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 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
Journal of NeuroEngineering and Rehabilitation
Published in: Journal of NeuroEngineering and Rehabilitation 1/2010

Open Access 01-12-2010 | Research

Effect of obesity and low back pain on spinal mobility: a cross sectional study in women

Authors: Luca Vismara, Francesco Menegoni, Fabio Zaina, Manuela Galli, Stefano Negrini, Paolo Capodaglio

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2010

Login to get access

Abstract

Background

obesity is nowadays a pandemic condition. Obese subjects are commonly characterized by musculoskeletal disorders and particularly by non-specific chronic low back pain (cLBP). However, the relationship between obesity and cLBP remains to date unsupported by an objective measurement of the mechanical behaviour of the spine and its morphology in obese subjects. Such analysis may provide a deeper understanding of the relationships between function and the onset of clinical symptoms.

Purpose

to objectively assess the posture and function of the spine during standing, flexion and lateral bending in obese subjects with and without cLBP and to investigate the role of obesity in cLBP.

Study design

Cross-sectional study

Patient sample

thirteen obese subjects, thirteen obese subjects with cLBP, and eleven healthy subjects were enrolled in this study.

Outcome measures

we evaluated the outcome in terms of angles at the initial standing position (START) and at maximum forward flexion (MAX). The range of motion (ROM) between START and MAX was also computed.

Methods

we studied forward flexion and lateral bending of the spine using an optoelectronic system and passive retroreflective markers applied on the trunk. A biomechanical model was developed in order to analyse kinematics and define angles of clinical interest.

Results

obesity was characterized by a generally reduced ROM of the spine, due to a reduced mobility at both pelvic and thoracic level; a static postural adaptation with an increased anterior pelvic tilt. Obesity with cLBP is associated with an increased lumbar lordosis.
In lateral bending, obesity with cLBP is associated with a reduced ROM of the lumbar and thoracic spine, whereas obesity on its own appears to affect only the thoracic curve.

Conclusions

obese individuals with cLBP showed higher degree of spinal impairment when compared to those without cLBP. The observed obesity-related thoracic stiffness may characterize this sub-group of patients, even if prospective studies should be carried out to verify this hypothesis.
Appendix
Available only for authorised users
Literature
1.
Fanuele JC, Abdu WA, Hanscom B, Weinstein JN: Association between obesity and functional status in patients with spine disease. Spine 2002, 27: 306-312. 10.1097/00007632-200202010-00021CrossRefPubMed
2.
Hangai M, Kaneoka K, Kuno S, Hinotsu S, Sakane M, Mamizuka N, Sakai S, Ochiai N: Factors associated with lumbar intervertebral disc degeneration in the elderly. Spine J 2008,8(5):732-40. 10.1016/j.spinee.2007.07.392CrossRefPubMed
3.
Kostova V, Koleva M: Back disorders (low back pain, cervicobrachial and lumbosacral radicular syndromes) and some related risk factors. J Neurol Sci 2001, 192: 17-25. 10.1016/S0022-510X(01)00585-8CrossRefPubMed
4.
Hinton R, Moody RL, Davis AW, Thomas SF: Osteoarthritis: diagnosis and therapeutic considerations. Am Fam Physician 2002, 65: 841-848.PubMed
5.
Sowers M: Epidemiology of risk factors for osteoarthritis: systemic factors. Curr Opin Rheumatol 2001, 13: 447-451. 10.1097/00002281-200109000-00018CrossRefPubMed
6.
Mellin G, Harkapaa K, Vanharanta H, Hupli M, Heinonen R, Järvikoski A: Outcome of a multimodal treatment including intensive physical training of patients with chronic low back pain. Spine 1993,18(7):825-829. 10.1097/00007632-199306000-00003CrossRefPubMed
7.
Leboeuf-Yde C: Body weight and low back pain. A systematic literature review of 56 journal articles reporting on 65 epidemiologic studies. Spine 2000, 25: 226-237. 10.1097/00007632-200001150-00015CrossRefPubMed
8.
Fransen M, Woodward M, Norton R, Coggan C, Dawe M, Sheridan N: Risk factors associated with the transition from acute to chronic occupational back pain. Spine 2002, 27: 92-98. 10.1097/00007632-200201010-00022CrossRefPubMed
9.
Han TS, Schouten JS, Lean ME, Seidell JC: The prevalence of low back pain and associations with body fatness, fat distribution and height. Int J Obes Relat Metab Disord 1997, 21: 600-607. 10.1038/sj.ijo.0800448CrossRefPubMed
10.
Andersen RE, Crespo CJ, Bartlett SJ, Bathon , Fontaine KR: Relationship between body weight gain and significant knee, hip, and back pain in older Americans. Obes Res 2003, 11: 1159-1162. 10.1038/oby.2003.159CrossRefPubMed
11.
Toda Y, Segal N, Toda T, Morimoto T, Ogawa R: Lean body mass and body fat distribution in participants with chronic low back pain. Arch Intern Med 2000, 160: 3265-3269. 10.1001/archinte.160.21.3265CrossRefPubMed
12.
Barofsky I, Fontaine KR, Cheskin LJ: Pain in the obese: Impact on health-related quality of life. Ann Behav Med 1998, 19: 408-410. 10.1007/BF02895160CrossRef
13.
Fontaine KR, Barofsky I, Andersen , Bartlett SJ, Wiersema L, Cheskin LJ, Franckowiak SC: Impact of weight loss on pain and health-related quality of life. Quality Life Res 1999, 8: 275-277. 10.1023/A:1008835602894CrossRef
14.
Fontaine KR, Cheskin LJ, Barofsky I: Health-related quality of life in obese persons seeking treatment. J Fam Pract 1996, 43: 265-270.PubMed
15.
Martin K, Fontaine KR, Nicklas , Dennis KE, Goldberg AP, Hochberg MC: Weight loss and exercise walking reduce pain and improve physical functioning in overweight post-menopausal women with knee osteoarthritis. J Clin Rheumatol 2001, 7: 219-223. 10.1097/00124743-200108000-00006CrossRefPubMed
16.
Liuke M, Solovieva S, Lamminen A, Luoma K, Leino-Arjas P, Luukkonen R, Riihimäki H: Disc degeneration of the lumbar spine in relation to overweight. Int J Obes (Lond) 2005,29(8):903-8. 10.1038/sj.ijo.0802974CrossRef
17.
Dunn KM, Croft PR: Epidemiology and natural history of low back pain. Eura Medicophys 2004,40(1):9-13.PubMed
18.
Flamme CH: Obesity and low back pain--biology, biomechanics and epidemiology. Orthopade 2005,34(7):652-7. 10.1007/s00132-005-0817-6CrossRefPubMed
19.
Janke AE, Collins A, Kozak AT: Overview of the relationship between pain and obesity: What do we know? Where do we go next? Journal of Rehabil Res and Dev 2007, 44: 245-262. 10.1682/JRRD.2006.06.0060CrossRef
20.
Leboeuf-Yde C, Kyvik KO, Bruun NH: Low back pain and lifestyle. Part II--Obesity. Information from a population-based sample of 29,242 twin subjects. Spine 1999, 15: 779-783. 10.1097/00007632-199904150-00009CrossRef
21.
Mirtz TA, Greene L: Is obesity a risk factor for low back pain? An example of using the evidence to answer a clinical question. Chiropractic & Osteopathy 2005, 13: 2.CrossRef
22.
Verbunt JA, Seelen HA, Vlaeyen JW, Heijden GJ, Heuts PH, Pons K, Knottnerus JA: Disuse and deconditioning in chronic low back pain: concepts and hypotheses on contributing mechanisms. Eur J Pain 2003,7(1):9-21. 10.1016/S1090-3801(02)00071-XCrossRefPubMed
23.
Yip YB, Ho SC, Chan SG: Tall stature, overweight and the prevalence of low back pain in Chinese middle-aged women. Int J Obes Relat Metab Disord 2001,25(6):887-92. 10.1038/sj.ijo.0801557CrossRefPubMed
24.
Fabris de Souza SA, Faintuch J, Valezi AC, Sant'Anna AF, Gama-Rodrigues JJ, de Batista Fonseca IC, de Melo RD: Postural changes in morbidly obese patients. Obes Surg 2005,15(7):1013-6. 10.1381/0960892054621224CrossRefPubMed
25.
O'Sullivan PB, Dankaerts W, Burnett AF, Farrell GT, Jefford E, Naylor CS, O'Sullivan KJ: Effect of different upright sitting postures on spinal-pelvic curvature and trunk muscle activation in a pain-free population. Spine 2006,31(19):E707-12. 10.1097/01.brs.0000234735.98075.50CrossRefPubMed
26.
Whitcome KK, Shapiro JL, Lieberman DL: Fetal load and the evolution of lumbar lordosis in bipedal hominins. Nature 2007,450(7172):1075-8. 10.1038/nature06342CrossRefPubMed
27.
Galli M, Crivellini M, Sibella F, Montesano A, Bertocco P, Parisio C: Sit-to-stand movement analysis in obese subjects. Int J Obes Relat Metab Disord 2000,24(11):1488-92. 10.1038/sj.ijo.0801409CrossRefPubMed
28.
Sibella F, Galli M, Romei M, Montesano A, Crivellini M: Biomechanical analysis of sit-to-stand movement in normal and obese subjects. Clin Biomech 2003,18(8):745-50. 10.1016/S0268-0033(03)00144-XCrossRef
29.
de Souza SA, Faintuch J, Valezi AC, Sant' Anna AF, Gama-Rodrigues JJ, de Batista Fonseca IC, Souza RB, Senhorini RC: Gait cinematic analysis in morbidly obese patients. Obes Surg 2005,15(9):1238-42. 10.1381/096089205774512627CrossRefPubMed
30.
Messier SP, Davies AB, Moore DT, Davis SE, Pack RJ, Kazmar SC: Severe obesity: effects on foot mechanics during walking. Foot Ankle Int 1994, 15: 29-34.CrossRefPubMed
31.
Saibene F, Minetti AE: Biomechanical and physiological aspects of legged locomotion in humans. Eur J Appl Physiol 2003,88(4-5):297-316. Review 10.1007/s00421-002-0654-9CrossRefPubMed
32.
Spyropoulos P, Pisciotta JC, Pavlou KN, Cairns MA, Simon SR: Biomechanical Gait Analysis in obese men. Arch Phys Med Rehabil 1991, 72: 1065-1070.PubMed
33.
Vismara L, Romei M, Galli M, Montesano A, Baccalaro G, Crivellini M, Grugni G: Clinical implications of gait analysis in the rehabilitation of adult patients with "Prader-Willi" Syndrome: a cross-sectional comparative study ("Prader-Willi" Syndrome vs matched obese patients and healthy subjects). J Neuroengineering Rehabil 2007,10(4):14. 10.1186/1743-0003-4-14CrossRef
34.
Lund T, Nydegger T, Schlenzka D, Oxland TR: Three-Dimensional Motion Patterns During Active Bending in Patients with Chronic Low Back Pain. Spine 2002,27(17):1865-1874. 10.1097/00007632-200209010-00012CrossRefPubMed
35.
Gilleard W, Smith T: Effect of obesity on posture and hip joint moments during a standing task, and trunk forward flexion motion. International Journal of Obesity 2007, 31: 267-27. 10.1038/sj.ijo.0803430CrossRefPubMed
36.
Buckwalter JA: Maintaining and restoring mobility in middle and old age: the importance of the soft tissues. Instr Course Lect 1997, 46: 459-69.PubMed
37.
Larsson UE: Influence of weight loss on pain, perceived disability functional limitations in obese women. Int J Obes Relat Metab Disord 2004, 28: 269-77. 10.1038/sj.ijo.0802732CrossRefPubMed
38.
Tsuritani I, Honda R, Noborisaka Y, Ishida M, Ishizaki M, Yamada Y: Impact of obesity on musculoskeletal pain and difficulty of daily movements in Japanese middle-aged women. Maturitas 2002,42(1):23-30. 10.1016/S0378-5122(02)00025-7CrossRefPubMed
39.
Hayden JA, van Tulder MW, Malmivaara A, Koes BW: Exercise therapy for treatment of non-specific low back pain. Cochrane Database Syst Rew 2005, 3: CD000335.
40.
Negrini S, Giovannoni S, Minozzi S, Barneschi G, Bonaiuti D, Bussotti A, D'Arienzo M, Di Lorenzo N, Mannoni A, Mattioli S, Modena V, Padua L, Serafini F, Violante FS: Diagnostic therapeutic flow-charts for low back pain patients: the Italian clinical guidelines. Eura Medicophys 2006, 42: 151-70.PubMed
41.
Schneider S, Randol D, Buchner M: Why do women have back pain more than man? A representative prevalence study in the federal repubblic in German. Clinical Journal of pain 2006, 22: 738-747. 10.1097/01.ajp.0000210920.03289.93CrossRefPubMed
42.
Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G: COST B13 Working Group on Guidelines for Chronic Low Back Pain. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 2006,15(Suppl 2):S192-300. 10.1007/s00586-006-1072-1PubMedCentralCrossRefPubMed
43.
Menegoni F, Vismara L, Capodaglio P, Crivellini M, Galli M: Kinematics of trunk movements: protocol design and application in obese females. JABB - Journal of Applied Biomaterials & Biomechanics 2008,6(3):178-185.
44.
Burkemper KM, Garris DR: Influences of obese (ob/ob) and diabetes (db/db) genotype mutations on lumber vertebral radiological and morphometric indices: skeletal deformation associated with dysregulated systemic glucometabolism. BMC Musculoskelet Disord 2006, 1: 7-10.
45.
McGill SM, Hughson RL, Parks K: Changes in lumbar lordosis modify the role of the extensor muscles. Clin Biomech 2000,15(10):777-80. 10.1016/S0268-0033(00)00037-1CrossRef
46.
Descarreaux M, Lafond D, Jeffrey-Gauthier R, Centomo H, Cantin V: Changes in the flexion relaxation response induced by lumbar muscle fatigue. BMC Musculoskelet Disord 2008,9(1):1. 10.1186/1471-2474-9-10CrossRef
47.
Lehman GL: Biomechanical assessments of lumbar spinal function. How low back pain suffers differ from normals. Implications for outcome measures research. Part I: Kinematic assessments of lumbar function. J Manip Physiol Ther 2004,27(1):57-62. 10.1016/j.jmpt.2003.11.007CrossRef
48.
Nattrass CL, Nitschke JE, Disler PB, Chou MJ, Ooi KT: Lumbar spine range of motion as a measure of physical and functional impairment: an investigation of validity. Clin Rehabil 1999, 13: 211-218. 10.1191/026921599672501899CrossRefPubMed
49.
Nourbakhsh MR, Arab AM: Ralation between mechanical factors and incidence of low back pain. J Orthop Sports Phys Ther 2002, 32: 447-460.CrossRefPubMed
50.
Davis RB, Ounpuu S, Tyburski , Gage GR: A gait analysis data collection and reduction technique. Hum Mov Sci 1991, 10: 575-87. 10.1016/0167-9457(91)90046-ZCrossRef
51.
Peharec S, Jerković R, Bacić P, Azman J, Bobinac D: Kinematic measurement of the lumbar spine and pelvis in the normal population. Coll Antropol 2007,31(4):1039-42.PubMed
Metadata
Title
Effect of obesity and low back pain on spinal mobility: a cross sectional study in women
Authors
Luca Vismara
Francesco Menegoni
Fabio Zaina
Manuela Galli
Stefano Negrini
Paolo Capodaglio
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2010
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/1743-0003-7-3

Other articles of this Issue 1/2010

Journal of NeuroEngineering and Rehabilitation 1/2010 Go to the issue

Research

Patient-cooperative control increases active participation of individuals with SCI during robot-aided gait training

Methodology

Introducing a feedback training system for guided home rehabilitation

Research

Kinematic analysis of the daily activity of drinking from a glass in a population with cervical spinal cord injury

Research

Assessing motor deficits in compressive neuropathy using quantitative electromyography

Research

Improvement of diaphragm and limb muscle isotonic contractile performance by K+ channel blockade

Short report

Balance perturbation system to improve balance compensatory responses during walking in old persons