Document Detail


Normal functional range of motion of the lumbar spine during 15 activities of daily living.
MedLine Citation:
PMID:  20065869     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Prospective clinical study. OBJECTIVE: The purpose of this investigation was to quantify normal lumbar range of motion (ROM) and compare these results with those used to perform 15 simulated activities of daily living (ADLs) in asymptomatic subjects. SUMMARY OF BACKGROUND DATA: Previous studies reporting the ROM of the lumbar spine during ADLs have been limited, only focusing on 4 ADLs. The purpose of this investigation was to quantify the extent of normal lumbar ROM and determine how much motion is necessary to perform 15 simulated ADLs. METHODS: A noninvasive electrogoniometer and torsiometer were used to measure the ROM of the lumbar spine. The accuracy and reliability of the devices were confirmed by comparing the ROM values acquired from dynamic flexion/extension and lateral bending radiographs with those provided by the device that was activated while the radiographs were obtained. Intraobserver reliability was established by calculating the intraclass correlation coefficient for repeated measurements on the same subjects by 1 investigator on consecutive days. These tools were employed in a clinical laboratory setting to evaluate the full active ROM of the lumbar spines (ie, flexion/extension, lateral bending, and axial rotation) of 60 asymptomatic subjects (30 women and 30 men; age 20 to 75 y) and to assess the functional ROM required to complete 15 simulated ADLs. RESULTS: When compared with radiographic measurements, the electrogoniometer was found to be accurate within 2.3+/-2.6 degrees (mean+/-SD). The intraobserver reliabilities for assessing full and functional ROM were both excellent (intraclass correlation coefficient of 0.96 and 0.88, respectively). The absolute ROM and percentage of full active lumbar spinal ROM used during the 15 ADLs was 3 to 49 degrees and 4% to 59% (median: 9 degrees/11%) for flexion/extension, 2 to 11 degrees and 6% to 31% (6 degrees/17%) for lateral bending, and 2 to 7 degrees and 6% to 20% (5 degrees/13%) for rotation. Picking up an object from the ground, either using a bending or squatting technique, required the most ROM of all the ADLs. Squatting required a significantly less amount of sagittal motion compared with bending at the waist (42 vs. 48 degrees, P=0.003). No difference was seen in both lateral and rotation motion between these 2 techniques (11 vs. 11 degrees and 6 vs. 6 degrees, respectively). Both ascending and descending stairs required equivalent amounts of total motion in all 3 motion planes. As a whole, personal hygiene ADLs (hand washing, washing hair, shaving, and make-up application) required a similar amount of motion compared with the 3 locomotive ADLs (walking, up and down stairs). CONCLUSIONS: By quantifying the amounts of lumbar motion required to execute a series of simulated ADLs, this study indicates that most individuals use a relatively small percentage of their full active ROM when performing such activities. These findings provide baseline data that may allow clinicians to accurately assess preoperative impairment and postsurgical outcomes.
Authors:
Jesse E Bible; Debdut Biswas; Christopher P Miller; Peter G Whang; Jonathan N Grauer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of spinal disorders & techniques     Volume:  23     ISSN:  1539-2465     ISO Abbreviation:  J Spinal Disord Tech     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-08     Completed Date:  2010-06-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140323     Medline TA:  J Spinal Disord Tech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  106-12     Citation Subset:  IM    
Affiliation:
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06520-8071, USA.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living*
Adult
Biomechanics
Electrodiagnosis / methods*
Female
Humans
Intervertebral Disk / physiology
Lumbar Vertebrae / anatomy & histology,  physiology*
Male
Middle Aged
Movement / physiology*
Outcome Assessment (Health Care) / methods
Prospective Studies
Range of Motion, Articular / physiology*
Reference Values
Task Performance and Analysis
Young Adult
Zygapophyseal Joint / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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