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Differences in spinal postures and mobility among adults with Prader-Willi syndrome, essential obesity, and normal-weight individuals
(2023)
Bayartai, Munkh-Erdene
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Luomajoki, Hannu
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Tringali, Gabriella
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De Micheli, Roberta
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Grugni, Graziano
INTRODUCTION: Spinal kinematics/motion are reported to be altered in adolescents and adults with essential obesity, while no information is available in patients with Prader-Willi syndrome so far. The aim of this study was to examine cross-sectionally the characteristics of spinal postures and mobility in 34 patients with PWS, in 35 age- and sex-matched adults with essential obesity, and in 37 normal-weight individuals. METHODS: Spinal posture and mobility were assessed using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Differences in spinal posture and mobility between the three groups were determined using a two-way analysis of variance. RESULTS: Adults with Prader-Willi syndrome had greater thoracic kyphosis [difference between groups (Δ) = 9.60, 95% CI 3.30 to 15.60, p = 0.001], less lumbar lordosis (Δ = -6.50, 95% CI -12.70 to -0.30, p = 0.03) as well as smaller lumbar and hip mobility than those with normal weight. DISCUSSION: Although the characteristics of the spine in patients with Prader-Will syndrome appear to be similar to that found in subjects with essential obesity, Prader-Willi syndrome was found to influence lumbar movements more than thoracic mobility. These results provide relevant information about the characteristics of the spine in adults with Prader-Willi syndrome to be taken into careful consideration in the management of spinal conditions. These findings also highlight the importance of considering the musculoskeletal assessment of spinal postures and approaches targeting spinal and hip flexibility in adults with Prader-Willi syndrome.
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Identifying Key Predictors of Sarcopenic Obesity in Italian Severely Obese Older Adults: Deep Learning Approach
(2025-04)
Cândido, Leticia Martins
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Bae, Jun-Hyun
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Kim, Dae Young
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Bayartai, Munkh-Erdene
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Abbruzzese, Laura
Background/Objectives: Sarcopenic obesity (SO), the coexistence of sarcopenia and obesity, poses serious health risks, such as increased mortality. Despite its clinical significance, key predictors of SO remain unclear, especially in severe obesity. This study aimed to identify independent predictors of SO in Italian older adults with obesity using a deep learning neural network. Methods: A cross-sectional study was conducted with hospitalized older adults diagnosed with severe obesity. SO was defined according to the 2022 ESPEN/EASO Statement Criteria, based on skeletal muscle function assessed by the five-repetition sit-to-stand test (5-SST) and body composition parameters evaluated using Dual X-ray Absorptiometry. A total of 42 independent variables were analyzed. Data normalization was performed using MinMaxScaler, and an optimal neural network architecture was selected via grid search with stratified 5-fold cross-validation. Model performance was assessed using accuracy, precision, recall, F1-score, AUC-ROC, and AUPRC metrics. Results: The correlation analysis revealed strong negative associations between SO and handgrip strength (HGS) (r = -0.785) and appendicular lean mass (ALM) (r = -0.745), as well as moderate correlations with 5-SST (r = 0.603), 30-second chair stand test (r = -0.474), 6-minute walking test (6m-WT) (r = 0.289), and waist circumference (WC) (r = 0.127). The deep learning model achieved an average classification accuracy of 72%, with a precision of 83% and an AUC of 0.9333. Conclusions: The main key predictors of SO were HGS, ALM, 5-SST, 30s-SST, 6m-WT, and WC in the early detection of this condition. The findings highlight deep learning's potential to improve SO diagnosis, risk assessment, clinical decision-making, and prevention in severely obese older adults.
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Differences in spinal posture and mobility between adults with obesity and normal weight individuals
(2023-08)
Bayartai, Munkh-Erdene
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Luomajoki, Hannu
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Tringali, Gabriella
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De Micheli, Roberta
;
Abbruzzese, Laura
The aim of this study was to cross-sectionally investigate the relationships between obesity and spinal posture as well as mobility by comparing the spinal parameters between adults with obesity and normal-weight individuals. The spinal parameters were measured in 71 adults with obesity and 142 normal-weight individuals using a radiation-free back scan, the Idiag M360. Differences in spinal posture and movements between the two groups were determined using a two-way analysis of variance. Adults with obesity had greater thoracic kyphosis [difference between groups (Δ) = 6.1°, 95% CI 3.3°-8.9°, p < 0.0001] and thoracic lateral flexion (Δ = 14.5°, 95% CI 5.1°-23.8°, p = 0.002), as well as smaller thoracic flexion (Δ = 3.5°, 95% CI 0.2°-6.9°, p = 0.03), thoracic extension (Δ = 4.1°, 95% CI 1.1°-7.1°, p = 0.008), lumbar flexion (Δ = 10.4°, 95% CI 7.7°-13.5°, p < 0.0001), lumbar extension (Δ = 4.8°, 95% CI 2.2°-7.4°, p = 0.0003) and lumbar lateral flexion (Δ = 12.8°, 95% CI 9.8°-15.7°, p = < 0.0001) compared to those with normal weight. These findings provide relevant information about the characteristics of the spine in adults with obesity to be taken into careful consideration in the prescription of adapted physical activities within integrated multidisciplinary pathways of metabolic rehabilitation.
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Association of Physical Performance with Mental and Physical Health-Related Quality of Life and Low Back Pain-Related Disabilities among Older Adults with Severe Obesity
(2024-09)
Bayartai, Munkh-Erdene
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Tringali, Gabriella
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De Micheli, Roberta
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Danielewicz, Ana Lúcia
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Sartorio, Alessandro
Background: Low back pain is one of the most prevalent musculoskeletal problems and continues to be the leading cause of disabilities worldwide. The aim of this study was to cross-sectionally investigate the association of physical performance with mental and physical health-related quality of life and low back pain-related disabilities among older adults with severe obesity. Methods: A total of 96 hospitalized older adults with severe obesity (45 males, 51 females, age: 69.7 ± 5.4 years; BMI: 43.7 ± 5.7 kg/m2) were recruited into the study. Physical performance, health-related quality of life, and low back pain-related disability were measured through physical performance tests, the 12-item short-form survey (SF-12), and the Oswestry disability index, respectively. Results: LBP-related disabilities, as well as physical health-related quality of life, were associated with all the physiological parameters measured by physical performance tests, including muscular strength, aerobic capacity, balance, and lower body flexibility (p < 0.05). In contrast, mental health-related quality of life was associated with fewer physiological parameters, such as primarily muscular strength (p < 0.05). Conclusions: These findings could provide important insights for developing rehabilitation strategies designed to improve LBP-related disabilities, as well as the physical and mental health-related quality of life, in older adults with severe obesity.
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Spinal Posture and Movement in Female Adolescents with Anorexia Nervosa
(2026-04)
Bayartai, Munkh-Erdene
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Tringali, Gabriella
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De Micheli, Roberta
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Grimoldi, Ilaria
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Abbruzzese, Laura
Background: Profound musculoskeletal alterations encompassing bones and soft tissues are common in people with anorexia nervosa (AN). This study aims to examine spinal posture and mobility in adolescents with AN, and to compare these outcomes with those obtained from normal-weight female controls. Methods: Spinal posture and movements were measured in 37 adolescents with AN and 31 normal-weight controls using the Idiag M360 scan tool, and between-group differences were analyzed using analysis of covariance. Results: Spinal postures and the lumbar-to-hip ratio were not different between subgroups. By contrast, AN had reduced thoracic (-21.8 degrees, p < 0.0001) and lumbar (-18.2 degrees, p < 0.0001) mobility in the frontal plane, as well as decreased hip flexion (-14 degrees, p = 0.001) and extension (-18.6 degrees, p < 0.0001) compared to the CG. Conclusions: Thoracic and lumbar spinal mobility, mainly in the frontal plane, and also hip mobility in the sagittal plane, are decreased in AN. These findings provide clinically relevant insights into spinal characteristics in adolescents with AN.

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