spinal flexibility
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The intervertebral disc (IVD) has long been known as a mechanical structure responsible for spinal flexibility and load distribution, while its dysfunction is a frequent source of pain and disability. In recent years, multiple signaling pathways contributing to the regulation of the IVD homeostasis in health and disease have been discovered. At the same time, crosstalk of the IVD with adjacent tissues, immune cells, nerve cells and systemic mediators has been identified as an essential mechanism of degeneration and repair. Such discoveries open the door for the design of new therapeutic and diagnostic targets. This Disc Biology Special Issue provides an abstract of cutting-edge findings in terms of tissue regulation, therapeutic intervention and preclinical models, which will help to improve the management of IVD disorders.

Background: Ankylosing spondylitis (AS) is a chronic autoimmune inflammatory spondyloarthropathy with unclear pathogenesis. The inflammatory pain in AS leads to restricted spinal mobility and significant disability. Yoga is a nonpharmacological intervention that has positive effects on various musculoskeletal-related problems. However, its role in AS is unknown. Objective: The present retrospective study assessed the efficacy of a two-week residential yoga intervention on spinal flexibility among AS patients. Methods: The records for 24 male AS patients within the age range 30 to 50 years (average age 38.3 ± 10.5 years) who underwent a two-week residential yoga retreat between 2015 and 2020 were obtained from a yoga center located in South India. Yoga intervention consisted of yoga postures, breathing practices, meditation, a healthy diet, and devotional sessions. Pre and Post data of the sit-and-reach test, blood pressure, heart rate, and symptom score were analyzed using Statistical Package for Social Sciences (SPSS). Results: Compared to the baseline, the post scores of the sit-and-reach test, systolic blood pressure and heart rate were found to be significantly ( P < .05) lower. The symptom score and analgesic medication score also showed significant improvement after two-weeks compared to the baseline. Conclusion: This retrospective study indicates the positive impact of on and analgesic use among AS patients. However, additional studies using robust research designs are warranted.

OBJECTIVE Preoperative planning for adult spinal deformity (ASD) surgery is essential to prepare the surgical team and consistently obtain postoperative alignment goals. Positional imaging may allow the surgeon to evaluate spinal flexibility and anticipate the need for more invasive techniques. The purpose of this study was to determine whether spine flexibility, defined by the change in alignment between supine and standing imaging, is associated with the need for an osteotomy in ASD surgery. METHODS A single-center, dual-surgeon retrospective analysis was performed of adult patients with ASD who underwent correction of a thoracolumbar deformity between 2014 and 2018 (pelvis to upper instrumented vertebra between L1 and T9). Patients were stratified into osteotomy (Ost) and no-osteotomy (NOst) cohorts according to whether an osteotomy was performed (Schwab grade 2 or higher). Demographic, surgical, and radiographic parameters were compared. The sagittal correction from intraoperative prone positioning alone (sagittal flexibility percentage [Sflex%]) was assessed by comparing the change in lumbar lordosis (LL) between preoperative supine to standing radiographs and preoperative to postoperative alignment. RESULTS Demographics and preoperative and postoperative sagittal alignment were similar between the Ost (n = 60, 65.9%) and NOst (n = 31, 34.1%) cohorts (p > 0.05). Of all Ost patients, 71.7% had a grade 2 osteotomy (mean 3 per patient), 21.7% had a grade 3 osteotomy, and 12.5% underwent both grade 3 and grade 2 osteotomies. Postoperatively, the NOst and Ost cohorts had similar pelvic incidence minus lumbar lordosis (PI-LL) mismatch (mean PI-LL 5.2° vs 1.2°; p = 0.205). Correction obtained through positioning (Sflex%) was significantly lower for in the osteotomy cohort (38.0% vs 76.3%, p = 0.004). A threshold of Sflex% < 70% predicted the need for osteotomy at a sensitivity of 78%, specificity of 56%, and positive predictive value of 77%. CONCLUSIONS The flexibility of the spine is quantitatively related to the use of an osteotomy. Prospective studies are needed to determine thresholds that may be used to standardize surgical decision-making in ASD surgery.

Background: Correlation between prediction tools of disability and traditional physical performance tests in ascertaining disability risks remains unexplored. Objectives: The present study aimed to assess the convergent validity of the STarT back tool (SBT) for predicting disability risk using the spinal range of motion (ROM). Methods: Thirty patients with low-back pain (LBP) volunteered for this study. We used the SBT and Dual inclinometers to assess the future risk for disability and spinal ROM, as well as Anthropometric factors and pain intensity. Results: Poor and moderate spinal ROM for forward (93.3%, 6.7%), left lateral (63.30%, 36.70%) and right lateral (80.00%, 20.00%) flexion respectively were common among the participants. Backward extension ROM (36.70%, 46.70%) was mostly good and very good. There was a 60% medium risk for future physical disability based on SBT. There was no significant association between spinal ROM and SBT future disability prediction (χ2 = 3.367, P > 0.05). Conclusions: The SBT and spinal ROM assessment are independent measures of functional disability. They should complement one another in clinical assessment procedures for effective outcomes in the treatment of LBP.

The purposes of this study were (1) to evaluate the relationship between lumbosacral flexibility and the effects of total knee arthroplasty (TKA) on whole-body alignment; and (2) to determine the prerequisites of the adjacent joints for successful TKA. A total of 116 patients (156 cases) who had whole-body X-ray and flexion-extension lumbar radiograph available were enrolled. For the sagittal alignment evaluation, hip–knee–ankle (HKA) angle, pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), and C7 plumb line-sacrum distance (SVA) were evaluated on the whole-body radiographs. Lumbar flexibility (LF) was evaluated using the flexion-extension lumbar radiographs, and pelvic flexibility (PF) was evaluated using the pelvic incidence (PI). The disparities in the knee joint between postoperative passive motion and weight-bearing posture were assessed. LF was significantly correlated with ΔLL and ΔSVA (LL: p = 0.039, SVA: p = 0.040; Pearson correlation coefficient (PCC): −0.206 and 0.205, respectively). There were correlations between PF and ΔSS (p < 0.001, PCC: −0.362), and between the disparity and LF (p = 0.005, PCC = −0.275). Linear regression analysis demonstrated that LF was significantly associated with the presence of disparity (p = 0.005, β = −0.205). LF is an important factor for improved spinal and lower limb alignment after TKA. Additionally, reduced LF may result in knee joint disparity between passive extension and standing extension status. Therefore, surgeons should consider spinopelvic alignment, including lower limb alignment preoperatively, to be able to predict possible changes in whole-body alignment following TKA.

Badminton game when playing is influenced by certain factors, one of them is a component of physical condition. The forehand clear technique is very often used when playing. The component of physical condition that affects the forehand clear is spinal flexibility. This study aims to determine the correlation between the spinal flexibility with the ability to forehand clear in badminton games for students of the Physical Education, Health and Recreation Study Program FKIP Unsyiah class of 2011. This type of research is a descriptive correlation test. The population in this study was the students of Physical Education, Health and Recreation Study Program FKIP Unsyiah 2011 batch of 132 people. The samples in this study were 26 people obtained through random sampling. Data collection techniques are the Bridge-up test to measure spinal flexibility and clear tests to measure the forehand clear. Data processing with statistical form calculation of average value, SD, correlation, determination, and hypothesis testing. The results showed that x ̅ = 24.56, y ̅ = 79.27, SDx = 2.09, SDy = 8.39, rxy = 0.90, Kp = 81% and hypothesis testing with a T test of 10.23. The results showed that the variable x influenced the variable y by 81% and 19% was influenced by other elements. Hypothesis testing proves Thit = 10.23> Ttab = 1.711, meaning that it has a significant correlation. Based on the research conducted, the results of spinal flexibility have a significant correlation with the ability to forehand clear in badminton games for students of the Physical Education, Health and Recreation Study Program FKIP Unsyiah of the Class of 2011. Abstrak Permainan Bulutangkis saat bermain dipengaruhi oleh faktor-faktor tertentu, salah satunyanya komponen kondisi fisik. Teknik pukulan forehand clear sangat sering digunakan saat bermain. Komponen kondisi fisik yang mempengaruhi pukulan forehand clear adalah fleksibilitas togok. Penelitian ini bertujuan untuk mengetahui korelasi flexibilitas togok dengan kemampuan pukulan forehand clear dalam permainan bulutangkis pada mahasiswa Program Studi Pendidikan Jasmani, Kesehatan dan Rekreasi FKIP Unsyiah angkatan 2011. Jenis penelitian termasuk penelitian deskriptif uji korelasi. Populasi dalam penelitian ini mahasiswa Program Studi Pendidikan Jasmani, Kesehatan dan Rekreasi FKIP Unsyiah angkatan 2011 yang berjumlah sebanyak 132 orang. Sampel dalam penelitian ini sebanyak 26 orang didapatkan melalui random sampling. Teknik pengumpulan data adalah Bridge-up tes untuk mengukur kelentukan togok dan clear tes untuk mengukur pukulan forehand clear. Pengolahan data dengan statistik bentuk perhitungan nilai rata-rata, SD, korelasi, determinasi dan uji hipotesis. Hasil penelitian menunjukkan =24,56, =79,27, SDx=2,09, SDy= 8,39, rxy=0,90, Kp=81% dan uji hipotesis dengan uji T sebesar 10,23.  Hasil penelitian menunjukkan variabel x mempengaruhi variabel y sebesar 81%  dan 19% dipengaruhi oleh unsur lain. Uji hipotesis membuktikan Thit= 10,23 > Ttab= 1,711, berarti memiliki korelasi yang signifikan. Berdasarkan penelitian yang dilakukan, terlihat hasil flexibilitas togok memiliki korelasi signifikan dengan kemampuan pukulan forehand clear dalam permainan bulutangkis pada mahasiswa Program Studi Pendidikan Jasmani, Kesehatan dan Rekreasi FKIP Unsyiah Angkatan 2011. Kata kunci:Flexibilitas Togok, Pukulan Forehand Clear, Dan Bulutangkis

Abstract Introduction: Spine problems are common, and assessment of spine flexibility provides relevant information; however, alternative evaluation methods need to be validated. Objective: To evaluate the concurrent validity of the Flexicurve using 3D videogrammetry as a reference value to assess spinal flexion and extension in the lumbar and thoracic regions. Method: The consecutive sample consisted of 39 individuals aged between 18 and 50 years. Two consecutive evaluations were performed by the same rater on the same day and at the same location: (1) Flexicurve and (2) 3D videogrammetry. The assessments were performed with the spine in the neutral position, followed by maximum flexion and extension. The range of motion (ROM) in the maximum flexion and extension positions was calculated in MATLAB® and defined as the difference between the maximum flexion or extension angle and that of the neutral position. Statistical analyses used were the Pearson Product-Moment Correlation coefficient, RMS error and Bland-Altman plot (α < 0.05). Results: The ROM between instruments was similar, with high correlations for thoracic flexion (r = 0.751), extension (r = 0.814) and lumbar flexion (r = 0.853), and RMS errors under 8°. The correlation for lumbar extension was moderate (r = 0.613) and the RMS error was more than 10°. The limits of agreement varied between ± 10º and ± 21º. Conclusion: The Flexicurve is valid for assessing maximum flexion and extension of the thoracic spine, and maximum flexion of the lumbar spine. We suggest caution in evaluating the maximum extension of the lumbar spine.