Research Article
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Postural stability, body composition and functional ability of the lower extremity in patients with lumbar degenerative spondylolisthesis

Year 2022, , 44 - 49, 30.06.2022
https://doi.org/10.31459/turkjkin.1108377

Abstract

Although patients accessing rehabilitation services had been reported to have better functional ability of the lower limbs, postural stability, and low cardiovascular disease risk factors, updated data from developing countries is however vital for clinical practices. Hence, the aim of this study was to present the association between lower extremity functional ability (LEFA), stability, and body composition profiles in rehabilitative lumbar degenerative spondylolisthesis (LDS) patients considering age and gender. One hundred and twenty-four participants (45 females, 79 males), with a mean age of 56.45±11.13 years, volunteered for the study. Weight, height body fat percent (BFP), visceral fat, body mass index (BMI), resting systolic and diastolic blood pressure, and resting heart rate were measured while functional ability and stability tests were conducted on the participants. 53.4% were at least overweight; LEFA was below average, stability of both dominant and nondominant legs was very poor, blood pressure and heart rate were high. Women had high total body fat and visceral fat. Significant differences were observed in BMI (p=0.044) and BFP (p=0.035) based on age classification as well as BMI (p=0.000), BFP (p=0.000) and visceral fat (p=0.000) by gender. Overweight, high blood pressure, poor LEFA, and postural stability are crucial comorbidities of Ghanaian LDS patients in this study. Educationally and pragmatically comprehensive healthy lifestyle interventions of regular exercise regimes, adequate and quality nutrition, and occupational stress reduction would play major complementary roles in chiropractic treatment.

References

  • Abubakar, S.A., Chukuma, P.I., & Imam, M.I. (2017). Orthostatic intolerance without postural tachycardia complicating lumbar spondylolisthesis. Arch Int Surg, 7(1), 36-39.
  • Beschloss, A., Dicindio, C., Lombardi, J., Varthi, A., Ozturk, A., Lehman, R., Lenke, L., & Saifi, C. (2021). Marked increase in spinal deformity surgery throughout the United States. Spine, 46(20), 1402-1408.
  • Biely, S., Smith, S.S., & Silfies, S.P. (2006). Clinical instability of the lumbar spine: diagnosis and intervention. J Orthop Sports Phys Ther, 18(3), 11-18.
  • Binkley, J.M., Stratford, P.W., Lott, S.A., & Riddle, D.L., & North American Orthopaedic Rehabilitation Research Network. (1999). The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. Phys Ther, 79(4), 371-383.
  • Boyanov, M.A., Boneva, Z., & Christov, V.G. (2003). Testosterone supplementation in men with type 2 diabetes, visceral obesity and partial androgen deficiency. Aging Male, 6(1), 1-7.
  • Chaouachi, M., Granacher, U., Makhlouf, I., Hammami, R., Behm, D.G., & Chaouachi, A. (2017). Within session sequence of balance and plyometric exercises does not affect training adaptations with youth soccer athletes. J Sports Sci Med, 16(1), 125-136.
  • Davies, B., Mowforth, O., Sadler, I., Aarabi, B., Kwon, B., Kurpad, S., Harrop, J., Wilson, J., Grossman, R., Fehlings, M. (2019). OP01: Degenerative-cervical 1 A001: Pain is the recovery priority for patients with degenerative cervical myelopathy. Global Spine J, 9(2S), 2S-187S.
  • Denard, P.J., Holton, K.F., Miller, J., Fink, H.A., Kado, D.M., Marshall, L.M., & Yoo, J.U. (2010). Osteoporotic Fractures in Men (MrOS) Study Group. Back pain, neurogenic symptoms, and physical function in relation to spondylolisthesis among elderly men. Spine J, 10(10), 865-873.
  • DeVine, J.G., Schenk-Kisser, J.M., & Skelly, A.C. (2012). Risk factors for degenerative spondylolisthesis: A systematic review. Evid Based Spine Care J, 3(02), 25-34.
  • Deyo, R.A., Gray, D.T., Kreuter, W., Mirza, S., & Martin, B.I. (2005). United States trends in lumbar fusion surgery for degenerative conditions. Spine, 30(12), 1441-1445.
  • Duruöz, M.T., Özcan, E., Ketenci, A., & Karan, A. (2013). Development and validation of a functional disability index for chronic low back pain. J Back Musculoskelet Rehabil, 26(1), 45-54.
  • Gailey, R., Allen, K., Castles, J., Kucharik, J., & Roeder, M. (2008). Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use. J Rehabil Res Dev, 45(1), 15-30.
  • Grob, D., Benini, A., Junge, A., & Mannion, A.F. (2005). Clinical experience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient-oriented outcome in 50 cases after an average of 2 years. Spine J, 30(3), 324-331.
  • Hicks, G.E., Simonsick, E.M., Harris, T.B., Newman, A.B., Weiner, D.K., Nevitt, M.A., Tylavsky, F.A. (2005). Trunk muscle composition as a predictor of reduced functional capacity in the health, aging and body composition study: the moderating role of back pain. J Gerontol A Biol Sci Med Sci, 60(11), 1420-1424.
  • Hsu, H.C., Chang, C.J., Tung, H.H., & Wang, T.J. (2019). Disability, emotional distress and well‐being among patients with lumbar spondylolisthesis. J Clin Nurs, 28(21-22), 3866-3878.
  • Jakobsen, A.S., Speyer, H., Nørgaard, H.C., Hjorthøj, C., Krogh, J., Mors, O., & Nordentoft, M. (2018). Associations between clinical and psychosocial factors and metabolic and cardiovascular risk factors in overweight patients with schizophrenia spectrum disorders–Baseline and two-years findings from the change trial. Schizophr Res, 199, 96-102.
  • Jiang, X., Chen, D., Li. Z., & Lou, Y. (2019). Correlation between Lumbar Spine Facet Joint Orientation and Intervertebral Disk Degeneration: A Positional MRI Analysis. J Neurol Surg Part A, 80(4), 255-261.
  • Kalichman, L., Kim, D.H., Li, L., Guermazi, A., Berkin, V., & Hunter, D.J. (2009). Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population. Spine (Phila Pa 1976), 34(2), 199-205.
  • Kamal, Z., & Rouhi, G. (2019). Significance of spine stability criteria on trunk muscle forces following unilateral muscle weakening: A comparison between kinematics-driven and stability-based kinematics-driven musculoskeletal models. Med Eng Phys, 73, 51-63.
  • Kohno, M., Iwamura, Y., Inasaka, R., Akiyama, G., Higashihira, S., Kawai, T., Niimura, T., & Inaba, Y. (2020). Influence of comorbid knee osteoarthritis on surgical outcome and sagittal spinopelvic/lower-extremity alignment in elderly patients with degenerative lumbar spondylolisthesis undergoing transforaminal lumbar interbody fusion. J Neurosurg, 32(6), 850-858.
  • Lee, K., Park, D., & Lee, G. (2019). Progressive respiratory muscle training for improving trunk stability in chronic stroke survivors: A pilot randomized controlled trial. J Stroke Cerebrovasc Dis, 28(5), 1200-1211. Liu, J., & Hai, Y. (2019). E-Posters. Global Spine J, 9(2S), 188S-533S.
  • Moo, H., Tan, S.W., Kasat, N., & Thing, L.K. (2015). A case report of 3-level degenerative spondylolisthesis with spinal canal stenosis. Int J Surg Case Rep, 8, 120-123.
  • Nazarov, S., Manuwald, U., Leonardi, M., Silvaggi, F., Foucaud, J., Lamore, K., Guastafierro, E., Scaratti, C., Lindström, J. & Rothe, U. (2019). Chronic diseases and employment: which interventions support the maintenance of work and return to work among workers with chronic illnesses? A systematic review. Int J Environ Res Public Health, 16(10), 1864.
  • Ogden, C.L., Carroll, M.D., Fryar, C.D., & Flegal, K.M. (2015). Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief., No. 219, 1–8.
  • Pfingsten, M., Lueder, S., Luedtke, K., Petzke, F., & Hildebrandt, J. (2014). Significance of physical performance tests for patients with low back pain. Pain Med.,15(7),1211-1221.
  • Piché, M.E., Poirier, P., Lemieux, I., & Després, J.P. (2018). Overview of epidemiology and contribution of obesity and body fat distribution to cardiovascular disease: an update. Prog Cardiovasc Dis., 61(2),103-113.
  • Rihn, J. A., Hilibrand, A. S., Zhao, W., Lurie, J. D., Vaccaro, A. R., Albert, T. J., & Weinstein, J. (2015). Effectiveness of surgery for lumbar stenosis and degenerative spondylolisthesis in the octogenarian population: analysis of the Spine Patient Outcomes Research Trial (SPORT) data. J Bone Joint Surg Am, 97(3), 177.
  • Sharma, A., Alahmari, K., & Ahmed, I. (2015). Efficacy of manual therapy versus conventional physical therapy in chronic low back pain due to lumbar spondylosis: A pilot study. Am J Med Sci., 3(3),55-63.
  • Simmonds, A.M., Rampersaud, Y.R., Dvorak, M.F., Dea, N., Melnyk, A.D., Fisher, C.G. (2015). Defining the inherent stability of degenerative spondylolisthesis: a systematic review. J Neurosurg., 23(2),178-189.
  • Sions, J. M., Coyle, P. C., Velasco, T. O., Elliott, J. M., & Hicks, G. E. (2017). Multifidi muscle characteristics and physical function among older adults with and without chronic low back pain. Arch. Phys. Med. Rehabil., 98(1), 51-57.
  • Smith, S., Devine, M., Taddeo, J., & McAlister, V.C. (2017). Injury profile suffered by targets of antipersonnel improvised explosive devices: prospective cohort study. BMJ Open, 7(7), e014697.
  • Thornes, E., Robinson, H.S., & Vøllestad, N.K. (2018). Degenerative lumbar spinal stenosis and physical functioning: an exploration of associations between self-reported measures and physical performance tests. Disabil Rehabil, 40(2), 232-237.
  • Verkouter, I., Noordam, R., de Roos, A., Lamb, H.J., Rosendaal, F.R., van Heemst, D., de Mutsert, R. (2019). Adult weight change in relation to visceral fat and liver fat at middle age: The Netherlands epidemiology of obesity study. Int J Obes (Lond), 43(4), 790-799.
  • Vlok, G.J. (2008). Degenerative spondylolisthesis: Part of the normal ageing process. J Orthop Sports Phys Ther, 7(2), 50-55.
  • Wang, C., Chang, H., Gao, X., Xu, J., & Meng, X. (2019). Risk factors of degenerative lumbar scoliosis in patients with lumbar spinal canal stenosis. Medicine (Baltimore), 98(38), e17177
  • Wang, Y. X. J., Kaplar, Z., Deng, M., & Leung, J. C. (2017). Lumbar degenerative spondylolisthesis epidemiology: a systematic review with a focus on gender-specific and age-specific prevalence. J Orthop Translat, 11, 39-52.
  • Wasiak, R., Kim, J., & Pransky, G.S. (2007). The association between timing and duration of chiropractic care in work-related low back pain and work-disability outcomes. Ann Occup Environ Med, 49(10), 1124-1134.
  • Wong, L.C. (2004). Rehabilitation of a patient with a rare multi-level isthmic spondylolisthesis: A case report. J Can Chiropr Assoc, 48(2), 142–151.
Year 2022, , 44 - 49, 30.06.2022
https://doi.org/10.31459/turkjkin.1108377

Abstract

References

  • Abubakar, S.A., Chukuma, P.I., & Imam, M.I. (2017). Orthostatic intolerance without postural tachycardia complicating lumbar spondylolisthesis. Arch Int Surg, 7(1), 36-39.
  • Beschloss, A., Dicindio, C., Lombardi, J., Varthi, A., Ozturk, A., Lehman, R., Lenke, L., & Saifi, C. (2021). Marked increase in spinal deformity surgery throughout the United States. Spine, 46(20), 1402-1408.
  • Biely, S., Smith, S.S., & Silfies, S.P. (2006). Clinical instability of the lumbar spine: diagnosis and intervention. J Orthop Sports Phys Ther, 18(3), 11-18.
  • Binkley, J.M., Stratford, P.W., Lott, S.A., & Riddle, D.L., & North American Orthopaedic Rehabilitation Research Network. (1999). The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. Phys Ther, 79(4), 371-383.
  • Boyanov, M.A., Boneva, Z., & Christov, V.G. (2003). Testosterone supplementation in men with type 2 diabetes, visceral obesity and partial androgen deficiency. Aging Male, 6(1), 1-7.
  • Chaouachi, M., Granacher, U., Makhlouf, I., Hammami, R., Behm, D.G., & Chaouachi, A. (2017). Within session sequence of balance and plyometric exercises does not affect training adaptations with youth soccer athletes. J Sports Sci Med, 16(1), 125-136.
  • Davies, B., Mowforth, O., Sadler, I., Aarabi, B., Kwon, B., Kurpad, S., Harrop, J., Wilson, J., Grossman, R., Fehlings, M. (2019). OP01: Degenerative-cervical 1 A001: Pain is the recovery priority for patients with degenerative cervical myelopathy. Global Spine J, 9(2S), 2S-187S.
  • Denard, P.J., Holton, K.F., Miller, J., Fink, H.A., Kado, D.M., Marshall, L.M., & Yoo, J.U. (2010). Osteoporotic Fractures in Men (MrOS) Study Group. Back pain, neurogenic symptoms, and physical function in relation to spondylolisthesis among elderly men. Spine J, 10(10), 865-873.
  • DeVine, J.G., Schenk-Kisser, J.M., & Skelly, A.C. (2012). Risk factors for degenerative spondylolisthesis: A systematic review. Evid Based Spine Care J, 3(02), 25-34.
  • Deyo, R.A., Gray, D.T., Kreuter, W., Mirza, S., & Martin, B.I. (2005). United States trends in lumbar fusion surgery for degenerative conditions. Spine, 30(12), 1441-1445.
  • Duruöz, M.T., Özcan, E., Ketenci, A., & Karan, A. (2013). Development and validation of a functional disability index for chronic low back pain. J Back Musculoskelet Rehabil, 26(1), 45-54.
  • Gailey, R., Allen, K., Castles, J., Kucharik, J., & Roeder, M. (2008). Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use. J Rehabil Res Dev, 45(1), 15-30.
  • Grob, D., Benini, A., Junge, A., & Mannion, A.F. (2005). Clinical experience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient-oriented outcome in 50 cases after an average of 2 years. Spine J, 30(3), 324-331.
  • Hicks, G.E., Simonsick, E.M., Harris, T.B., Newman, A.B., Weiner, D.K., Nevitt, M.A., Tylavsky, F.A. (2005). Trunk muscle composition as a predictor of reduced functional capacity in the health, aging and body composition study: the moderating role of back pain. J Gerontol A Biol Sci Med Sci, 60(11), 1420-1424.
  • Hsu, H.C., Chang, C.J., Tung, H.H., & Wang, T.J. (2019). Disability, emotional distress and well‐being among patients with lumbar spondylolisthesis. J Clin Nurs, 28(21-22), 3866-3878.
  • Jakobsen, A.S., Speyer, H., Nørgaard, H.C., Hjorthøj, C., Krogh, J., Mors, O., & Nordentoft, M. (2018). Associations between clinical and psychosocial factors and metabolic and cardiovascular risk factors in overweight patients with schizophrenia spectrum disorders–Baseline and two-years findings from the change trial. Schizophr Res, 199, 96-102.
  • Jiang, X., Chen, D., Li. Z., & Lou, Y. (2019). Correlation between Lumbar Spine Facet Joint Orientation and Intervertebral Disk Degeneration: A Positional MRI Analysis. J Neurol Surg Part A, 80(4), 255-261.
  • Kalichman, L., Kim, D.H., Li, L., Guermazi, A., Berkin, V., & Hunter, D.J. (2009). Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population. Spine (Phila Pa 1976), 34(2), 199-205.
  • Kamal, Z., & Rouhi, G. (2019). Significance of spine stability criteria on trunk muscle forces following unilateral muscle weakening: A comparison between kinematics-driven and stability-based kinematics-driven musculoskeletal models. Med Eng Phys, 73, 51-63.
  • Kohno, M., Iwamura, Y., Inasaka, R., Akiyama, G., Higashihira, S., Kawai, T., Niimura, T., & Inaba, Y. (2020). Influence of comorbid knee osteoarthritis on surgical outcome and sagittal spinopelvic/lower-extremity alignment in elderly patients with degenerative lumbar spondylolisthesis undergoing transforaminal lumbar interbody fusion. J Neurosurg, 32(6), 850-858.
  • Lee, K., Park, D., & Lee, G. (2019). Progressive respiratory muscle training for improving trunk stability in chronic stroke survivors: A pilot randomized controlled trial. J Stroke Cerebrovasc Dis, 28(5), 1200-1211. Liu, J., & Hai, Y. (2019). E-Posters. Global Spine J, 9(2S), 188S-533S.
  • Moo, H., Tan, S.W., Kasat, N., & Thing, L.K. (2015). A case report of 3-level degenerative spondylolisthesis with spinal canal stenosis. Int J Surg Case Rep, 8, 120-123.
  • Nazarov, S., Manuwald, U., Leonardi, M., Silvaggi, F., Foucaud, J., Lamore, K., Guastafierro, E., Scaratti, C., Lindström, J. & Rothe, U. (2019). Chronic diseases and employment: which interventions support the maintenance of work and return to work among workers with chronic illnesses? A systematic review. Int J Environ Res Public Health, 16(10), 1864.
  • Ogden, C.L., Carroll, M.D., Fryar, C.D., & Flegal, K.M. (2015). Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief., No. 219, 1–8.
  • Pfingsten, M., Lueder, S., Luedtke, K., Petzke, F., & Hildebrandt, J. (2014). Significance of physical performance tests for patients with low back pain. Pain Med.,15(7),1211-1221.
  • Piché, M.E., Poirier, P., Lemieux, I., & Després, J.P. (2018). Overview of epidemiology and contribution of obesity and body fat distribution to cardiovascular disease: an update. Prog Cardiovasc Dis., 61(2),103-113.
  • Rihn, J. A., Hilibrand, A. S., Zhao, W., Lurie, J. D., Vaccaro, A. R., Albert, T. J., & Weinstein, J. (2015). Effectiveness of surgery for lumbar stenosis and degenerative spondylolisthesis in the octogenarian population: analysis of the Spine Patient Outcomes Research Trial (SPORT) data. J Bone Joint Surg Am, 97(3), 177.
  • Sharma, A., Alahmari, K., & Ahmed, I. (2015). Efficacy of manual therapy versus conventional physical therapy in chronic low back pain due to lumbar spondylosis: A pilot study. Am J Med Sci., 3(3),55-63.
  • Simmonds, A.M., Rampersaud, Y.R., Dvorak, M.F., Dea, N., Melnyk, A.D., Fisher, C.G. (2015). Defining the inherent stability of degenerative spondylolisthesis: a systematic review. J Neurosurg., 23(2),178-189.
  • Sions, J. M., Coyle, P. C., Velasco, T. O., Elliott, J. M., & Hicks, G. E. (2017). Multifidi muscle characteristics and physical function among older adults with and without chronic low back pain. Arch. Phys. Med. Rehabil., 98(1), 51-57.
  • Smith, S., Devine, M., Taddeo, J., & McAlister, V.C. (2017). Injury profile suffered by targets of antipersonnel improvised explosive devices: prospective cohort study. BMJ Open, 7(7), e014697.
  • Thornes, E., Robinson, H.S., & Vøllestad, N.K. (2018). Degenerative lumbar spinal stenosis and physical functioning: an exploration of associations between self-reported measures and physical performance tests. Disabil Rehabil, 40(2), 232-237.
  • Verkouter, I., Noordam, R., de Roos, A., Lamb, H.J., Rosendaal, F.R., van Heemst, D., de Mutsert, R. (2019). Adult weight change in relation to visceral fat and liver fat at middle age: The Netherlands epidemiology of obesity study. Int J Obes (Lond), 43(4), 790-799.
  • Vlok, G.J. (2008). Degenerative spondylolisthesis: Part of the normal ageing process. J Orthop Sports Phys Ther, 7(2), 50-55.
  • Wang, C., Chang, H., Gao, X., Xu, J., & Meng, X. (2019). Risk factors of degenerative lumbar scoliosis in patients with lumbar spinal canal stenosis. Medicine (Baltimore), 98(38), e17177
  • Wang, Y. X. J., Kaplar, Z., Deng, M., & Leung, J. C. (2017). Lumbar degenerative spondylolisthesis epidemiology: a systematic review with a focus on gender-specific and age-specific prevalence. J Orthop Translat, 11, 39-52.
  • Wasiak, R., Kim, J., & Pransky, G.S. (2007). The association between timing and duration of chiropractic care in work-related low back pain and work-disability outcomes. Ann Occup Environ Med, 49(10), 1124-1134.
  • Wong, L.C. (2004). Rehabilitation of a patient with a rare multi-level isthmic spondylolisthesis: A case report. J Can Chiropr Assoc, 48(2), 142–151.
There are 38 citations in total.

Details

Primary Language English
Subjects Physical Training and Sports
Journal Section Original Research Articles
Authors

Wonder Yao Nanevı This is me 0000-0001-9982-5704

Monday Moses 0000-0001-5785-9551

Emmanuel Ansu Gyeabour 0000-0002-1381-7285

Robert Junior Boateng This is me 0000-0002-1782-305X

Publication Date June 30, 2022
Submission Date April 24, 2022
Acceptance Date June 18, 2022
Published in Issue Year 2022

Cite

APA Nanevı, W. Y., Moses, M., Ansu Gyeabour, E., Boateng, R. J. (2022). Postural stability, body composition and functional ability of the lower extremity in patients with lumbar degenerative spondylolisthesis. Turkish Journal of Kinesiology, 8(2), 44-49. https://doi.org/10.31459/turkjkin.1108377

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