Association between trunk extensor endurance and dynamic spinal alignment changes during walking in older patients with adult spinal deformity

Spine Deform. 2026 Aug 3. doi: 10.1007/s43390-026-01525-5. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the association between trunk extensor endurance time and dynamic alignment changes during walking in older patients with adult spinal deformity (ASD).

METHODS: This cross-sectional study targeted patients with ASD who were dissatisfied with their posture and pain during walking. Trunk extensor endurance was defined as the maximum endurance time (ET) for maintaining the upper body posture, measured using the Ito-Shirado test. Dynamic spinal alignment changes during walking were evaluated by calculating the change in sagittal trunk shift (STS), measured before and after a 3-min walk using a three-dimensional motion analysis system, referred to as ΔSTS. To examine the association between ET and ΔSTS, multivariable linear regression analysis was performed, adjusting for potential confounders to calculate standardized partial regression coefficients (β) and 95% confidence intervals (95% CI). Model 1 was adjusted for age and body mass index (BMI); Model 2 was additionally adjusted for sagittal vertical axis, pelvic incidence minus lumbar lordosis, and maximum coronal Cobb angle.

RESULTS: Thirty-five female patients with ASD were included in the final analysis. Multivariable linear regression analysis revealed a significant association between ET and ΔSTS in both models. (Model 1: β = – 0.694, 95% CI – 0.941 to – 0.447, p < 0.01; Model 2: β = – 0.781, 95% CI – 1.100 to – 0.461, p < 0.01).

CONCLUSION: This study demonstrated the relationship between trunk extensor endurance and dynamic alignment changes during walking in individuals with ASD. These findings may have important implications for health professionals involved in the management of patients with ASD.

PMID:42547760 | DOI:10.1007/s43390-026-01525-5