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

SUMMARY: 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.