Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Geriatrics
Published in: BMC Geriatrics 1/2019

Open Access 01-12-2019 | Research Article

Changes of upright body posture in the sagittal plane of men and women occurring with aging – a cross sectional study

Authors: Huan Gong, Liang Sun, Ruiyue Yang, Jing Pang, Beidong Chen, Ruomei Qi, Xin Gu, Yaonan Zhang, Tie-mei Zhang

Published in: BMC Geriatrics | Issue 1/2019

Login to get access

Abstract

Background

Body posture is a fundamental indicator for assessing health and quality of life, especially for elderly people. Deciphering the changes in body posture occurring with age is a current topic in the field of geriatrics. The aims of this study were to assess the parameters of standing body posture in the global sagittal plane and to determine the dynamics of changes in standing body posture occurring with age and differences between men and women.

Methods

The measurements were performed on 226 individuals between the ages of 20 to 89 with a new photogrammetry, via which we assessed five postural angles - neck, thorax, waist, hip and knee. The data were analyzed with t-test, one-way ANOVA, linear regression model and generalized additive model.

Results

Among these segments studied here, neck changed most, while the middle segments of the body, waist and hip, were relative stable. Significant differences between men and women were found with respect to the angles of neck, thorax and hip. Three of the five postural angles were significantly influenced with aging, including increasing cervical lordosis, thoracic kyphosis and knee flexion, starting from no older than around 50 yrs. showed by fitting curve derived with generalized additive model. These changes were more marked among women. Besides, this study highlights the effects of age and gender on the complex interrelation between adjacent body segments in standing.

Conclusions

The presented results showed changes in the parameters describing body posture throughout consecutive ages and emphasized that for an individualized functional analysis, it is essential to consider age-and gender-specific changes in the neck, thorax and knee. This paper presents useful externally generalizable information not only for clinical purposes but also to inform further research on larger numbers of subjects.
Appendix
Available only for authorised users
Literature
1.
Harper S. Economic and social implications of aging societies. Science. 2014;346(6209):587–91.PubMed
2.
Bloom DE, Chatterji S, Kowal P, Lloyd-Sherlock P, McKee M, Rechel B, Rosenberg L, Smith JP. Macroeconomic implications of population ageing and selected policy responses. Lancet. 2015;385(9968):649–57.PubMed
3.
Diebo BG, Varghese JJ, Lafage R, Schwab FJ, Lafage V. Sagittal alignment of the spine: what do you need to know? Clin Neurol Neurosurg. 2015;139:295–301.PubMed
4.
Blondel B, Schwab F, Ungar B, Smith J, Bridwell K, Glassman S, Shaffrey C, Farcy JP, Lafage V. Impact of magnitude and percentage of global sagittal plane correction on health-related quality of life at 2-years follow-up. Neurosurgery. 2012;71(2):341–8 discussion 348.PubMed
5.
Lin WY, Chou WC, Tsai TH, Lin CC, Lee MY. Development of a Wearable Instrumented Vest for Posture Monitoring and System Usability Verification Based on the Technology Acceptance Model. Sensors (Basel). 2016;16(12):2172–83.
6.
Ostrowska B. The shape of anterior-posterior spinal curvature in post-menopausal women with osteoporosis. Ortop Traumatol Rehabil. 2006;8(5):537–42.PubMed
7.
Eguchi Y, Suzuki M, Yamanaka H, Tamai H, Kobayashi T, Orita S, Yamauchi K, Suzuki M, Inage K, Fujimoto K, et al. Associations between sarcopenia and degenerative lumbar scoliosis in older women. Scoliosis Spinal Disord. 2017;12:9.PubMedPubMedCentral
8.
Narayanan MR, Redmond SJ, Scalzi ME, Lord SR, Celler BG, Lovell Ast NH. Longitudinal falls-risk estimation using triaxial accelerometry. IEEE Trans Biomed Eng. 2010;57(3):534–41.PubMed
9.
Robinovitch SN, Feldman F, Yang Y, Schonnop R, Leung PM, Sarraf T, Sims-Gould J, Loughin M. Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study. Lancet. 2013;381(9860):47–54.PubMed
10.
Coskun Benlidayi I, Basaran S. Comparative study of lumbosacral alignment in elderly versus young adults: data on patients with low back pain. Aging Clin Exp Res. 2015;27(3):297–302.PubMed
11.
Kim YJ, Bridwell KH, Lenke LG, Rhim S, Cheh G. Pseudarthrosis in long adult spinal deformity instrumentation and fusion to the sacrum: prevalence and risk factor analysis of 144 cases. Spine (Phila Pa 1976). 2006;31(20):2329–36.
12.
Adams MA. Biomechanics of back pain. Acupunct Med. 2004;22(4):178–88.PubMed
13.
Lamartina C, Berjano P, Petruzzi M, Sinigaglia A, Casero G, Cecchinato R, Damilano M, Bassani R. Criteria to restore the sagittal balance in deformity and degenerative spondylolisthesis. Eur Spine J. 2012;21(Suppl 1):S27–31.PubMed
14.
Barrey C, Roussouly P, Le Huec JC, D'Acunzi G, Perrin G. Compensatory mechanisms contributing to keep the sagittal balance of the spine. Eur Spine J. 2013;22(Suppl 6):S834–41.PubMed
15.
Kumar MN, Baklanov A, Chopin D. Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion. Eur Spine J. 2001;10(4):314–9.PubMedPubMedCentral
16.
Park MS, Moon SH, Lee HM, Kim SW, Kim TH, Lee SY, Riew KD. The effect of age on cervical sagittal alignment: normative data on 100 asymptomatic subjects. Spine (Phila Pa 1976). 2013;38(8):E458–63.
17.
Drzal-Grabiec J, Rykala J, Podgorska J, Snela S. Changes in body posture of women and men over 60 years of age. Ortop Traumatol Rehabil. 2012;14(5):467–75.PubMed
18.
Drzal-Grabiec J, Snela S, Rykala J, Podgorska J, Banas A. Changes in the body posture of women occurring with age. BMC Geriatr. 2013;13:108.PubMedPubMedCentral
19.
Lee ES, Ko CW, Suh SW, Kumar S, Kang IK, Yang JH. The effect of age on sagittal plane profile of the lumbar spine according to standing, supine, and various sitting positions. J Orthop Surg Res. 2014;9(1):11.PubMedPubMedCentral
20.
Hammerberg EM, Wood KB. Sagittal profile of the elderly. J Spinal Disord Tech. 2003;16(1):44–50.PubMed
21.
Gelb DE, Lenke LG, Bridwell KH, Blanke K, McEnery KW. An analysis of sagittal spinal alignment in 100 asymptomatic middle and older aged volunteers. Spine (Phila Pa 1976). 1995;20(12):1351–8.
22.
Imagama S, Ito Z, Wakao N, Seki T, Hirano K, Muramoto A, Sakai Y, Matsuyama Y, Hamajima N, Ishiguro N, et al. Influence of spinal sagittal alignment, body balance, muscle strength, and physical ability on falling of middle-aged and elderly males. Eur Spine J. 2013;22(6):1346–53.PubMedPubMedCentral
23.
Kado DM. The rehabilitation of hyperkyphotic posture in the elderly. Eur J Phys Rehabil Med. 2009;45(4):583–93.PubMed
24.
Been E, Shefi S, Soudack M. Cervical lordosis: the effect of age and gender. Spine J. 2017;17(6):880–8.
25.
Fon GT, Pitt MJ, Thies AC Jr. Thoracic kyphosis: range in normal subjects. AJR Am J Roentgenol. 1980;134(5):979–83.PubMed
26.
Nowotny-Czupryna O, Czupryna K, Nowotny J, Brzęk A. Some possibilities of correction and compensation in body posture regulation among children and adolescents with low degree scoliosis. Ortop Traumatol Rehabil. 2012;14(6):11.
27.
Farcy JP, Schwab FJ. Management of flatback and related kyphotic decompensation syndromes. Spine (Phila Pa 1976). 1997;22(20):2452–7.
28.
Diebo BG, Ferrero E, Lafage R, Challier V, Liabaud B, Liu S, Vital JM, Errico TJ, Schwab FJ, Lafage V. Recruitment of compensatory mechanisms in sagittal spinal malalignment is age and regional deformity dependent: a full-standing axis analysis of key radiographical parameters. Spine (Phila Pa 1976). 2015;40(9):642–9.
29.
Diebo BG, Oren JH, Challier V, Lafage R, Ferrero E, Liu S, Vira S, Spiegel MA, Harris BY, Liabaud B, et al. Global sagittal axis: a step toward full-body assessment of sagittal plane deformity in the human body. J Neurosurg Spine. 2016;25(4):494–9.PubMed
30.
Lafage V, Schwab F, Patel A, Hawkinson N, Farcy JP. Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity. Spine (Phila Pa 1976). 2009;34(17):E599–606.
31.
Obeid I, Hauger O, Aunoble S, Bourghli A, Pellet N, Vital JM. Global analysis of sagittal spinal alignment in major deformities: correlation between lack of lumbar lordosis and flexion of the knee. Eur Spine J. 2011;20(Suppl 5):681–5.PubMedPubMedCentral
32.
Yukawa Y, Kato F, Suda K, Yamagata M, Ueta T. Age-related changes in osseous anatomy, alignment, and range of motion of the cervical spine. Part I: radiographic data from over 1,200 asymptomatic subjects. Eur Spine J. 2012;21(8):1492–8.PubMedPubMedCentral
33.
Kuo YL, Tully EA, Galea MP. Video based measurement of sagittal range of spinal motion in young and older adults. Man Ther. 2009;14(6):618–22.PubMed
34.
Ostrowska B, Rozek-Mroz K, Giemza C. Body posture in elderly, physically active males. Aging Male. 2003;6(4):222–9.PubMed
35.
Machino M, Yukawa Y, Imagama S, Ito K, Katayama Y, Matsumoto T, Inoue T, Ouchida J, Tomita K, Ishiguro N, et al. Age-related and degenerative changes in the osseous anatomy, alignment, and range of motion of the cervical spine: a comparative study of radiographic data from 1016 patients with cervical Spondylotic myelopathy and 1230 asymptomatic subjects. Spine (Phila Pa 1976). 2016;41(6):476–82.
36.
Yoshida G, Yasuda T, Togawa D, Hasegawa T, Yamato Y, Kobayashi S, Arima H, Hoshino H, Matsuyama Y. Craniopelvic alignment in elderly asymptomatic individuals: analysis of 671 cranial centers of gravity. Spine (Phila Pa 1976). 2014;39(14):1121–7.
37.
Afiah IN, Nakashima H, Loh PY, Muraki S. An exploratory investigation of changes in gait parameters with age in elderly Japanese women. Springerplus. 2016;5(1):1069.PubMedPubMedCentral
38.
Singer ML, Smith LK, Dibble LE, Foreman KB. Age-related difference in postural control during recovery from posterior and anterior perturbations. Anat Rec (Hoboken). 2015;298(2):346–53.
39.
Lim D, Kim C, Jung H, Jung D, Chun KJ. Use of the Microsoft Kinect system to characterize balance ability during balance training. Clin Interv Aging. 2015;10:1077–83.PubMedPubMedCentral
40.
Lee CS, Lee CK, Kim YT, Hong YM, Yoo JH. Dynamic sagittal imbalance of the spine in degenerative flat back: significance of pelvic tilt in surgical treatment. Spine (Phila Pa 1976). 2001;26(18):2029–35.
41.
Singh DK, Bailey M, Lee R. Biplanar measurement of thoracolumbar curvature in older adults using an electromagnetic tracking device. Arch Phys Med Rehabil. 2010;91(1):137–42.PubMed
42.
Dreischarf M, Albiol L, Rohlmann A, Pries E, Bashkuev M, Zander T, Duda G, Druschel C, Strube P, Putzier M, et al. Age-related loss of lumbar spinal lordosis and mobility--a study of 323 asymptomatic volunteers. PLoS One. 2014;9(12):e116186.PubMedPubMedCentral
43.
Pries E, Dreischarf M, Bashkuev M, Putzier M, Schmidt H. The effects of age and gender on the lumbopelvic rhythm in the sagittal plane in 309 subjects. J Biomech. 2015;48(12):3080–7.PubMed
44.
Kado DM, Huang MH, Barrett-Connor E, Greendale GA. Hyperkyphotic posture and poor physical functional ability in older community-dwelling men and women: the rancho Bernardo study. J Gerontol A Biol Sci Med Sci. 2005;60(5):633–7.PubMedPubMedCentral
45.
Kado DM, Huang MH, Nguyen CB, Barrett-Connor E, Greendale GA. Hyperkyphotic posture and risk of injurious falls in older persons: the rancho Bernardo study. J Gerontol A Biol Sci Med Sci. 2007;62(6):652–7.PubMed
46.
Sinaki M, Brey RH, Hughes CA, Larson DR, Kaufman KR. Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength. Osteoporos Int. 2005;16(8):1004–10.PubMed
47.
Kado DM, Huang MH, Karlamangla AS, Barrett-Connor E, Greendale GA. Hyperkyphotic posture predicts mortality in older community-dwelling men and women: a prospective study. J Am Geriatr Soc. 2004;52(10):1662–7.PubMed
48.
Takahashi T, Ishida K, Hirose D, Nagano Y, Okumiya K, Nishinaga M, Matsubayashi K, Doi Y, Tani T, Yamamoto H. Trunk deformity is associated with a reduction in outdoor activities of daily living and life satisfaction in community-dwelling older people. Osteoporos Int. 2005;16(3):273–9.PubMed
49.
Boyle JJ, Milne N, Singer KP. Influence of age on cervicothoracic spinal curvature: an ex vivo radiographic survey. Clin Biomech (Bristol, Avon). 2002;17(5):361–7.
50.
Miyakoshi N, Kudo D, Hongo M, Kasukawa Y, Ishikawa Y, Shimada Y. Comparison of spinal alignment, muscular strength, and quality of life between women with postmenopausal osteoporosis and healthy volunteers. Osteoporos Int. 2017;28(11):3153–60.PubMed
51.
Kobayashi T, Atsuta Y, Matsuno T, Takeda N. A longitudinal study of congruent sagittal spinal alignment in an adult cohort. Spine (Phila Pa 1976). 2004;29(6):671–6.
52.
Jiang S, Li P. Current development in elderly comprehensive assessment and research methods. Biomed Res Int. 2016;2016:3528248.PubMedPubMedCentral
53.
Furlanetto TS, Sedrez JA, Candotti CT, Loss JF. Photogrammetry as a tool for the postural evaluation of the spine: a systematic review. World J Orthop. 2016;7(2):136–48.PubMedPubMedCentral
54.
Ferreira EA, Duarte M, Maldonado EP, Burke TN, Marques AP. Postural assessment software (PAS/SAPO): validation and reliabiliy. Clinics (Sao Paulo). 2010;65(7):675–81.
55.
do Rosario JL. Photographic analysis of human posture: a literature review. J Bodyw Mov Ther. 2014;18(1):56–61.PubMed
56.
Macedo, Ribeiro AF, Bergmann A, Lemos T, Pacheco AG, Mello Russo M, Santos de Oliveira LA, de Carvalho Rodrigues E. Reference values for human posture measurements based on computerized photogrammetry: a systematic review. J Manip Physiol Ther. 2017;40(3):156–68.
Metadata
Title
Changes of upright body posture in the sagittal plane of men and women occurring with aging – a cross sectional study
Authors
Huan Gong
Liang Sun
Ruiyue Yang
Jing Pang
Beidong Chen
Ruomei Qi
Xin Gu
Yaonan Zhang
Tie-mei Zhang
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2019
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-019-1096-0

Other articles of this Issue 1/2019

BMC Geriatrics 1/2019 Go to the issue

Research article

Advanced glycation end products and their ratio to soluble receptor are associated with limitations in physical functioning only in women: results from the CARLA cohort

Study protocol

The (cost-) effectiveness of exergaming in people living with dementia and their informal caregivers: protocol for a randomized controlled trial

Research article

A longitudinal analysis of the association between the living arrangements and psychological well-being of older Chinese adults: the role of income sources

Research article

Asymptomatic bacteriuria in older adults: the most fragile women are prone to long-term colonization

Research article

Leukocyte telomere length and serum polyunsaturated fatty acids, dietary habits, cardiovascular risk factors and features of myocardial infarction in elderly patients

Research article

Family involvement in managing medications of older patients across transitions of care: a systematic review
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits