Science In Brief

Chiropractic Literature Review


The Study: The association between whole body sagittal balance and risk of falls among elderly patients seeking treatment for back pain.


The Facts:

  1. The authors wished to study the relationship between whole body sagittal alignment of elderly patients who had sought treatment for back pain and their chance of falling.
  2. The patients were over 70 years of age and they received "whole-body radiography."
  3. These radiographs were both anteroposterior and lateral whole-body radiographs. (For the real nerds among us these were images stitched together and "The detector to tube distance was 508cm...")
  4. Through the use of a diary, or if they had problems keeping a diary, monthly telephone calls were made, falls of the subjects were determined for a 12 month follow up period.
  5. Falls that were because of "syncope, dizziness or extrinsic causes such as a traffic accident were not" included in the falls statistics.
  6. The study followed 144 subjects of which 120 were female and 20 were male.
  7. During the one year followup, 21.5% of patients reported at least one fall.
  8. "In conclusion, whole body sagittal imbalance, measured by the horizontal distance between the C7 plumb line and the centre of the ankle, was significantly associated with risk of falls among elderly patients with back pain."

Take Home:

An imbalance of the C7 plumb line relative to the center of the ankle in the sagittal plane was associated with a risk of falling.

Reviewer's Comments:

Once again we see a relationship between whole body spinal alignment and a problem and we thank our medical colleagues for writing this interesting article.

Reviewer: Roger Coleman DC

Editor’s Comments: Falls are the leading cause of death in the elderly. Costs as far back as year 2000 were exceeding $31 billion annually and are certain to increase as the population continues to age. Proactive chiropractors who are willing to take time to rehabilitate full spine postures and institute balance workshops are doing a great service for their elderly patients. This area offers chiropractors a wide open opportunity to better serve their patients. As usual, the medical research community is far out in front of ours on this issue, but there is no profession better equipped to rehab these patients toward better global spinal posture than ours.

Editor: Mark R. Payne DC


Reference: Kim J, Hwang JY, Oh JK, Park MS, Kim SW, Chang H, Kim TH. The association between whole body sagittal balance and risk of falls among elderly patients seeking treatment for back pain. Bone Joint Res 2017 May;6(5):337-344. doi: 10.1302/2046-3758.65.BJR-2016-0271.R2.

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