Does the Fists-on-Clavicles Position Represent a Functional Standing Position?

Does the Fists-on-Clavicles Position Represent a Functional Standing Position?
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DOI：
10.1097/brs.0b013e31819e2191
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发表时间：
2009-04-15
期刊：
SPINE
影响因子：
3
通讯作者：
Mizuma, Koichi
Mizuma, Koichi
中科院分区：
医学2区
文献类型：
--
作者：
Aota, Yoichi;Saito, Tomoyuki;Mizuma, Koichi

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研究设计。3种不同臂位下脊柱侧位片矢状垂直轴（SVA）的前瞻性分析。检查是否拳头在锁骨上的位置代表一个功能性的站立位置。背景资料摘要。在放松站立时，由于手臂的干扰，脊柱和骨盆矢状面形态的影像学显示很困难；然而，站立时手臂前屈会导致SVA的负变化。拳对锁骨的位置是为了提供一个更功能性的矢状位和充分的脊柱可视化。目前还没有研究比较拳对锁骨和放松站立姿势的SVA。在14名健康受试者的站立侧位x线片上测量SVA，采用3种不同的手臂姿势：手臂侧放放松，手臂前屈至45度（肩部屈曲[SF]），以及拳贴锁骨。放松站立时的平均SVA为1.4±1.9 cm。SF产生显著的SVA负移（-3.7 +/- 2.3 cm, P < 0.001）。与放松站立相比，拳对锁骨体位导致SVA负移位减少但显著（-2.3 +/- 2.1 cm, P < 0.001）。虽然拳对锁骨体位在减少SVA负移方面优于SF体位，但与放松站立相比，拳对锁骨体位确实出现了显著的负移。
Study Design. Prospective analysis of sagittal vertical axis (SVA) on lateral spine radiographs using 3 different arm positions.Objective. To examine whether fists-on-clavicles position represents a functional standing position.Summary of Background Data. Radiographic visualization of spinal and pelvic sagittal morphology is difficult during relaxed standing because of interference from the arms; however, standing with arms forward-flexed results in a negative shift in SVA. The fists-on-clavicles position was proposed to provide a more functional sagittal profile and adequate visualization of the spine. No existing study compares the SVA between the fists-on-clavicle and relaxed standing positions.Methods. The SVA was measured on standing lateral radiographs of 14 healthy subjects using 3 different arm positions: relaxed with arms-at-side, arms forward-flexed to 45 (shoulder flexion [SF]), and fists-on-clavicles.Results. The mean SVA with relaxed standing was 1.4 +/- 1.9 cm. SF produced a significant SVA negative shift (-3.7 +/- 2.3 cm, P < 0.001). The fists-on-clavicle position resulted in a reduced but significant SVA negative shift (-2.3 +/- 2.1 cm, P < 0.001) compared with relaxed standing.Conclusion. Although the fists-on-clavicles position was better than SF in reducing the SVA negative shift, a significant negative shift did occur in the fists-on-clavicle position compared with relaxed standing.