New population-based reference values for spinal mobility measures based on the 2009-2010 National Health and Nutrition Examination Survey

Shervin Assassi, Michael H. Weisman, Min Jae Lee, Laurie Savage, Laura Diekman, Tiffany A. Graham, Mohammad H. Rahbar, Joan I. Schall, Lianne S. Gensler, Atul A. Deodhar, Daniel O. Clegg, Robert A. Colbert, John D. Reveille

Research output: Contribution to journalArticle

Abstract

Objective. To report population-based percentile reference values for selected spinal mobility measures in a nationally representative sample of 5,001 US adults ages 20-69 years who were examined in the 2009-2010 US National Health and Nutrition Examination Survey (NHANES). Methods. Occiput-to-wall distance (OWD), thoracic expansion (TE), and anterior lumbar flexion (ALF; by modified Schober test) were measured by trained examiners in a standardized manner. TE was measured at the xiphisternal level, while the lower reference point for ALF was a line marked at the level of the superior margin of the lateral iliac crests. We report reference values based on the 95th percentile for the OWD and the 5th percentile for TE and ALF, as well as other summary statistics for these measures, in the study population. Results. An OWD of >0 was present in 3.8% of the participants, while 8.8% of them had out-of-range values for TE based on the commonly used threshold of 2.5 cm. The 95th percentile of the OWD measurement was 0, while the 5th percentile for TE and ALF were 1.9 cm and 2 cm, respectively. The spinal measures were significantly associated with sex, age, ethnicity, height, and body mass index (BMI). Exclusion of individuals with severe obesity (BMI >35 kg/m2) changed the proposed reference values for TE and ALF to 2.2 cm and 1.9 cm, respectively. Conclusion. We verified a reference value of 0 for the OWD in the general population. Using the reported population-based percentile values, new reference values for TE and ALF can be derived.

Original languageEnglish (US)
Pages (from-to)2628-2637
Number of pages10
JournalArthritis and Rheumatology
Volume66
Issue number9
DOIs
StatePublished - Sep 2014
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology

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    Assassi, S., Weisman, M. H., Lee, M. J., Savage, L., Diekman, L., Graham, T. A., Rahbar, M. H., Schall, J. I., Gensler, L. S., Deodhar, A. A., Clegg, D. O., Colbert, R. A., & Reveille, J. D. (2014). New population-based reference values for spinal mobility measures based on the 2009-2010 National Health and Nutrition Examination Survey. Arthritis and Rheumatology, 66(9), 2628-2637. https://doi.org/10.1002/art.38692