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Degenerative Spine DiseaseNCT06557837

Evaluation of Deterioration in Body Posture of Older Patients During Gait Compared to Stance

An observational study of Degenerative Spine Disease and Sagittal Balance, run by University Medical Centre Ljubljana at 2 sites in Slovenia.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this observational study is to analyze how spinal alignment changes when walking compared to standing still in adults aged 50 to 80 years who have sagittal imbalance. The main questions we aim to answer are: 1. Read more about this study

Who is it for?
Ages 50 to 80 yearsHealthy volunteers can take part
Conditions the study is for
Degenerative Spine Disease, Sagittal Balance
What is being tested?
Questionnaires and pain assessment, Standing sagittal whole spine X-ray and Dynamic test
How many people
64 participants
Where
2 sitesSlovenia
Study dates
1 Sep 2023to 1 May 2024
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 50 to 80 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Participants are selected from the outpatient clinic at the specialized orthopedic department of the University Medical Centre Ljubljana.

Who may be able to join

  • Pelvic incidence-lumbar lordosis deficit (PI-LL) greater than 10 or sagittal vertical axis (SVA) greater than 4 centimeters
  • The main symptom is low back pain
  • Age between 50-80 years.

Who cannot join

  • Symptoms of spinal stenosis
  • Previous instrumented spinal surgery
  • Cobb angle greater than 30°
  • Symptoms of hip or knee arthrosis
  • Symptoms of vascular intermittent claudication
  • Cardio-pulmonary disease that lowers the patient's physical capability
  • Neuromuscular disease

Trial locations and contacts

2 sites in 1 country.

Slovenia2 sites
  • Faculty of Sport, University of Ljubljana

    Ljubljana, 1000

  • University Medical Centre Ljubljana

    Ljubljana, 1000

Other trials in Slovenia

About this study

The goal of this observational study is to analyze how spinal alignment changes when walking compared to standing still in adults aged 50 to 80 years who have sagittal imbalance. The main questions we aim to answer are:

  1. Do patients with radiological parameters indicative of sagittal imbalance experience a statistically significant deterioration in sagittal balance during walking compared to a control group?
  2. Do radiographs taken after six minutes of walking provide comparable results to dynamic measurements during the walking test?
  3. Do patients with a greater deterioration in sagittal balance during walking show poorer clinical self-assessment scores?
  4. Is there a significant correlation between parameters obtained using established diagnostic methods and the degree of sagittal balance deterioration during walking?
Read more

Participants will be divided into two groups: patients with radiological indicators of sagittal imbalance and a control group of healthy individuals with back pain of similar age. Participants will:

  1. Complete questionnaires about their back pain and mobility.
  2. Have X-ray images taken of their spine before and after walking for six minutes.
  3. Undergo muscle strength tests and gait analysis using motion capture and electromyography (EMG) to monitor muscle activity while walking.
Being tested
Questionnaires and pain assessment, Standing sagittal whole spine X-ray, Dynamic test, Muscle strength and body composition measurement

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Questionnaires and pain assessmentDiagnostic test

    Participants complete two questionnaires: the Oswestry Disability Index (ODI) and the EQ-5D-5L. They also rate their low back pain using the Visual Analogue Score (VAS) scale and respond to two additional questions about their posture and gait.

  • Standing sagittal whole spine X-rayDiagnostic test

    Participants undergo standard preoperative X-ray imaging of the entire spine to capture the upright posture. This imaging is conducted before and after 6-minute of continuous walking to compare changes in spino-pelvic and sagittal balance parameters.

  • Dynamic testDiagnostic test

    With the dynamic test, we analyze body movements of participants during gait using 49 reflective markers placed on their bodies according to the Qualisys PAF package: Instituti Ortopedici Rizzoli (IOR) and 10 EMG electrodes on specific leg and back muscles. Participants walk for 6 minutes between two cones set 7 meters apart, while a 12-camera Qualisys Motion Capture System tracks marker movements for comprehensive kinematic analysis. Data are recorded at five key moments: standing before and after the test, and during three phases of gait (at the beginning, middle, and end). Participants are barefoot and dressed in underwear for accurate measurement. Static recordings before and after walking involve stepping on a tensiometric force plate to measure the center of gravity. Before the test, participants perform stretching exercises to ensure consistent preparation.

  • Muscle strength and body composition measurementDiagnostic test

    Participants have their body composition analyzed and the maximum isometric strength of their paraspinal and abdominal muscles measured using the Dr. Wolff BackCheck device.

Study groups in NCT06557837
Study groupRoleWhat they receive
Patients with sagittal imbalancePatients that have pelvic incidence-lumbar lordosis deficit (PI-LL) greater than 10 or sagittal vertical axis (SVA) greater than 4 centimetres on X-ray imaging.
Receives: Diagnostic Test: Questionnaires and pain assessment; Diagnostic Test: Standing sagittal whole spine X-ray; Diagnostic Test: Dynamic test; Diagnostic Test: Muscle strength and body composition measurement
Control groupParticipants with normal pelvic incidence-lumbar lordosis deficit (PI-LL) and sagittal vertical axis (SVA) on X-ray imaging.
Receives: Diagnostic Test: Questionnaires and pain assessment; Diagnostic Test: Standing sagittal whole spine X-ray; Diagnostic Test: Dynamic test; Diagnostic Test: Muscle strength and body composition measurement

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in C7-STS During Gait

    The change in the value of the C7 - sagittal trunk shift (C7-STS) will be measured at five points during the dynamic test. The measurement is in millimeters. C7-STS is defined as the distance between vertical line through the marker placed on spinous process C7 and the marker on spinous process L5.

    Measured: Within 2 months from enrollment

  2. Change in AM-STS During Gait

    The change in the value of the Auditory meatus - sagittal trunk shift (AM-STS) will be measured at five points during the dynamic test. The measurement is in millimeters. AM-STS is defined as the distance between vertical line through the middle of the markers placed on each side of the head just above the ear and the middle of the markers placed on both greater trochanters.

    Measured: Within 2 months from enrollment

  3. Change in SVA on X-ray During Walking

    A comparison of the Sagittal Vertical Axis (SVA) in an upright stance, as captured by X-ray imaging, before and after 6 minutes of continuous walking. The measurement is in millimeters. SVA is measured as the horizontal distance between a vertical line from the center of the C7 vertebra and the posterior superior corner of the sacrum on a sagittal X-ray.

    Measured: At enrollment

  4. Change in CAM-HA on X-ray During Walking

    A comparison of the Center of Auditory Meatus to Hip Axis Plumbline (CAM-HA) in an upright stance, as captured by X-ray imaging, before and after 6 minutes of continuous walking. The measurement is in millimeters. CAM-HA is measured as the horizontal distance between a vertical line from the center of auditory meatus and the axis of the femoral heads on a sagittal X-ray.

    Measured: At enrollment

Secondary outcomes (25)
  1. Change in PA During Gait

    The change in the value of the Pelvic angle (PA) will be measured at five points during the dynamic test. The measurement is in degrees. PA is defined as the angle between the markers placed on the posterior superior iliac spines and anterior superior iliac spines and horizontal plane.

    Measured: Within 2 months from enrollment

  2. Change in LLA During Gait

    The change in the value of the Lumbar lordosis angle (LLA) will be measured at five points during the dynamic test. The measurement is in degrees. LLA is defined as the angle between the markers placed on spinous processes of L1, L3 and L5.

    Measured: Within 2 months from enrollment

  3. Change in TKA During Gait

    The change in the value of the Thoracic kyphosis angle (TKA) will be measured at five points during the dynamic test. The measurement is in degrees. TKA is defined as the angle between the markers placed on spinous process of C7, spinous process of vertebra between the inferior edge of the scapulae and spinous process L1.

    Measured: Within 2 months from enrollment

  4. Change in STA During Gait

    The change in the value of the Sagittal trunk angle (STA) will be measured at five points during the dynamic test. The measurement is in degrees. STA is defined as the angle between the line connecting the middle of the markers placed on each side of the head just above the ear and the middle of the markers placed on both greater trochanters and vertical line.

    Measured: Within 2 months from enrollment

  5. Change in GTA During Gait

    The change in the value of the Global tilt angle (GTA) will be measured at five points during the dynamic test. The measurement is in degrees. GTA is defined as the angle between the markers placed on spinous process C7, L5 and the middle of the markers placed on both greater trochanters.

    Measured: Within 2 months from enrollment

  6. Change in PT on X-ray During Walking

    A comparison of the Pelvic Tilt (PT) in an upright stance, as captured by X-ray imaging, before and after 6 minutes of continuous walking. The measurement is in degrees. PT is defined as the angle between the vertical and the line connecting the center of the sacral endplate to the axis of the femoral heads on a sagittal X-ray.

    Measured: At enrollment

  7. Change in SS on X-ray During Walking

    A comparison of the Sacral Slope (SS) in an upright stance, as captured by X-ray imaging, before and after 6 minutes of continuous walking. The measurement is in degrees. SS is defined as the angle between a line tangent to the upper S1 endplate and horizontal line.

    Measured: At enrollment

  8. Change in LL on X-ray During Walking

    A comparison of the Lumbar Lordosis (LL) in an upright stance, as captured by X-ray imaging, before and after 6 minutes of continuous walking. The measurement is in degrees. LL is defined as the angle between the superior endplate of the first lumbar vertebra and the superior endplate of the first sacral vertebra.

    Measured: At enrollment

  9. Change in TK on X-ray During Walking

    A comparison of the Thoracic Kyphosis (TK) in an upright stance, as captured by X-ray imaging, before and after 6 minutes of continuous walking. The measurement is in degrees. TK is defined as the angle between the superior endplate of the first thoracic vertebra and the inferior endplate of the twelfth thoracic vertebra.

    Measured: At enrollment

  10. Change in PI-LL on X-ray During Walking

    A comparison of the Pelvic Incidence-Lumbar Lordosis Deficit (PI-LL) in an upright stance, as captured by X-ray imaging, before and after 6 minutes of continuous walking. The measurement is in degrees. PI-LL is defined as the difference between the pelvic incidence (PI) and lumbar lordosis (LL) angles.

    Measured: At enrollment

  11. Change in Angle of the hip on X-ray During Walking

    A comparison of the Angle of the Hip in an upright stance, as captured by X-ray imaging, before and after 6 minutes of continuous walking. The measurement is in degrees. Angle of the Hip is defined as the angle between the line connecting the center of the sacral endplate to the axis of the femoral heads and the line drawn from the axis of the femoral heads along the femoral shaft.

    Measured: At enrollment

  12. Change in OD-HA on X-ray During Walking

    A comparison of the Odontoid Hip Axis Angle (OD-HA) in an upright stance, as captured by X-ray imaging, before and after 6 minutes of continuous walking. The measurement is in degrees. OD-HA is defined as the angle between the vertical and the highest point of the odontoid process (dens) connecting to the center of the acetabulum (bi-coxo-femoral axis).

    Measured: At enrollment

  13. Change in GT on X-ray During Walking

    A comparison of the Global Tilt (GT) in an upright stance, as captured by X-ray imaging, before and after 6 minutes of continuous walking. The measurement is in degrees. GT is defined as the angle between a vertical line and a line drawn from the center of the C7 vertebra to the center of the sacral endplate.

    Measured: At enrollment

  14. Oswestry Disability Index (ODI) Questionnaire

    The Oswestry Disability Index (ODI) is a questionnaire used to assess a patient's level of disability related to lower back pain. It is scored on a scale from 0 to 100%, where higher scores indicate worse outcomes.

    Measured: At enrollment

  15. EQ-5D-5L Questionnaire

    The European Quality of Life in 5 Dimensions and 5 Levels (EQ-5D-5L) is a standardized questionnaire used to measure a patient's health-related quality of life across five dimensions and five levels. It is scored on a scale from -0,573 to 1, where higher scores indicate better outcomes.

    Measured: At enrollment

  16. Visual Analogue Score (VAS) for low back pain

    The Visual Analogue Score (VAS) for low back pain is a tool used to measure patient's pain intensity in the lower back. It is scored on a scale from 0 to 10, where higher scores indicate worse outcomes.

    Measured: At enrollment

  17. Additional Question: Is it hard for you to stand upright?

    The additional question "Is it hard for you to stand upright?" is assessed with a "yes" or "no" response, where "yes" indicates a worse outcome, signifying difficulty in maintaining an upright posture.

    Measured: At enrollment

  18. Additional Question: Does your body lean forward during gait?

    The additional question "Does your body lean forward during gait?" is assessed with a "yes" or "no" response, where "yes" indicates a worse outcome, signifying a forward lean during walking.

    Measured: At enrollment

  19. Maximum Isometric Strength of the Paraspinal Muscles

    The maximum isometric strength of the paraspinal muscles is measured using the Dr. Wolff BackCheck device. The muscle strength is recorded in Newton-meters (Nm) and then adjusted according to the participant's body weight for accurate comparison.

    Measured: Within 2 months from enrollment

  20. Maximum Isometric Strength of the Abdominal Muscles

    The maximum isometric strength of the abdominal muscles is measured using the Dr. Wolff BackCheck device. The muscle strength is recorded in Newton-meters (Nm) and then adjusted according to the participant's body weight for accurate comparison.

    Measured: Within 2 months from enrollment

  21. Skeletal Muscle Mass

    Patients have their skeletal muscle mass measured using the InBody 720 device, with the results recorded in kilograms (kg).

    Measured: Within 2 months from enrollment

  22. Body Fat Mass

    Patients have their body fat mass measured using the InBody 720 device, with the results recorded in kilograms (kg).

    Measured: Within 2 months from enrollment

  23. Body Fat Percentage

    Patients have their body fat percentage measured using the InBody 720 device, with the results recorded as a percentage (%).

    Measured: Within 2 months from enrollment

  24. Total Body Water

    Patients have their total body water measured using the InBody 720 device, with the results recorded in liters (L).

    Measured: Within 2 months from enrollment

  25. Extracellular Water / Total Body Water

    Patients have their extracellular water versus total body water proportion measured using the InBody 720 device, with the results recorded as a ratio.

    Measured: Within 2 months from enrollment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Aug 2024
  2. Study start1 Sep 2023
  3. Primary completion1 May 2024
  4. Study completion1 May 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
64 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06557837
Sponsor's protocol ID
0120-22/2023/47
Other IDs
AOS-Startup-23-028
Status last verified
Aug 2024
First submitted
7 Aug 2024
Last updated
16 Aug 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Degenerative Spine Disease and Sagittal Balance, run by University Medical Centre Ljubljana at 2 sites in Slovenia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Slovenia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in C7-STS During Gait (time frame: Within 2 months from enrollment). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Aug 2024.

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