The effects of age and gender on the lumbopelvic rhythm in the sagittal plane in 309 subjects.

Frequent upper body bending is associated with low back pain (LBP). The complex flexion movement, combining lumbar and pelvic motion, is known as "lumbopelvic rhythm" and can be quantified by dividing the change in the lumbar spine curvature by the change in pelvic orientation during flexion movement (L/P ratio). This parameter is clinically essential for LBP prevention, for diagnostic procedures and therapy; however, the effects of age and gender, in detail, are unknown. The Epionics SPINE system, utilizing strain-gauge technology and acceleration sensors, was used to assess lumbar lordosis and sacrum orientation during standing and lumbar angle and sacrum orientation during maximal upper body flexion in 309 asymptomatic subjects (age: 20-75 yrs; ♂: 134; ♀: 175). The effects of age and gender on these characteristics as well as on the resultant range of flexion (RoF) and lumbopelvic rhythm were investigated. Aging significantly reduced lumbar lordosis by 8.2° and sacrum orientation by 6.6° during standing in all subjects. With aging, the lumbar RoF decreased by 7.7°, whereas the pelvic RoF compensated for this effect and increased by 7.0°. The L/P ratio decreased from 0.80 to 0.65 with age; however, this decrease was only significant in men. Gender affected sacrum orientation in standing and in flexion as well as the L/P ratio. This study demonstrated the effects of age and gender on lordosis, sacrum orientation and lumbopelvic rhythm. These findings are of importance for the individual prevention of LBP, and provide a baseline for differentiating symptomatic from asymptomatic age- and gender-matched subjects.