Heritability of motion in healthy people : A systematic review and multi-level meta-analysis

Introduction: Genetics can play an important role in determining whether we are predisposed to various clinical conditions. People can be more susceptible to health conditions such as cardiovascular disease, metabolic syndrome, as well as musculoskeletal disorders and injury due to their genetic predisposition (Goodlin et al., 2015, Loughlin et al., 2004, Videman et al., 2009). Among the musculoskeletal conditions that can be influenced by genetics, low back pain (LBP) and osteoarthritis are the most common examples. For instance, monozygotic (MZ) twins, who share 100% of their genes, are five times more likely than dizygotic (DZ) twins, who share 50% of their genes, to experience LBP if their other twin had previously experienced LBP (Junqueira et al., 2014). The heritability is defined as the amount of phenotypic variation in a trait or disease that is attributable to genetic differences. The heritability estimate for LBP ranged between 21% and 67% (Ferreira, Beckenkamp, Maher, Hopper, & Ferreira, 2013), whilst the heritability of hip osteoarthritis was estimated at 58% (MacGregor, Antoniades, Matson, Andrew, & Spector, 2000), demonstrating a moderate genetic influence on these conditions.

Musculoskeletal conditions may also be influenced by the way in which we move during everyday activities, as well as postural alterations (Sadler et al., 2017, Shull et al., 2013) with such movement patterns and posture potentially being heritable. A recent systematic review that included 12 prospective cohort studies demonstrated that restricted lumbar lordosis and reduced lateral bending range of motion were found to increase the likelihood of developing LBP by 37% and 144%, respectively (Sadler et al., 2017). In addition, another systematic review found that coordination exercises have contributed to improving the quality of life in the elderly population (Dunsky, 2019). Muscle coordination is also commonly integrated in prevention program for sports-related injuries, as good muscle coordination may prevent musculoskeletal injuries (McBain et al., 2012). Thus, it is likely that part of the mechanisms and development of particular musculoskeletal conditions can be explained by alterations in range of motion, coordination and posture.
Musculoskeletal conditions are commonly characterised by variations in movement patterns (Crosbie, de Faria Negrao Filho, Nascimento, & Ferreira, 2013, Leporace et al., 2013), but also appear to be influenced by genetics (Ferreira et al., 2013). Presently, it is unclear to what extent genetics influence the contributing structural and motion related factors, such as range of motion, coordination of motion, as well as postural alignment. For example, predisposition to back pain or osteoarthritis may be related to alterations in range of motion and posture (Sadler et al., 2017), but may also be associated with the structural characteristics of articular cartilage or vertebral discs (Williams et al., 2013).

The aim of this systematic review is to investigate the level of heritability associated with posture, range of motion and coordination characteristics of the musculoskeletal system. The findings of this review may provide insight into the level with which genetics, and conversely environmental factors, contribute to posture and range of motion, as well as coordination of motion in the musculoskeletal system. This, in turn, will have implications for further research into prevention and management of musculoskeletal conditions, including an understanding of the level of potentially modifiable risk factors.

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