An exploration of familial associations in spinal posture defined using a clinical grouping method

Abstract

The primary aim of this study was to examine familial associations in spinal posture, defined using postural angles and a clinical classification method. A secondary aim was to investigate the reliability of clinical postural classification. Postural angles were calculated from sagittal photographs, while two experienced clinicians made use of standing sagittal images to classify participants into one of four postural groups (sway, flat, hyperlordotic, neutral). Parent-child associations in postural angles and postural groups were evaluated using Pearson's correlation and Fisher's exact test, respectively. Inter-rater reliability was expressed using percentage agreement and Kappa coefficients (K). Daughters whose father or mother had a hyperlordotic posture were 4.0 or 3.5 times, respectively, more likely to have a hyperlordotic posture than daughters whose parents did not have a hyperlordotic posture. These participants in the hyperlorotic group had a significantly higher body mass index than members of the other postural groups (p < 0.03). Percentage agreement between clinicians was 63.5% (K = 0.48). These results provide preliminary evidence of a familial association in the hyperlordotic posture and support the use of postural classification.

Fat infiltration in the lumbar multifidus and erector spinae muscles in subjects with sway-back posture

“…One of the limitations of our study is the lack of a universal postural standard to evaluate quantitatively sway-back posture alterations, which in turn would help clinicians in the postural classification. We agree with some authors [29] that recognize that definitive allocation of a posture type is difficult. Future studies are necessary in order to determine the limits between different postures.…”

“…Sway-back posture is one among the most common deviations of sagittal alignment [16,19,20,30]. Sway-back posture is clinically identified by the posterior displacement of the trunk relative to the pelvis, long thoracic kyphosis, reduced lumbar lordosis, posterior pelvic tilt, and extended hip and knee joints [14,29,30]. It is radiographically defined as one of four possible types of lumbar lordosis on the sagittal plane, as described by Roussouly et al [27,30].…”

Lumbar posture and trunk muscle activation during a typing task when sitting on a novel dynamic ergonomic chair

“…More neutral sitting postures, involving slight lumbar lordosis and a relaxed thorax, have been recommended to facilitate activation of key trunk muscles without excessive compressive spinal load ). Since posture is influenced by a wide range of factors including genetics (Seah et al 2011), gender Callaghan 2005, Smith et al 2010), body mass index ) and psychological factors (O'Sullivan et al 2011a), the best sitting posture may need to consider these factors as well as individual variations in specific aggravating/easing factors (Dankaerts et al 2009). …”

An exploration of familial associations of two movement pattern-derived subgroups of chronic disabling low back pain; a cross-sectional cohort study

“…Recently, a familial association has been reported for spinal posture [28] in people with CDLBP. Specifically, hyperlordotic lumbar postures in standing have been shown to be more common in daughters of parents with such postures [28].…”

“…Specifically: spinal structures such as degenerated discs [10] and bone loss [13,14]; pain sensitivity and development of chronic pain [15,16]; psychological factors such as depression and anxiety [17], pain catastrophizing [18], distress [19], pain behaviours and coping strategies [20,21]; lifestyle factors [22,23], body mass index (BMI) [22,23] and physical activity levels [24,25] as well as lumbar range of motion [26] and back muscle endurance [27]. Recently, a familial association has been reported for spinal posture [28] in people with CDLBP. Specifically, hyperlordotic lumbar postures in standing have been shown to be more common in daughters of parents with such postures [28].…”