The Study: Correlation between radiographic sagittal alignment, range of motion, muscle strength, and quality of life in adults with spinal deformities      

The Facts:

a. The authors looked at the relationship of muscle strength in the spine and lower limbs to range of motion, sagittal spinal alignment and the patient’s quality of life.

b. The study used what remains as the gold standard to evaluate spinal sagittal alignment, standing lateral radiographs.

c. The study looked at 26 subjects.

d. They took standing lateral radiographs and measured a number of parameters of spinal and pelvic alignment. (See figure 1 in the full text for more specificity) 

e. These included: the sagittal alignment of the spine, lumbar lordosis (LL), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), sagittal vertical axis (SVA) , pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS).

f. They also looked at both spinal and lower limb motion as well as strength of both the spinal muscles and the lower limbs.

g. They used questionnaires to evaluate pain related disorder and assess the impact on quality of life.

h. The authors concluded, “… our study demonstrated that hip extension ROM and back extensor endurance were important factors in sagittal alignment, and lumbar spine ROM, as well as hip and knee extension ROM were important factors for QOL. These factors should be targeted for assessment and treatment in adults with spinal deformities.” 

Take Home:

There is an interplay between sagittal spinal alignment and function and these affect quality of life.

Reviewer's Comments: The relationship between all these factors is complex and important. When you do a study you look at a subject from a specific point of view using a particular set of tools. As we do more studies we are able to get a more complete picture. But what keeps coming through loud and clear is that mechanical alignment is an important part of the equation. There is a lot to this article so give it a read. Also note that this study represents a continued interest in sagittal postures and the use of spinal radiography by the medical profession. Also note that their measurements in this study did not go above C7.

Reviewer:  Roger Coleman DC 

Editor’s Comments: This was a small study which was further complicated by a large dropout rate due to pain while assessing lumbar ROM and extensor strength. Nevertheless, it’s worth a read and worth noting how medicine continues to research the uniquely chiropractic idea that spinal misalignment is related to bodily function.

Editor: Mark R. Payne DC 

Reference: Saimon Y, Goh AC, Momose K, Ryuzaki D, Akahane H, Oba A, Mukaiyama K. Correlation between radiographic sagittal alignment, range of motion, muscle strength, and quality of life in adults with spinal deformities. J Phys Ther Sci. 2020 Feb;32(2):140-147. doi: 10.1589/jpts.32.140. Epub 2020 Feb 14.

Link to Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7032984/