Arshad Rizwan, Pan Fumin, Reitmaier Sandra, Schmidt Hendrik
Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
J Biomech. 2019 Jan 3;82:1-19. doi: 10.1016/j.jbiomech.2018.11.022. Epub 2018 Nov 17.
Lumbar lordosis (LL) and the range of motion (RoM) are important physiological measurements when initiating any diagnosis and treatment plan for patients with low back pain. Numerous studies reported differences in LL and the RoM due to age and sex. However, these findings remain contradictory. A systematic review and meta-analysis were performed to synthesize mean values and the differences in LL and the RoM because of age and sex. The quality assessment tool for quantitative studies was applied to assess the methodological quality of the studies included. We identified 2372 papers through electronic (2309) and physical (63) searches. We assessed 218 full-text studies reporting measurements of LL or the RoM. In total, 65 studies were included, and a normative database for LL and the RoM is provided as supplementary material. Among these, 11 were included in the meta-analysis. LL and the RoM displayed non-monotonic variations with significant age and sex differences. Young females showed a significantly greater LL and the range of extension (RoE), whereas young males exhibited a greater range of flexion (RoF). Sex differences in the range of lateral bending (RoLB) were small but were significant for the axial rotation (RoAR). For the RoF, RoE and RoLB, differences because of age were significant among most of the age groups in both sexes, whereas for the RoAR, differences were significant only between the 20s vs the 30s-40s (males) and 40s vs 50s (females). Significant differences because of age/sex were identified. However, the age-dependent reduction in LL and the RoM was non-monotonic and differed in both sexes. These findings will help to better distinguish between functional deficits caused by spinal disorders and natural factors/conditions related to age and sex.
腰椎前凸（LL）和活动范围（RoM）是对腰痛患者启动任何诊断和治疗方案时重要的生理测量指标。众多研究报告了因年龄和性别导致的LL和RoM差异。然而，这些研究结果仍相互矛盾。进行了一项系统综述和荟萃分析，以综合LL和RoM的平均值以及因年龄和性别导致的差异。应用定量研究的质量评估工具来评估纳入研究的方法学质量。我们通过电子检索（2309篇）和手工检索（63篇）共识别出2372篇论文。我们评估了218项报告LL或RoM测量值的全文研究。总共纳入了65项研究，并提供了LL和RoM的规范数据库作为补充材料。其中，11项纳入了荟萃分析。LL和RoM呈现非单调变化，存在显著的年龄和性别差异。年轻女性的LL和伸展范围（RoE）显著更大，而年轻男性的屈曲范围（RoF）更大。侧屈范围（RoLB）的性别差异较小，但轴向旋转范围（RoAR）的性别差异显著。对于RoF、RoE和RoLB，大多数年龄组的男女因年龄导致的差异均显著，而对于RoAR，仅20多岁与30多岁至40多岁（男性）以及40多岁与50多岁（女性）之间存在显著差异。确定了因年龄/性别导致的显著差异。然而，LL和RoM随年龄的降低是非单调的，且男女情况不同。这些发现将有助于更好地区分脊柱疾病引起的功能缺陷与与年龄和性别相关的自然因素/状况。
