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Measurement of the number of lumbar spinal movements in the sagittal plane in a 24-hour period

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Abstract

Purpose

Little is known about the number of spinal movements in the sagittal plane in daily life, mainly due to the lack of adequate techniques to assess these movements. Our aim was to measure these movements in asymptomatic volunteers.

Methods

Two sensor strips based on strain gauge technology (Epionics SPINE system) were fixed on the skin surface of the back parallel to the spine on a total of 208 volunteers without back pain. First, the lordosis angle was determined during relaxed standing. The volunteers were then released to daily life. The increases and decreases in the back lumbar lordosis angle over a period of 24 h were determined and classified into 5° increments. Changes in the lordosis angle greater than 5° were considered.

Results

The median number of spinal movements performed within 24 h was approximately 4,400. Of these movements, 66 % were between 5° and 10°. The proportions of higher-magnitude lordosis angle changes were much lower (e.g., 3 % for the 20–25° movement bin). Surprisingly, the median total number of movements was significantly higher (29 %) in women than in men. Large inter-individual differences were observed in the number of movements performed. The volunteers spent a median of 4.9 h with the lumbar spine flexed between 20° and 30° and only 24 min with the spine extended relative to the reference standing position. A median of 50 movements reached or exceeded full-flexion angle and zero movements full-extension angle.

Conclusions

These data illustrate the predominantly small range of movement of the spine during daily activities and the small amount of time spent in extension. These unique data strongly contribute to the understanding of patients’ everyday behavior, which might affect the development and testing of spinal implants and the evaluation of surgical and nonsurgical treatments.

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Acknowledgments

The authors would like to thank the volunteers for their contribution to this study, Dr. D. Weinland for IT support, and C. Tran for support during the evaluation of the results. This study was partially supported by Epionics Medical GmbH and the German Federal Institute of Sport Science, Bonn, Germany (MiSpEx—the National Research Network for Medicine in Spine Exercise).

Conflict of interest

T. Consmüller was an employee of Epionics Medical GmbH, a commercial funder of this research. A. Rohlmann was a consultant for Epionics Medical GmbH.

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Authors and Affiliations

  1. Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Antonius Rohlmann, Marcel Dreischarf, Maxim Bashkuev, Esther Pries, Georg N. Duda & Hendrik Schmidt

  2. Epionics Medical GmbH, Am Luftschiffhafen 1, 14471, Potsdam, Germany

    Tobias Consmüller

  3. Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Alexander Disch

Authors
  1. Antonius Rohlmann
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  2. Tobias Consmüller
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  3. Marcel Dreischarf
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  4. Maxim Bashkuev
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  5. Alexander Disch
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  6. Esther Pries
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  7. Georg N. Duda
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  8. Hendrik Schmidt
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Correspondence to Antonius Rohlmann.

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Rohlmann, A., Consmüller, T., Dreischarf, M. et al. Measurement of the number of lumbar spinal movements in the sagittal plane in a 24-hour period. Eur Spine J 23, 2375–2384 (2014). https://doi.org/10.1007/s00586-014-3588-0

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  • DOI: https://doi.org/10.1007/s00586-014-3588-0

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