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Brühl M, Hmida J, Tomschi F, Cucchi D, Wirtz DC, Strauss AC, Hilberg T. Smartphone Use-Influence on Posture and Gait during Standing and Walking. Healthcare (Basel) 2023; 11:2543. [PMID: 37761740 PMCID: PMC10531398 DOI: 10.3390/healthcare11182543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/05/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Prolonged gaze at a smartphone is characterized by pronounced flexion of the cervical spine and is associated with health risks. In addition, it is suspected that smartphone distraction could lead to gait changes. Therefore, the aim of this study was to detect smartphone-associated postural changes at thoracic and lumbar levels as well as gait changes. Spinal analysis was performed prospectively in 21 healthy men using the DIERS 4Dmotion®Lab in a controlled crossover design to evaluate posture-associated parameters while standing and walking. The examination sequence provided three randomized gaze directions: GN = Gaze Neutral; S1H = Smartphone one-handed; S2H = Smartphone two-handed. Results reveal a higher vertebra prominens (VP)-flexion in S1H (23.8° ± 6.9°; p ≤ 0.001) and S2H (22.4° ± 4.7°; p ≤ 0.001) compared to GN (17.6° ± 3.8°). Kyphosis angles were also different with higher values observed in S1H (58.8° ± 5.8°; p ≤ 0.001) and S2H (61.6° ± 4.9°; p ≤ 0.001) compared to GN (49.1° ± 4.6°). During walking, similar results were observed in kyphosis angles. No differences were observed in gait during smartphone use (p = 0.180-0.883). The study revealed a significantly increased inclination of the lower cervical and thoracic spine during smartphone use. However, the inclination was larger during S2H. Standing or walking conditions did not affect the measurement outcomes. Long-term smartphone use associated with a larger inclination of the cervical and thoracic spine might result in increased pressure and shear forces acting on vertebral bodies, intervertebral discs, and muscles, which potentially increases the risk of spinal pain and disease.
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Affiliation(s)
- Marius Brühl
- Department of Sports Medicine, University of Wuppertal, Moritzstraße 14, 42117 Wuppertal, Germany; (M.B.); (T.H.)
- Department of Orthopaedics and Trauma Surgery, University of Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Jamil Hmida
- Department of Sports Medicine, University of Wuppertal, Moritzstraße 14, 42117 Wuppertal, Germany; (M.B.); (T.H.)
- Department of Orthopaedics and Trauma Surgery, University of Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Fabian Tomschi
- Department of Sports Medicine, University of Wuppertal, Moritzstraße 14, 42117 Wuppertal, Germany; (M.B.); (T.H.)
| | - Davide Cucchi
- Department of Orthopaedics and Trauma Surgery, University of Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Dieter C. Wirtz
- Department of Orthopaedics and Trauma Surgery, University of Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Andreas C. Strauss
- Department of Orthopaedics and Trauma Surgery, University of Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Moritzstraße 14, 42117 Wuppertal, Germany; (M.B.); (T.H.)
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Huthwelker J, Konradi J, Wolf C, Westphal R, Schmidtmann I, Drees P, Betz U. Reference Values for 3D Spinal Posture Based on Videorasterstereographic Analyses of Healthy Adults. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9120809. [PMID: 36551015 PMCID: PMC9774435 DOI: 10.3390/bioengineering9120809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
Visual examinations are commonly used to analyze spinal posture. Even though they are simple and fast, their interrater reliability is poor. Suitable alternatives should be objective, non-invasive, valid and reliable. Videorasterstereography (VRS) is a corresponding method that is increasingly becoming established. However, there is a lack of reference data based on adequate numbers of participants and structured subgroup analyses according to sex and age. We used VRS to capture the spinal posture of 201 healthy participants (aged 18-70 years) divided into three age cohorts. Three-dimensional reference data are presented for the global spine parameters and for every vertebral body individually (C7-L4) (here called the specific spine parameters). The vertebral column was found to be systematically asymmetric in the transverse and the coronal planes. Graphical presentations of the vertebral body posture revealed systematic differences between the subgroups; however, large standard deviations meant that these differences were not significant. In contrast, several global parameters (e.g., thoracic kyphosis and lumbar lordosis) indicated differences between the analyzed subgroups. The findings confirm the importance of presenting reference data not only according to sex but also according to age in order to map physiological posture changes over the life span. The question also arises as to whether therapeutic approximations to an almost symmetrical spine are biomechanically desirable.
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Affiliation(s)
- Janine Huthwelker
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany
- Correspondence:
| | - Jürgen Konradi
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany
| | - Claudia Wolf
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany
| | - Ruben Westphal
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, D-55131 Mainz, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, D-55131 Mainz, Germany
| | - Philipp Drees
- Department of Orthopedics and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany
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Dindorf C, Konradi J, Wolf C, Taetz B, Bleser G, Huthwelker J, Drees P, Fröhlich M, Betz U. General method for automated feature extraction and selection and its application for gender classification and biomechanical knowledge discovery of sex differences in spinal posture during stance and gait. Comput Methods Biomech Biomed Engin 2020; 24:299-307. [PMID: 33135504 DOI: 10.1080/10255842.2020.1828375] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Modern technologies enable to capture multiple biomechanical parameters often resulting in relational data. The current work proposes a generally applicable method comprising automated feature extraction, ensemble feature selection and classification to best capture the potentials of the data also for generating new biomechanical knowledge. Its benefits are demonstrated in the concrete biomechanically and medically relevant use case of gender classification based on spinal data for stance and gait. Very good results for accuracy were obtained using gait data. Dynamic movements of the lumbar spine in sagittal and frontal plane and of the pelvis in frontal plane best map gender differences.
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Affiliation(s)
- Carlo Dindorf
- Department of Sports Science, Technische Universität Kaiserslautern, Kaiserslautern, Germany
| | - Jürgen Konradi
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Claudia Wolf
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bertram Taetz
- Department Augmented Vision, German Research Center for Artificial Intelligence, Kaiserslautern, Germany
| | - Gabriele Bleser
- Junior Research Group wear HEALTH, Technische Universität Kaiserslautern, Kaiserslautern, Germany
| | - Janine Huthwelker
- Department of Orthopedics and Trauma Surgery, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp Drees
- Department of Orthopedics and Trauma Surgery, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael Fröhlich
- Department of Sports Science, Technische Universität Kaiserslautern, Kaiserslautern, Germany
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
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Żurawski AŁ, Kiebzak WP, Kowalski IM, Śliwiński G, Śliwiński Z. Evaluation of the association between postural control and sagittal curvature of the spine. PLoS One 2020; 15:e0241228. [PMID: 33108407 PMCID: PMC7591056 DOI: 10.1371/journal.pone.0241228] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 10/09/2020] [Indexed: 12/04/2022] Open
Abstract
Introduction Balance is key to controlling body posture. Balance is typically assessed by measures of the body’s vertical orientation, obtained by balancing out the forces acting on different body segments. The ability to maintain balance is assessed by evaluating centre of pressure (CoP) displacement; such assessments are typically used to evaluate responses to a treatment process. Purpose of study This study evaluated the efficiency of compensatory reactions in children according to the extent of thoracic kyphosis and lumbar lordosis. Materials and method The study enrolled 312 children aged 8‒12 years, including 211 patients with postural disorders: thoracic kyphosis outside the 47‒50-degree range and lordosis outside the 38‒42-degree range (study group). A control group was also recruited and comprised 101 children without postural disorders. The DIERS formetric 4D system was used to assess posture and CoP displacement. Results Children in the study group showed a significantly greater range of CoP displacement than children in the control group. The kyphosis angle correlated with the maximum CoP displacement in the coronal plane and the maximum CoP displacement in the sagittal plane during gait. The kyphosis angle also correlated with the maximum CoP displacement back in the static test. The size of the lordosis angle correlated with the maximum displacement of CoP in the coronary plane during gait, and with the maximum displacement of CoP toward the left, forward, and backward in the static test. The correlation coefficient of the lordosis angle with displacement of the CoP in the sagittal plane was 0.999. Conclusions
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Affiliation(s)
- Arkadiusz Łukaz Żurawski
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
- Świętokrzyskie Centre for Paediatrics, Provincial Integrated Hospital, Kielce, Poland
- * E-mail:
| | - Wojciech Piotr Kiebzak
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
- Świętokrzyskie Centre for Paediatrics, Provincial Integrated Hospital, Kielce, Poland
| | | | - Grzegorz Śliwiński
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
- Institute of Biomedical Engineering, TU Dresden, Dresden, Germany
| | - Zbigniew Śliwiński
- Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
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Schröder G, Kundt G, Otte M, Wendig D, Schober HC. Impact of pregnancy on back pain and body posture in women. J Phys Ther Sci 2016; 28:1199-207. [PMID: 27190453 PMCID: PMC4868213 DOI: 10.1589/jpts.28.1199] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 12/26/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this single-center investigation was to study the impact of pregnancy on back pain and body posture. [Subjects] The subjects were 26 pregnant females. [Methods] Data were generated with a spine scanner (Diers(®) formetric 4D), trunk strength measurement (Diers(®) myoline), a numeric pain scale (0 to 10), and a biomechanical model. Parameters were compared during each trimester. [Results] The alteration in pain level at rest and lumbar lordosis angle in the females revealed a statistical trend during pregnancy. Spearman's test showed positive correlations between body weight and trunk inclination during the second trimester, and between body weight and the kyphosis angle in the third trimester. The trunk inclination and the kyphosis angle revealed a negative correlation in the third trimester. Based on our analysis, the highest moments and muscle strength must be expended in the third trimester. The actual muscle strength is greatest in the second trimester. [Conclusion] Pain at rest must be given greater attention in pregnant females, and their increasing lumbar kyphosis must be counteracted. Exercising the deep segmental muscles may serve as a preventive measure.
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Affiliation(s)
- Guido Schröder
- Division of Internal Medicine I, Department of Internal Medicine, Germany
| | - Günther Kundt
- Institute of Biostatistics and Informatics in Medicine and Aging Research, University of Rostock, Germany
| | - Mandy Otte
- Division of Internal Medicine I, Department of Internal Medicine, Germany
| | - Detlef Wendig
- Division of Internal Medicine I, Department of Internal Medicine, Germany
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Schröder J, Braumann KM, Reer R. Wirbelsäulenform- und Funktionsprofile. DER ORTHOPADE 2014; 43:841-9. [DOI: 10.1007/s00132-014-2316-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Auswirkung von thorakalen Manipulationen auf die sagittale Ausrichtung der Wirbelsäule. MANUELLE MEDIZIN 2012. [DOI: 10.1007/s00337-012-0913-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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