConclusionsThe Epionics SPINE system allows the practical and reliable dynamic assessment of lumbar spine shape and RoM, and may therefore provide a clinical solution for the evaluation of lower back pain as well as therapy monitoring.

[1]  S. Boonen,et al.  Measurements of vertebral shape by radiographic morphometry: sex differences and relationships with vertebral level and lumbar lordosis , 1998, Skeletal Radiology.

[2]  Wafa Skalli,et al.  Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects. , 2005, The Journal of bone and joint surgery. American volume.

[3]  K. Buckup Clinical Tests for the Musculoskeletal System: Examinations - Signs - Phenomena , 2008 .

[4]  G. Fitzgerald,et al.  Objective assessment with establishment of normal values for lumbar spinal range of motion. , 1983, Physical therapy.

[5]  L. Manchikanti,et al.  Periradicular infiltration for sciatica. , 2002, Spine.

[6]  Wafa Skalli,et al.  Differences in Male and Female Spino-Pelvic Alignment in Asymptomatic Young Adults: A Three-Dimensional Analysis Using Upright Low-Dose Digital Biplanar X-rays , 2009, Spine.

[7]  Thomas C. Erren,et al.  A new approach to assess movements and isometric postures of spine and trunk at the workplace , 2011, European Spine Journal.

[8]  K. Jacobsen,et al.  Congenital dislocation of the knee. , 1985, Acta orthopaedica Scandinavica.

[9]  A. Mannion,et al.  A new skin-surface device for measuring the curvature and global and segmental ranges of motion of the spine: reliability of measurements and comparison with data reviewed from the literature , 2004, European Spine Journal.

[10]  F D'Osualdo,et al.  New tridimensional approach to the evaluation of the spine through surface measurement: the BACES system. , 2002, Journal of medical engineering & technology.

[11]  B Drerup,et al.  [Functional rasterstereographic images. A new method for biomechanical analysis of skeletal geometry]. , 2001, Der Orthopade.

[12]  James H. McAuley,et al.  Relationship between physical activity and disability in low back pain: A systematic review and meta-analysis , 2011, PAIN®.

[13]  Frymoyer Jw,et al.  An overview of the incidences and costs of low back pain. , 1991 .

[14]  W. Cats-Baril,et al.  An overview of the incidences and costs of low back pain. , 1991, The Orthopedic clinics of North America.

[15]  William R Taylor,et al.  A novel system for the dynamic assessment of back shape. , 2010, Medical engineering & physics.

[16]  J. Leong,et al.  Development and Validation of a New Technique for Assessing Lumbar Spine Motion , 2002, Spine.

[17]  K. Buckup Clinical Tests for the Musculoskeletal System , 2004 .

[18]  Kevin Huang,et al.  Development of a real-time three-dimensional spinal motion measurement system for clinical practice , 2006, Medical and Biological Engineering and Computing.

[19]  S. Bigos,et al.  Spinal flexibility and individual factors that influence it. , 1987, Physical therapy.

[20]  A. Moore,et al.  A normative database of lumbar spine ranges of motion. , 2005, Manual therapy.

[21]  J. Caro,et al.  A systematic review of low back pain cost of illness studies in the United States and internationally. , 2008, The spine journal : official journal of the North American Spine Society.

[22]  Raymond Y.W. Lee,et al.  Dynamic measurement of lumbar curvature using fibre-optic sensors. , 2010, Medical engineering & physics.

[23]  M. Pearcy Stereo radiography of lumbar spine motion. , 1985, Acta orthopaedica Scandinavica. Supplementum.

[24]  M. Panjabi,et al.  Normal motion of the lumbar spine as related to age and gender , 2004, European Spine Journal.

[25]  Marisa A. Colston,et al.  Sagittal lumbar spine position during standing, walking, and running at various gradients. , 2007, Journal of athletic training.

[26]  William S Marras,et al.  Revised protocol for the kinematic assessment of impairment. , 2004, The spine journal : official journal of the North American Spine Society.

[27]  Lumbar corsets: their effect on three-dimensional kinematics of the pelvis. , 1999, Journal of rehabilitation research and development.