Does the fists-on-clavicles position represent a functional standing position?
METHODS
Prospective analysis of sagittal vertical axis (SVA) on lateral spine radiographs using 3 different arm positions.


OBJECTIVE
To examine whether fists-on-clavicles position represents a functional standing position.


BACKGROUND
Radiographic visualization of spinal and pelvic sagittal morphology is difficult during relaxed standing because of interference from the arms; however, standing with arms forward-flexed results in a negative shift in SVA. The fists-on-clavicles position was proposed to provide a more functional sagittal profile and adequate visualization of the spine. No existing study compares the SVA between the fists-on-clavicle and relaxed standing positions.


METHODS
The SVA was measured on standing lateral radiographs of 14 healthy subjects using 3 different arm positions: relaxed with arms-at-side, arms forward-flexed to 45 degrees (shoulder flexion [SF]), and fists-on-clavicles. RESULTS.: The mean SVA with relaxed standing was 1.4 +/- 1.9 cm. SF produced a significant SVA negative shift (-3.7 +/- 2.3 cm, P < 0.001). The fists-on-clavicle position resulted in a reduced but significant SVA negative shift (-2.3 +/- 2.1 cm, P < 0.001) compared with relaxed standing.


CONCLUSIONS
Although the fists-on-clavicles position was better than SF in reducing the SVA negative shift, a significant negative shift did occur in the fists-on-clavicle position compared with relaxed standing.
Aota
Yoichi
Y
Department of Orthopaedic Surgery, Yokohama City University, Kanazawa-ku, Yokohama, Japan. yaota@yokohama-cu.ac.jp
Saito
Tomoyuki
T
Uesugi
Masaaki
M
Ishida
Koh
K
Shinoda
Keisuke
K
Mizuma
Koichi
K
D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D005240:Feasibility Studies; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D015588:Observer Variation; D010388:Pelvis / Q000000981:diagnostic imaging; D011187:Posture / Q000502:physiology*; D011446:Prospective Studies; D011859:Radiography / Q000379:methods*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging*; D055815:Young Adult