Functional analysis of postural spinal and pelvic parameters using static and dynamic spinometry

Tobias Bode; Schima Zoroofchi; Eik Vettorazzi; Jan-Niklas Droste; Götz H Welsch; René Schwesig; Robert Percy Marshall

doi:10.1016/j.heliyon.2024.e29239

Functional analysis of postural spinal and pelvic parameters using static and dynamic spinometry

Heliyon. 2024 Apr 4;10(7):e29239. doi: 10.1016/j.heliyon.2024.e29239. eCollection 2024 Apr 15.

Authors

Tobias Bode¹, Schima Zoroofchi¹, Eik Vettorazzi², Jan-Niklas Droste^{3

4}, Götz H Welsch^{1

5}, René Schwesig⁶, Robert Percy Marshall^{3

6}

Affiliations

¹ Athleticum, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
² Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
³ RasenBallsport Leipzig GmbH, Cottaweg 3, 04177, Leipzig, Germany.
⁴ BG Klinikum Hamburg-Boberg, Bergedorfer Str. 10, 21033, Hamburg, Germany.
⁵ Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
⁶ Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, 06120 Halle (Saale), Germany.

Abstract

Background: Spinometry is a radiation-free method to three-dimensional spine imaging that provides additional information about the functional gait patterns related to the pelvis and lower extremities. This radiation-free technology uses the surface topography of the trunk to analyze surface asymmetry and identify bony landmarks, thereby aiding the assessment of spinal deformity and supporting long-term treatment regimes. Especially reliable dynamic spinometric data for spine and pelvis are necessary to evaluate the management of non-specific back pain.

Research aim: This study aims to generate reliable dynamic spinometric data for spine and pelvis parameters that can serve as reference data for future studies and clinical practice.

Methods: This study assessed 366 subjects (185 females) under static and 360 subjects (181 females) under dynamic (walking on a treadmill at 3 km/h and 5 km/h) conditions. The DIERS Formetric 4Dmotion® system uses stripes of light to detect the surface topography of the spine and pelvis and identifies specific landmarks to analyze the spine during standing and walking.

Results: Relevant gender effects were calculated for lordotic angle (η_p² = 0.22) and pelvic inclination (η_p² = 0.26). Under static conditions, female subjects showed larger values for both parameters (lordotic angle: 41.6 ± 8.60°; pelvic inclination: 25.5 ± 7.49°). Regarding speed effects, three relevant changes were observed (sagittal imbalance: η_p² = 0.74, kyphotic angle: η_p² = 0.13, apical deviation: η_p² = 0.11). The most considerable changes were observed between static condition and 3 km/h, especially for sagittal imbalance and lordotic angle. For these parameters, relevant effect sizes (d > 0.8) were calculated between static and 3 km/h for males and females. Concerning clinical vertebral parameters, only lordotic angle and pelvic inclination were correlated with each other (r = 0.722).

Conclusion: This study generated a gender-specific reference database of asymptomatic individuals for static and dynamic spinometry. It demonstrated that the DIERS Formetric 4Dmotion® system could capture natural changes in static and dynamic situations and catalogue functional adaptations of spino-pelvic statics at different speeds. The lordotic angle is an indirect marker of pelvic inclination, allowing spinometry to identify individuals at risk even under dynamic conditions.

Keywords: Back pain; Functional movement; Motion analysis; Posture; Spino-pelvic dysfunction; Spinometry; Video rasterstereography.