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Eur Spine J (2014) 23:14141419 DOI 10.1007/s00586-014-3251-9
ORIGINAL ARTICLE
Impact of spinal alignment and back muscle strength on shoulder range of motion in middle-aged and elderly people in a prospective cohort study
Shiro Imagama Yukiharu Hasegawa
Norimitsu Wakao Kenichi Hirano
Akio Muramoto Naoki Ishiguro
Received: 25 September 2013 / Revised: 13 February 2014 / Accepted: 16 February 2014 / Published online: 1 March 2014 Springer-Verlag Berlin Heidelberg 2014
AbstractPurpose The relationship between spine and shoulder motion has not been well evaluated. The purpose of this study was to clarify the relationships among thoracic kyphosis and lumbar lordosis, spinal range of motion (ROM), spinal alignment and shoulder ROM.
Methods Evaluation of spinal alignment was prospectively conducted in 317 subjects (114 males and 203 females, the average age: 67 years) who attended a public health checkup. Shoulder ROM with an angle meter and shoulder pain were evaluated. Thoracic kyphosis angle, lumbar lordosis angle, thoracic ROM, lumbar ROM and spinal inclination angle were measured using Spinal-Mouse. The relationships of these factors with grip strength, back muscle strength, physical ability, osteoporosis and body mass index were examined and multivariate logistic regression analysis was performed to identify the risk factors for limited shoulder ROM.
Results Limited shoulder exion was found in 35 patients (11 %) and limited abduction in 50 patients (16 %). In multivariate logistic regression analyses adjusted for age, shoulder pain and other parameters, increased thoracic
kyphosis angle and increased spinal inclination angle were risk factors for limited shoulder exion (p \ 0.05).
Increased thoracic kyphosis angle and weak back muscle strength were also determined as risk factors for limited shoulder abduction (p \ 0.05).
Conclusions This study provides the rst evidence that increased thoracic kyphosis, increased spinal inclination and weak back muscle strength are the risk factors for limited shoulder ROM. These results suggest that maintenance of spinal alignment and back muscle strength may be important for better shoulder ROM.
Keywords Shoulder range of motion Thoracic
kyphosis Spinal inclination Back muscle strength
Spine-shoulder syndrome
Introduction
Spinal and shoulder diseases are common orthopedic problems found in elderly people. Aging-related changes in the spine and shoulder are generally thought to cause kyphosis, spinal sagittal imbalance and limited shoulder range of motion (ROM). Spinal diseases and limited shoulder ROM both...