Influence of sagittal balance and physical ability associated with exercise on quality of life in middle-aged and elderly people

UNLABELLED We examined 304 persons (135 males and 169 females) who underwent a basic health checkup to evaluate the relationship of quality of life (QOL) with osteoporosis, spinal sagittal balance, spinal mobility, muscle strength, and physical ability, including daily exercise. QOL of middle-aged and elderly subjects was strongly related to sagittal balance and physical ability. INTRODUCTION Spinal kyphosis with compression fracture and osteoporosis decrease QOL and increase mortality. However, it is unclear if kyphosis, spinal sagittal balance, muscle strength, and physical ability influence QOL. PURPOSE The goal of the study was to evaluate the relationship of QOL with osteoporosis, spinal sagittal balance, spinal mobility, back muscle strength, and physical ability, including daily exercise, in middle-aged and elderly people. METHODS The subjects were 304 persons (135 males and 169 females) who underwent a basic health checkup. Lumbar lateral radiograph findings, sagittal balance and spinal mobility determined with SpinalMouse®, grip, back muscle strength, and 10-m gait time were evaluated. RESULTS SF-36 physical component summary (PCS) scores showed a significant negative correlation with age (r = -0.375), spinal inclination angle (r = -0.322), and 10-m gait time (r = -0.470), and a significant positive correlation with percent of the young adult mean of bone mineral density (r = 0.223), lumbar lordosis angle (r = 0.184), thoracic spinal range of motion (ROM; r = 0.136), lumbar spinal ROM (r = 0.130), grip strength (r = 0.211), and back muscle strength (r = 0.301). In multiple regression analysis, age (r = -0.372, p < 0.0005), spinal inclination angle (r = -0.336, p < 0.05) and 10-m gait time (r = -2.898, p < 0.0001) were significantly associated with SF-36 PCS (R(2) = 0.288). In the exercise group, SF-36 PCS scores were significantly better (p < 0.05) due to good spinal balance, thoracic spinal ROM, back muscle strength, and gait speed. CONCLUSIONS QOL of middle-aged and elderly subjects was related to sagittal balance and physical ability. Thus, exercises for spine, muscle, and physical ability may improve QOL in middle-aged and elderly people.