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Rubega M, Passarotto E, Paramento M, Formaggio E, Masiero S. EEG Microstate as a Marker of Adolescent Idiopathic Scoliosis. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2024; 5:339-344. [PMID: 38899012 PMCID: PMC11186641 DOI: 10.1109/ojemb.2024.3399469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/22/2024] [Accepted: 05/07/2024] [Indexed: 06/21/2024] Open
Abstract
The pathophysiology of Adolescent Idiopathic Scoliosis (AIS) is not yet fully understood, but multifactorial hypotheses have been proposed that include defective central nervous system (CNS) control of posture, biomechanics, and body schema alterations. To deepen CNS control of posture in AIS, electroencephalographic (EEG) activity during a simple balance task in adolescents with and without AIS was parsed into EEG microstates. Microstates are quasi-stable spatial distributions of the electric potential of the brain that last tens of milliseconds. The spatial distribution of the EEG characterised by the orientation from left-frontal to right-posterior remains stable for a greater amount of time in AIS compared to controls. This spatial distribution of EEG, commonly named in the literature as class B, has been found to be correlated with the visual resting state network. Both vision and proprioception networks provide critical information in mapping the extrapersonal environment. This neurophysiological marker probably unveils an alteration in the postural control mechanism in AIS, suggesting a higher information processing load due to the increased postural demands caused by scoliosis.
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Affiliation(s)
- M. Rubega
- Department of NeuroscienceUniversity of Padova, Section of Rehabilitation35128PadovaItaly
| | - E. Passarotto
- Department of NeuroscienceUniversity of Padova, Section of Rehabilitation35128PadovaItaly
| | - M. Paramento
- Department of NeuroscienceUniversity of Padova, Section of Rehabilitation35128PadovaItaly
- Department of Information EngineeringUniversity of Padova35131PadovaItaly
| | - E. Formaggio
- Department of NeuroscienceUniversity of Padova, Section of Rehabilitation35128PadovaItaly
| | - S. Masiero
- Department of NeuroscienceUniversity of Padova, Section of Rehabilitation35128PadovaItaly
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McCallum-Loudeac J, Moody E, Williams J, Johnstone G, Sircombe KJ, Clarkson AN, Wilson MJ. Deletion of a conserved genomic region associated with adolescent idiopathic scoliosis leads to vertebral rotation in mice. Hum Mol Genet 2024; 33:787-801. [PMID: 38280229 PMCID: PMC11031364 DOI: 10.1093/hmg/ddae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/15/2023] [Accepted: 01/12/2024] [Indexed: 01/29/2024] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis, in which spinal curvature develops in adolescence, and 90% of patients are female. Scoliosis is a debilitating disease that often requires bracing or surgery in severe cases. AIS affects 2%-5.2% of the population; however, the biological origin of the disease remains poorly understood. In this study, we aimed to determine the function of a highly conserved genomic region previously linked to AIS using a mouse model generated by CRISPR-CAS9 gene editing to knockout this area of the genome to understand better its contribution to AIS, which we named AIS_CRMΔ. We also investigated the upstream factors that regulate the activity of this enhancer in vivo, whether the spatial expression of the LBX1 protein would change with the loss of AIS-CRM function, and whether any phenotype would arise after deletion of this region. We found a significant increase in mRNA expression in the developing neural tube at E10.5, and E12.5, for not only Lbx1 but also other neighboring genes. Adult knockout mice showed vertebral rotation and proprioceptive deficits, also observed in human AIS patients. In conclusion, our study sheds light on the elusive biological origins of AIS, by targeting and investigating a highly conserved genomic region linked to AIS in humans. These findings provide valuable insights into the function of the investigated region and contribute to our understanding of the underlying causes of this debilitating disease.
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Affiliation(s)
- Jeremy McCallum-Loudeac
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Edward Moody
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Jack Williams
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Georgia Johnstone
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Kathleen J Sircombe
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Andrew N Clarkson
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Megan J Wilson
- Department of Anatomy, School of Biomedical Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
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Fan Y, To MKT, Yeung EHK, Kuang GM, Liang R, Cheung JPY. Electromyographic Discrepancy in Paravertebral Muscle Activity Predicts Early Curve Progression of Untreated Adolescent Idiopathic Scoliosis. Asian Spine J 2023; 17:922-932. [PMID: 37690987 PMCID: PMC10622813 DOI: 10.31616/asj.2023.0199] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 09/12/2023] Open
Abstract
STUDY DESIGN This study adopted a prospective cohort study design. PURPOSE This study aimed to examine electromyogram (EMG) discrepancy in paravertebral muscle activity and scoliosis progression, determine how vertebral morphology and EMG discrepancy evolve during scoliosis progression, and identify differences in EMG activity between individuals with and without adolescent idiopathic scoliosis (AIS). OVERVIEW OF LITERATURE Higher EMG activity is observed in the convex side of scoliotic curves, but not in populations without scoliosis, suggesting that higher EMG activity is a causative factor for curve progression. METHODS In this study, 267 matched pairs of AIS and controls were recruited. The participants underwent EMG measurements at their first presentation and did not receive any treatment for 6 months at which point they underwent EMG and radiographs. Early curve progression was defined as >5° in Cobb angle at 6 months. The root mean square of the EMG (rms-EMG) signal was recorded with the participants in sitting and back extension. The rms-EMG ratio at the upper end vertebrae, apical vertebrae (AV), and lower end vertebrae (LEV) of the major curve was calculated. RESULTS The rms-EMG ratio in the scoliosis cohort was high compared with that in the controls (sitting: 1.2±0.3 vs. 1.0±0.1, p<0.01; back extension: 1.1±0.2 vs. 1.0±0.1, p<0.01). An AV rms-EMG ratio in back extension, with a cutoff threshold of ≥1.5 in the major thoracic curve and ≥1.3 in the major lumbar curve, was a risk factor for early curve progression after 6 months without treatment (odds ratio, 4.1; 95% confidence interval, 2.8-5.9; p<0.01). Increases in side deviation (SD) (distance between the AV and the central sacral line) were related to a higher rms-EMG ratio in LEV of the major thoracic curve (baseline: rs=0.2, p=0.03; 6 months: rs=0.3, p<0.01). CONCLUSIONS An EMG discrepancy was detected in the scoliosis cohort, which was related to increases in SD in the major thoracic curve. The AV rms-EMG ratio in back extension was correlated with curve progression after 6 months of no treatment.
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Affiliation(s)
- Yunli Fan
- Department of Physiotherapy, The University of Hong Kong–Shenzhen Hospital, Shenzhen,
China
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong SAR,
China
| | - Michael Kai-Tsun To
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong SAR,
China
- Department of Orthopaedics, The University of Hong Kong–Shenzhen Hospital, Shenzhen,
China
| | - Eric Hiu Kwong Yeung
- Department of Physiotherapy, The University of Hong Kong–Shenzhen Hospital, Shenzhen,
China
| | - Guan-Ming Kuang
- Department of Orthopaedics, The University of Hong Kong–Shenzhen Hospital, Shenzhen,
China
| | - Ruixin Liang
- Laboratory for Artificial Intelligence in Design, Hong Kong SAR,
China
| | - Jason Pui Yin Cheung
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong SAR,
China
- Department of Orthopaedics, The University of Hong Kong–Shenzhen Hospital, Shenzhen,
China
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Wilczyński J, Habik Tatarowska N, Mierzwa Molenda M. Deficits of Sensory Integration and Balance as Well as Scoliotic Changes in Young Schoolgirls. SENSORS (BASEL, SWITZERLAND) 2023; 23:1172. [PMID: 36772216 PMCID: PMC9919114 DOI: 10.3390/s23031172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/06/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to assess the relationship between sensory integration and balance deficits as well as scoliotic changes in young schoolgirls. The study comprised 54 girls aged 11 years with scoliotic changes. The Clinical Test of Sensory Integration and Balance of the Biodex Balance System platform were used to analyze the deficits in sensory integration and balance. Scoliotic changes were assessed using the Diers Formetric III 4D optoelectronic method. In the present study, there was a significant relationship between sensory integration and balance deficits as well as spine curvature angle (°) (p = 0.01), vertebral surface rotation (°) (p = 0.03), pelvic tilt (°) (p = 0.02), and lateral deviation (mm) (p = 0.04). The integration of the sensory systems has a positive effect on the structure of the intended and controlled movement as well as body posture and the development of the spine. In the treatment of scoliotic changes, one should also consider exercises that improve sensory integration as well as position and balance reactions.
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Kastrinis A, Koumantakis G, Tsekoura M, Nomikou E, Katsoulaki M, Theodosopoulos E, Strimpakos N, Dimitriadis Z. The Effect of Schroth Method on Postural Control and Balance in Patients with Adolescent Idiopathic Scoliosis: A Literature Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:469-476. [PMID: 37581820 DOI: 10.1007/978-3-031-31986-0_45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
The objective of this review was to offer new information on the effectiveness of Schroth method on postural control and balance in patients with adolescent idiopathic scoliosis (AIS). PubMed, EBSCO, and Google Scholar databases were searched from June 2022 to August 2022 for prospective controlled trials and randomized controlled trials related to effects of Schroth exercises on postural control and balance in patients with AIS. The key words AIS, Schroth, balance, postural control, and proprioception were used. Studies written in English language, in the last decade were included. Seven studies were included in the review, with a total of 244 study subjects. Three studies investigated the effectiveness of Schroth exercises on balance and postural control. Two studies included investigated the effectiveness of Schroth method in combination with additional treatments of bracing and hippotherapy, while two other studies investigated effectiveness of Schroth when compared with Pilates and proprioceptive neuromuscular facilitation (PNF). The treatment duration varied from a week to 6 months. From the findings of this review, it is supported that Schroth method can have positive effects on balance and postural control in AIS patients. Further investigation is necessary.
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Affiliation(s)
- A Kastrinis
- Physiotherapy Department, Health Assessment and Quality of Life Research Laboratory, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - G Koumantakis
- Department of Physiotherapy, Faculty of Health and Care Sciences, University of West Attica, Athens, Greece
| | - M Tsekoura
- Physiotherapy Department, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece
| | - E Nomikou
- The House, Rehabilitation Center for Children, Athens, Greece
| | - M Katsoulaki
- PhysioDrasis, Physiotherapy Clinic, Athens, Greece
| | | | - N Strimpakos
- Physiotherapy Department, Health Assessment and Quality of Life Research Laboratory, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - Z Dimitriadis
- Physiotherapy Department, Health Assessment and Quality of Life Research Laboratory, School of Health Sciences, University of Thessaly, Lamia, Greece
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6
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Shen X, Yang Z, Zhang P, Xu Y, Wang J. Effects of balance training combined with Schroth therapy on adolescents with mild idiopathic scoliosis: A six-week randomized controlled trial. J Back Musculoskelet Rehabil 2023; 36:1365-1373. [PMID: 37458026 DOI: 10.3233/bmr-220383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) has a great negative impact on the physical and mental health of patients; thus, a range of effective, timely interventions are urgently needed. Currently, there is a lack of evidence to illustrate the effect of balance training in patients with AIS, and the traditional AIS therapy often ignores the recovery in balance function of patients with AIS. OBJECTIVE To investigate the effect of balance training combined with Schroth therapy among adolescent with mild idiopathic scoliosis. METHODS 59 adolescents (aged 10 to 18, 35.59% male) with idiopathic scoliosis were selected and divided into an intervention group (n= 30) and a control group (n= 29). Participants in both groups received routine rehabilitation treatment based on Schroth therapy, and balance training was added in the intervention group. The duration of treatment for both groups was 6 weeks. The Trunk Rotation Angle (ATR), Cobb angle, Scoliosis Research Society 22 (SRS-22) scale and balance function of the two groups were evaluated at baseline and after the intervention. RESULTS No significant difference of outcomes were observed between groups at baseline (P> 0.05). After 6 weeks of intervention, the ATR, Cobb angle, SRS-22 and balance function of the two groups improved significantly compared with those before treatment (P< 0.05), and the intervention group had a significant improvement than the control group (P< 0.05). CONCLUSION Balance training combined with Schroth therapy for adolescents with mild idiopathic scoliosis can significantly improve ATR, Cobb angle and quality of life, as well as overall balance function.
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Affiliation(s)
- Xiangyu Shen
- School of Physical Education and Sports, Soochow University, Suzhou, Jiangsu, China
| | - Zhen Yang
- Department of Movement Science, KU Leuven, Leuven, Belgium
| | - Peng Zhang
- Department of Rehabilitation Medicine, Suzhou Science and Technology Town Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu, China
| | - Yingye Xu
- School of Physical Education and Sports, Soochow University, Suzhou, Jiangsu, China
| | - Jielong Wang
- School of Physical Education and Sports, Soochow University, Suzhou, Jiangsu, China
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7
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Pogorzała A, Kądzielawska E, Kubaszewski Ł, Dąbrowski M. Factors Influencing Treatment Outcome and Proprioception after Electrocoagulation of the Femoral Insertion of the Anterior Cruciate Ligament. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13569. [PMID: 36294149 PMCID: PMC9603566 DOI: 10.3390/ijerph192013569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Studies have established that exercises shaping the sense of deep sensation are an important element of medical rehabilitation of patients after vaporization of the femoral insertion of the anterior cruciate ligament and affect the restoration of correct movement patterns, thus reducing the risk of injuries. The aim of this study was to determine the factors influencing the treatment outcome and deep-feeling function after applying a specific rehabilitation scheme 12 weeks after anterior cruciate ligament electrocoagulation surgery. (2) Methods: The study group consisted of 41 patients after partial rupture of the anterior cruciate ligament, who underwent electrocoagulation of the femoral cruciate ligament attachment and microfracture of the femoral attachment area. All patients were operated on by the same surgeon and then rehabilitated according to the same medical rehabilitation protocol. The anthropometric and clinical data were collected through an anterior drawer test, Lachman test, assessment of the range of movements in the knee joint, muscle strength test, Unterberger test and Lysholm questionnaire. The assessment was performed before the surgery, and then on days 7-10, after 6 and 12 weeks of rehabilitation treatment. (3) Results: Statistical improvement of the parameters was demonstrated by strength of the quadriceps and hamstrings muscle, the Unterberger test, and the Lysholm scale after surgery. A negative correlation was found between the Unterberger test and Lysholm scale at the end of the research period and it differed depending on the gender and the dominant limb. The Lysholm scale and muscle strength were independent of sex, dominant extremity and associated damage of the meniscus and cartilage. The Lysholm scale 6 weeks after surgery negatively correlated with BMI. (4) Conclusions: Stability of the knee joint and improvement of proprioception were demonstrated 12 weeks after treatment with an ACL electrocoagulation and rehabilitation regimen. The factors contributing to a better treatment outcome were greater muscle strength, less thigh asymmetry, better sense of depth, younger age and lower body weight.
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Affiliation(s)
- Adam Pogorzała
- Institute of Applied Mechanics, Poznan University of Technology, 60-965 Poznan, Poland
| | - Ewa Kądzielawska
- Institute of Applied Mechanics, Poznan University of Technology, 60-965 Poznan, Poland
| | - Łukasz Kubaszewski
- Adult Spine Orthopaedics Department, Poznan University of Medical Sciences, 61-545 Poznan, Poland
| | - Mikołaj Dąbrowski
- Adult Spine Orthopaedics Department, Poznan University of Medical Sciences, 61-545 Poznan, Poland
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Lau KKL, Law KKP, Kwan KYH, Cheung JPY, Cheung KMC, Wong AYL. Timely Revisit of Proprioceptive Deficits in Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis. Global Spine J 2022; 12:1852-1861. [PMID: 34911378 PMCID: PMC9609540 DOI: 10.1177/21925682211066824] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Systematic review and meta-analysis. OBJECTIVES The present review aimed to summarize the evidence regarding differences in proprioception between children with and without adolescent idiopathic scoliosis (AIS). METHODS Seven electronic databases were searched from their inception to April 10, 2021. Articles were included if they involved: (1) AIS patients aged between 10 and 18 years, (2) measurements of proprioceptive abilities, and (3) comparisons with non-AIS controls. Animal studies, case reports, commentaries, conference proceedings, research protocols, and reviews were excluded. Two reviewers independently conducted literature screening, data extraction, risks of bias assessments, and quality of evidence evaluations. Relevant information was pooled for meta-analyses. RESULTS From 432 identified citations, 11 case-control studies comprising 1121 participants were included. The meta-analyses showed that AIS participants displayed proprioceptive deficits as compared to non-AIS controls. Moderate evidence supported that AIS participants showed significantly larger repositioning errors than healthy controls (pooled mean difference = 1.27 degrees, P < .01). Low evidence substantiated that AIS participants had significantly greater motion detection threshold (pooled mean difference = 1.60 degrees, P < .01) and abnormal somatosensory evoked potentials (pooled mean difference = .36 milliseconds, P = .01) than non-AIS counterparts. CONCLUSIONS Consistent findings revealed that proprioceptive deficits occurred in AIS patients. Further investigations on the causal relationship between AIS and proprioception, and the identification of the subgroup of AIS patients with proprioceptive deficit are needed.
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Affiliation(s)
- Kenney K. L. Lau
- Department of Orthopaedics and
Traumatology, The University of Hong
Kong, Hong Kong
| | - Karlen K. P. Law
- Department of Orthopaedics and
Traumatology, The University of Hong
Kong, Hong Kong
| | - Kenny Y. H. Kwan
- Department of Orthopaedics and
Traumatology, The University of Hong
Kong, Hong Kong
| | - Jason P. Y. Cheung
- Department of Orthopaedics and
Traumatology, The University of Hong
Kong, Hong Kong
| | - Kenneth M. C. Cheung
- Department of Orthopaedics and
Traumatology, The University of Hong
Kong, Hong Kong,Kenneth M. C. Cheung, Department of
Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital,
Pokfulam Road, Hong Kong.
| | - Arnold Y. L. Wong
- Department of Rehabilitation
Sciences, The Hong Kong Polytechnic
University, Hong Kong,Arnold Y. L. Wong, Department of
Rehabilitation Sciences, The Hong Kong Polytechnic University, Yuk Choi Road,
Hong Kong.
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Akyurek E, Zengin Alpozgen A, Akgul T. The preliminary results of physiotherapy scoliosis-specific exercises on spine joint position sense in adolescent idiopathic scoliosis: A randomized controlled trial. Prosthet Orthot Int 2022; 46:510-517. [PMID: 36215059 DOI: 10.1097/pxr.0000000000000136] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 03/14/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND It has been observed that there are difficulties in maintaining spinal harmony in the absence of proprioceptive information, which has an important role in achieving postural control in scoliosis. One of the tests used to evaluate proprioceptive mechanisms is joint position reproduction. OBJECTIVES The main aim of our study was to investigate the effect of physiotherapy scoliosis-specific exercise (PSSE) on spine joint reposition (JR) sense. The second aim was to determine the effects of PSSE on the angle of trunk rotation (ATR), posture, and deformity perception in adolescent idiopathic scoliosis. METHODS Twenty-nine patients with adolescent idiopathic scoliosis (mean age 13.79 ± 1.82 years) were randomly allocated to two groups. "Schroth" exercises were applied to the PSSE group for 8 weeks (16 sessions). The control group was placed on the waiting list. Patients' JR error (dual inclinometer), ATR (scoliometer), posture parameters (PostureScreen Mobile, Posterior Trunk Asymmetry Index, and Anterior Trunk Asymmetry Index), and deformity perception (Walter Reed Visual Assessment Scale [WRVAS]) were assessed at the first session and at the end of 8 weeks. RESULTS The initial demographic characteristics, Cobb (thoracal: 19.41 ± 7.03 degrees; lumbar: 20.76 ± 7.24 degrees) and ATR (thoracal: 5.86 ± 3.98 degrees; lumbar: 5.66 ± 3.33 degrees) and clinical test parameters of the groups (JR, posture parameters, and WRVAS) were similar (P > .05). According to the findings, thoracal and lumbar JR error values (P < .05), ATR (P ≤ .001), posture parameters (P ≤ .001), and WRVAS (P = .048) were significantly improved in the PSSE group. Besides, when the groups were compared, a significant difference was found in favor of PSSE except for the deformity perception (P < .05). CONCLUSIONS Schroth exercises have a positive contribution for improving JR sense of the spine, vertebral rotation, and posture.
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Affiliation(s)
- Elcin Akyurek
- Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Institute of Graduate Studies, Istanbul, Turkey
| | - Ayse Zengin Alpozgen
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Turgut Akgul
- Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul University, Istanbul, Turkey
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Marin L, Lovecchio N, Pedrotti L, Manzoni F, Febbi M, Albanese I, Patanè P, Carnevale Pellino V, Vandoni M. Acute Effects of Self-Correction on Spine Deviation and Balance in Adolescent Girls with Idiopathic Scoliosis. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22051883. [PMID: 35271030 PMCID: PMC8914676 DOI: 10.3390/s22051883] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 05/07/2023]
Abstract
Background: Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of spine and trunk with a higher incidence in girls. AIS alters and reduces postural control and balance. Self-correction movement (SCM) is a well-known non-invasive approach to ameliorate spine curve in AIS subjects. We aimed to evaluate the effects of SCM on the spine and on the balance of adolescents with AIS with a new non-invasive instrumentation. Methods: A total of 38 girls with AIS were recruited. To evaluate the acute effects of SCM and the oscillations of center of pressure (COP), we used LiDAR technology combined with a stabilometric platform to evaluate both changes in spinal curves and balance at the same time. Two tests were carried out simultaneously using the two instruments: before the execution of SCM, in the spontaneously assumed position of each subject (SP) and after the execution of SCM, during the achieved position (SC). Sway area, COP medio-lateral and antero-posterior directions, eccentricity of the ellipse and vertebral lateral deviation were recorded. The two conditions were compared with a Wilcoxon signed-rank test. Results: In general, all measures showed lower values in SC condition (p < 0.05), except the variation along the Y axis. Conclusions: Thanks to objective measured data, the therapists observed real-time changes during the performance of SCM, appreciating its efficacy on curve correction.
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Affiliation(s)
- Luca Marin
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (M.V.)
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy; (M.F.); (I.A.); (P.P.)
- Department of Rehabilitation, Città di Pavia Hospital, 27100 Pavia, Italy
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta
- Correspondence:
| | - Nicola Lovecchio
- Department of Human and Social Science, University of Bergamo, 24127 Bergamo, Italy;
| | - Luisella Pedrotti
- Orthopedics Unit, Department of Clinical Surgical Sciences, Diagnostic and Pediatrics, University of Pavia, 27100 Pavia, Italy;
- Department of Pediatric Orthopedics, Città di Pavia Hospital, 27100 Pavia, Italy
| | - Federica Manzoni
- Epidemiological Observatory Unit, Health Protection Agency, 27100 Pavia, Italy;
| | - Massimiliano Febbi
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy; (M.F.); (I.A.); (P.P.)
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta
| | - Ilaria Albanese
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy; (M.F.); (I.A.); (P.P.)
- Department of Industrial Engineering, University of Tor Vergata, 00133 Rome, Italy
| | - Pamela Patanè
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy; (M.F.); (I.A.); (P.P.)
- Department of Industrial Engineering, University of Tor Vergata, 00133 Rome, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (M.V.)
- Department of Industrial Engineering, University of Tor Vergata, 00133 Rome, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (V.C.P.); (M.V.)
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11
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Severijns P, Overbergh T, Ackermans T, Beaucage-Gauvreau E, Brumagne S, Desloovere K, Scheys L, Moke L. The Function Assessment Scale for Spinal Deformity: Validity and Reliability of a New Clinical Scale. Spine (Phila Pa 1976) 2022; 47:E64-E72. [PMID: 34669676 DOI: 10.1097/brs.0000000000004266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE The aim of this study was to develop and validate the Function Assessment scale for Spinal Deformity (FASD). SUMMARY OF BACKGROUND DATA Spinal malalignment impacts daily functioning. Standard evaluation of adult spinal deformity (ASD) is based on static radiography and patient-reported scores, which fail to assess functional impairments. A clinical scale, quantifying function and balance of patients with ASD, could increase our insights on the impact of ASD on functioning. METHODS To develop the FASD, 70 ASD patients and 20 controls were measured to identify the most discriminating items of the Balance Evaluation Systems Test and Trunk Control Measurement Scale. Discussions between experts on the clinical relevance of selected items led to further item reduction. The FASD's discriminative ability was established between 43 patients and 19 controls, as well as between three deformity subgroups. For its responsiveness to treatment, 10 patients were reevaluated 6 months postoperatively. Concurrent validity was assessed through correlation analysis with radiographic parameters (pelvic tilt; sagittal vertical axis [SVA]; pelvic incidence minus lumbar lordosis [PI-LL]; coronal vertical axis) and patient-reported scores [Oswestry Disability Index]; Scoliosis Research Society outcome questionnaire; Falls Efficacy Scale-International). Test-retest and interrater reliability were tested on two groups of ten patients using intraclass correlation coefficients (ICC). RESULTS Patients with ASD, mainly with sagittal malalignment, scored worse compared to controls on FASD (P < 0.001) and its subscales. No significant improvement was observed 6 months postoperatively (P = 0.758). FASD correlated significantly to all patient-reported scores and to SVA and PI-LL. Reliability between sessions (ICC = 0.97) and raters (ICC = 0.93) was excellent. Subscales also showed good to excellent reliability, except FASD 1 on "spinal mobility and balance" between sessions (ICC = 0.71). CONCLUSION FASD proved to be a valid and reliable clinical scale for evaluation of functional impairments in ASD. Objective information on function and balance might ultimately guide physiotherapeutic treatment toward improved functioning.Level of Evidence: 2.
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Affiliation(s)
- Pieter Severijns
- Institute for Orthopedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Clinical Motion Analysis Laboratory (CMAL), University Hospitals Leuven, Leuven, Belgium
| | - Thomas Overbergh
- Institute for Orthopedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Thijs Ackermans
- Institute for Orthopedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Erica Beaucage-Gauvreau
- Institute for Orthopedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Simon Brumagne
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Clinical Motion Analysis Laboratory (CMAL), University Hospitals Leuven, Leuven, Belgium
| | - Lennart Scheys
- Institute for Orthopedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Division of Orthopedics, University Hospitals Leuven, Leuven, Belgium
| | - Lieven Moke
- Institute for Orthopedic Research and Training (IORT), Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Division of Orthopedics, University Hospitals Leuven, Leuven, Belgium
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12
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Catanzariti JF, Darchicourt D, Chevutschi A, Le Berre M, Tanche L, Guyot MA. Is self-image, in reference to the gravitational vertical, altered in adolescent idiopathic scoliosis? A multicenter, single-blind, case-control study. J Pediatr Rehabil Med 2022; 15:477-486. [PMID: 36031914 DOI: 10.3233/prm-200689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Adolescent idiopathic scoliosis (AIS) is associated with perturbation of orthostatic postural control. In humans, orthostatic postural control is organized around the gravitational vertical (GV). Perception of the GV involves a bottom-up process (central integration of multisensorial information) and a top-down process that uses cognitive mechanisms relying on body image. This study hypothesized that AIS would be associated with an erroneous central representation of verticality. The objective was to demonstrate an altered top-down process of sense of verticality in AIS. METHODS This multicenter, single-blind, case-control study evaluated 63 adolescent girls with AIS divided into two groups (major AIS (n = 31) and minor AIS (n = 32)) and 30 matched non-scoliotic adolescents. Participants scored their perception of trunk appearance in an upright position using a pictographic scale. The outcome measure was the difference between perception score and real trunk deformity. RESULTS Participants with major AIS presented with misperception of their trunk appearance in an upright position when compared with those with minor AIS or controls. CONCLUSION Adolescents with major AIS underestimate their trunk deformity in an upright position. This suggests an altered representation of body image, affecting top-down control of sense of verticality.
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Affiliation(s)
- Jean-François Catanzariti
- Pediatric Rehabilitation Center Marc Sautelet, Villeneuve-d'Ascq, France.,Physical Therapy School, Loos, France.,La Maison de la Scoliose, Villeneuve-d'Ascq, France
| | | | - Alain Chevutschi
- Physical Therapy School, Loos, France.,COMUE Lille Nord de France, University Nord de France, Villeneuve d'Ascq, France
| | - Morgane Le Berre
- Department of Physical Medicine and Rehabilitation, Hospital Swynghedauw - Lille University Hospital, Lille, France
| | - Laetitia Tanche
- Pediatric Rehabilitation Center Marc Sautelet, Villeneuve-d'Ascq, France.,La Maison de la Scoliose, Villeneuve-d'Ascq, France
| | - Marc-Alexandre Guyot
- COMUE Lille Nord de France, University Nord de France, Villeneuve d'Ascq, France.,Department of Physical Medicine and Rehabilitation, Hospital Saint Philibert, Lille Catholic University Hospital, Lomme, France
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13
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Xu L, Feng Z, Dai Z, Lee WYW, Wu Z, Liu Z, Sun X, Tang N, Cheng JCY, Qiu Y, Zhu Z. A Functional SNP in the Promoter of LBX1 Is Associated With the Development of Adolescent Idiopathic Scoliosis Through Involvement in the Myogenesis of Paraspinal Muscles. Front Cell Dev Biol 2021; 9:777890. [PMID: 34917617 PMCID: PMC8670502 DOI: 10.3389/fcell.2021.777890] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/28/2021] [Indexed: 01/22/2023] Open
Abstract
Previous studies have shown that LBX1 is associated with adolescent idiopathic scoliosis (AIS) in multiple populations. For the first time, rs1322330 located in the putative promoter region of LBX1 was found significantly associated with AIS in the Chinese population [p = 6.08 × 10–14, odds ratio (OR) = 1.42, 95% confidence interval of 1.03–1.55]. Moreover, the luciferase assay and electrophoretic mobility shift assay supported that the allele A of rs1322330 could down-regulate the expression of LBX1 in the paraspinal muscles of AIS. In addition, silencing LBX1 in the myosatellite cells resulted in significantly inhibited cell viability and myotube formation, which supported an essential role of LBX1 in muscle development of AIS. To summarize, rs1322330 may be a novel functional SNP regulating the expression of LBX1, which was involved in the etiology of AIS possibly via regulation of myogenesis in the paraspinal muscles.
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Affiliation(s)
- Leilei Xu
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Joint Scoliosis Research Center of The Chinese University of Hong Kong and Nanjing University, Nanjing/Hong Kong, China
| | - Zhenhua Feng
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Joint Scoliosis Research Center of The Chinese University of Hong Kong and Nanjing University, Nanjing/Hong Kong, China
| | - Zhicheng Dai
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Joint Scoliosis Research Center of The Chinese University of Hong Kong and Nanjing University, Nanjing/Hong Kong, China
| | - Wayne Y. W. Lee
- Joint Scoliosis Research Center of The Chinese University of Hong Kong and Nanjing University, Nanjing/Hong Kong, China
- SH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhichong Wu
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Joint Scoliosis Research Center of The Chinese University of Hong Kong and Nanjing University, Nanjing/Hong Kong, China
| | - Zhen Liu
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Joint Scoliosis Research Center of The Chinese University of Hong Kong and Nanjing University, Nanjing/Hong Kong, China
| | - Xu Sun
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Joint Scoliosis Research Center of The Chinese University of Hong Kong and Nanjing University, Nanjing/Hong Kong, China
| | - Nelson Tang
- Joint Scoliosis Research Center of The Chinese University of Hong Kong and Nanjing University, Nanjing/Hong Kong, China
- SH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
- Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong, China
| | - Jack Chun-Yiu Cheng
- Joint Scoliosis Research Center of The Chinese University of Hong Kong and Nanjing University, Nanjing/Hong Kong, China
- SH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Yong Qiu
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Joint Scoliosis Research Center of The Chinese University of Hong Kong and Nanjing University, Nanjing/Hong Kong, China
| | - Zezhang Zhu
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- Joint Scoliosis Research Center of The Chinese University of Hong Kong and Nanjing University, Nanjing/Hong Kong, China
- *Correspondence: Zezhang Zhu,
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14
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Szczygieł E, Gigoń A, Chudyba IC, Joanna G, Edward G. Evaluation attempt of own body sensing amongst persons with and without scoliosis. J Back Musculoskelet Rehabil 2021; 34:425-430. [PMID: 33459696 DOI: 10.3233/bmr-191761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a common structural spine deformity affecting 2%-4% of adolescents. Due to the unknown cause of idiopathic scoliosis, its therapy is a long-term and often unsatisfactory process. In the literature, it is often suggested that problems related to the feeling of one's own body are caused by AIS. OBJECTIVE The aim of this study was to assess the feeling of one's own body among children with and without scoliosis on the example of feeling the head position, pelvis shape and balance. METHOD The research included 62 children: 30 with scoliosis and 25 without diagnosed scoliosis with an age range between 11 to 19 years. The minimum scoliosis value was 7∘ and the maximum was 53∘. The average value was 25∘. During the study, three functional tests were used: Cervical Joint Position Error Test (CJPET), Clinical Test of Sensory Integration on Balance (CTSIB) and Body proportion demonstration test (BPDT). RESULTS The results of the tests showed statistically significant differences (CJPET p= 3.54*10-14, CTSIB p= 0.0376, BPDT p= 0.0127). However, none of the studies showed a correlation between the results of people with scoliosis and the value of their Cobb angles.
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Affiliation(s)
- Elżbieta Szczygieł
- Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech Physical Academy Education, Krakow, Poland
| | - Agata Gigoń
- Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech Physical Academy Education, Krakow, Poland
| | | | - Golec Joanna
- Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech Physical Academy Education, Krakow, Poland
| | - Golec Edward
- Orthopedic Rehabilitation Institute, Clinical Rehabilitation Division, Motor Rehabilitation Department, Bronislaw Czech Physical Academy Education, Krakow, Poland
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15
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Displacement of Centre of Pressure during Rehabilitation Exercise in Adolescent Idiopathic Scoliosis Patients. J Clin Med 2021; 10:jcm10132837. [PMID: 34198971 PMCID: PMC8269167 DOI: 10.3390/jcm10132837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 01/03/2023] Open
Abstract
Background. Adolescent idiopathic scoliosis (AIS) is included into the category of pathologies that could affect postural control. Rarely AIS shows symptoms but often compromises the normal positioning of the head, trunk and, more generally, of the limbs in the space. We used a stabilometric platform to evaluate the motor control outcomes during a self-elongation in girls with AIS. Methods. In 10 girls with AIS, we evaluated the center of pressure (COP) modifications on a baropodometric platform in a standing position and after a self-elongation correction. Results. All the outcomes (except the eccentricity) showed an increasement during the self-elongation exercise even if the significant differences were not found. Conclusion. SE correction contributes to ameliorate the COP symmetry with a better repercussion on the balance management. This highlights the importance of repetitions during all activities of daily life.
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16
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Steinberg N, Tenenbaum S, Zeev A, Pantanowitz M, Waddington G, Dar G, Siev-Ner I. Generalized joint hypermobility, scoliosis, patellofemoral pain, and physical abilities in young dancers. BMC Musculoskelet Disord 2021; 22:161. [PMID: 33563260 PMCID: PMC7874653 DOI: 10.1186/s12891-021-04023-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 01/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background Many young girls with generalized joint hypermobility (GJH) choose to participate in dance because their bodies are suited for this activity. Scoliosis tends to occur often in thin girls, who also are more likely to choose dance. Both anomalies (GJH and scoliosis) may be related to reduced abilities such as diminished strength and insufficient postural balance, with increased risk for musculoskeletal conditions. The main objectives of the present study were to determine the prevalence of dancers with GJH, the prevalence of dancers with scoliosis, and the prevalence of dancers with these two anomalies; and, to determine differences in physical abilities and the presence of patellofemoral pain (PFP) between young female dancers with and without such anomalies. Methods One hundred thirty-two female dancers, aged 12–14 years, were assessed for anthropometric parameters, GJH, scoliosis, knee muscle strength, postural balance, proprioception ability, and PFP. Results GJH was identified in 54 dancers (40.9%) and scoliosis in 38 dancers (28.8%). Significant differences were found in the proportion of dancers with no anomalies (74 dancers, 56.1%) and dancers with both anomalies (34 dancers, 25.8%) (p < .001). Dancers with both anomalies had reduced dynamic postural balance in the anterior direction (p = .023), reduced proprioception ability (p < .001), and weaker knee extensors (p = .036) and flexors (p = .040) compared with dancers with no anomalies. Among dancers with both anomalies, 73.5% suffered bilateral PFP, 17.6% suffered unilateral PFP, and 8.8% had no PFP (p < .001). Conclusions A high prevalence of young girls participating in dance classes had GJH, as the increased joint flexibility probably provides them with some esthetic advantages. The high prevalence of scoliosis found in these young dancers might be attributed to their relatively low body mass, their delayed maturation, and the selection process of dancers. Dancers with both GJH and scoliosis had decreased muscle strength, reduced postural balance, reduced proprioception, with higher risk of PFP. The main clinical implications are the need to reduce the risk of PFP among dancers by developing appropriate strength and stabilizing exercises combined with proprioceptive and postural balance training, to improve the correct alignment of the hyperextended and hypermobile joints, and to improve their supporting muscle strength.
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Affiliation(s)
- Nili Steinberg
- Anatomy Laboratory, The Academic College at Wingate, Wingate Institute, Netanya, Israel.
| | - Shay Tenenbaum
- Department of Orthopedic Surgery, Chaim Sheba Medical Center Tel-Hashomer, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviva Zeev
- Anatomy Laboratory, The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Michal Pantanowitz
- Anatomy Laboratory, The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | | | - Gali Dar
- Department of Physical Therapy, Faculty of Social Welfare & Health Studies, University of Haifa, Haifa, Israel
| | - Itzhak Siev-Ner
- Orthopedic Rehabilitation Department, Chaim Sheba Medical Center, Tel-Hashomer, Israel
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17
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Luo M, Zhang Y, Huang S, Song Y. The Susceptibility and Potential Functions of the LBX1 Gene in Adolescent Idiopathic Scoliosis. Front Genet 2021; 11:614984. [PMID: 33537061 PMCID: PMC7848184 DOI: 10.3389/fgene.2020.614984] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/21/2020] [Indexed: 02/05/2023] Open
Abstract
Genome-wide association studies have identified many susceptibility genes for adolescent idiopathic scoliosis (AIS). However, most of the results are hard to be replicated in multi-ethnic populations. LBX1 is the most promising candidate gene in the etiology of AIS. We aimed to appraise the literature for the association of LBX1 gene polymorphisms with susceptibility and curve progression in AIS. We also reviewed the function of the LBX1 gene in muscle progenitor cell migration and neuronal determination processes. Three susceptibility loci (rs11190870, rs625039, and rs11598564) near the LBX1 gene, as well as another susceptibility locus (rs678741), related to LBX1 regulation, have been successfully verified to have robust associations with AIS in multi-ethnic populations. The LBX1 gene plays an essential role in regulating the migration and proliferation of muscle precursor cells, and it is known to play a role in neuronal determination processes, especially for the fate of somatosensory relay neurons. The LBX1 gene is the most promising candidate gene in AIS susceptibility due to its position and possible functions in muscle progenitor cell migration and neuronal determination processes. The causality between susceptibility loci related to the LBX1 gene and the pathogenesis of AIS deserves to be explored with further integrated genome-wide and epigenome-wide association studies.
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Affiliation(s)
- Ming Luo
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Yuxiao Zhang
- West China Hospital and West China School of Medicine, Sichuan University, Chengdu, China
| | - Shishu Huang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Yueming Song
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
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18
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Wang L, Wang C, Youssef ASA, Xu J, Huang X, Xia N. Physiotherapeutic scoliosis-specific exercises performed immediately after spinal manipulative therapy for the treatment of mild adolescent idiopathic scoliosis: study protocol for a randomized controlled pilot trial. Trials 2021; 22:58. [PMID: 33446270 PMCID: PMC7807706 DOI: 10.1186/s13063-020-05000-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 12/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Spinal manipulative therapy is commonly used in the treatment of adolescent idiopathic scoliosis. Some therapists also rely on physiotherapeutic scoliosis-specific exercise (PSSE). Combining these two modalities seems reasonable, but the effectiveness of this combination has never been rigorously tested. Here, a protocol for a pilot study is proposed to determine the feasibility of conducting a larger randomized trial. The pilot study was designed to test the hypothesis that spinal manipulative therapy followed by PSSE is more effective than PSSE alone in improving the Cobb angle, sensorimotor integration, the angle of trunk rotation (ATR), body symmetry, and quality of life. METHODS The protocol describes a randomized controlled pilot trial with 40 subjects divided into study and control groups. Both groups will receive 8 weeks of PSSE, but the study group will also receive spinal manipulative therapy during the first 2 weeks before PSSE. The primary outcome will be an estimate of the feasibility of conducting a full-scale experiment. The influencing factors will be the time to complete enrollment, the recruitment rate, subject retention, and adherence to the treatment allocations. The secondary outcomes that will be used to assess the efficacy of treatment will include the Cobb angle, somatosensory evoked potentials, ATR, three-dimensional postural parameters, and scores on the 22-item Scoliosis Research Society outcomes questionnaire. The Cobb angle will be measured at baseline and at the end of 8 weeks of training. The somatosensory evoked potentials will be measured at baseline and at the end of 2 weeks of training. The ATR, three-dimensional postural parameters, and scores on the 22-item Scoliosis Research Society outcomes questionnaire will be measured at baseline and at 2 weeks, 4 weeks, and 8 weeks of treatment. DISCUSSION This study will inform the design of a future full-scale trial. The outcomes will provide preliminary data about the efficacy of the combination of spinal manipulative therapy and exercise in treating scoliosis. TRIAL REGISTRATION Prospectively registered at Chinese clinical trial registry, ChiCTR1900027037 . Registered on 29 October 2019. http://www.chictr.org.cn/edit.aspx?pid=44954&htm=4.
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Affiliation(s)
- Li Wang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chun Wang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Rehabilitation Medicine, Shantou Central Hospital, Shantou, China
| | - Ahmed S A Youssef
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Basic Science Department, Faculty of Physical Therapy, Beni-Suef University, Beni-Suef, Egypt
| | - Jiang Xu
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaolin Huang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Nan Xia
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Burton DA, Karkenny AJ, Schulz JF, Hanstein R, Gomez JA. Sagittal spinopelvic changes after posterior spinal fusion in adolescent idiopathic scoliosis. J Child Orthop 2020; 14:544-553. [PMID: 33343750 PMCID: PMC7740676 DOI: 10.1302/1863-2548.14.200155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE This article examines if longer posterior spinal fusions with instrumentation (PSFI) into the lumbar spine (L3/4) alter spinopelvic parameters compared with selective fusions to T12/L1/L2 in adolescent idiopathic scoliosis (AIS) patients. METHODS We analysed radiographs of 84 AIS patients, 58 (69%) females and 26 (31%) males, who underwent PSFI at an mean age of 15 years ± 2.5 years, range 10 years to 21 years, between 1st January 2007 and 31st December 2014. Radiographic parameters were measured pre- and post-operatively at most recent follow-up (range 2 years to 8.2 years): pelvic incidence (PI), lumbar lordosis (LL, L1-S1 and L4-S1), sagittal vertical alignment (SVA), scoliosis angle and proximal junctional kyphosis (PJK). PI-LL was calculated. Data was analysed using t-tests or Wilcoxon rank-sum tests. RESULTS In total, 32 patients underwent a selective fusion with lowest instrumented vertebra (LIV) T12-L2, and 52 patients underwent a fusion with LIV L3-L4. In both groups, scoliosis angle was significantly corrected at follow-up (p < 0.005).Pre-operatively, both groups had similar LL (L1-S1) and PI-LL. Post-operatively, LL increased in the L3-4 fusion group (p < 0.005) but did not change in the selective fusion group (p = 0.116). This change in LL in the L3-4 fusion group affected the post-operative PI-LL (T12-L2 fusion -4.9° versus L3-4 fusion -13.6°, p = 0.002). No differences were seen in PI, SVA or LL L4-S1 between groups. Radiographic PJK occurred in seven of the L3-4 patients with and without PJK (noPJK -8.8° versus PJK -25.8°, p = 0.026). CONCLUSIONS In patients who underwent a fusion ending at L3 or L4, LL was increased. This altered the PI-LL relationship, and appeared to increase the risk of PJK. LEVEL OF EVIDENCE III.
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Affiliation(s)
| | - Alexa J. Karkenny
- Division of Pediatric Orthopaedics, Children’s Hospital at Montefiore Medical Center, Medical Arts Pavilion, Bronx, New York, USA
| | - Jacob F. Schulz
- Division of Pediatric Orthopaedics, Children’s Hospital at Montefiore Medical Center, Medical Arts Pavilion, Bronx, New York, USA
| | - Regina Hanstein
- Division of Pediatric Orthopaedics, Children’s Hospital at Montefiore Medical Center, Medical Arts Pavilion, Bronx, New York, USA
| | - Jaime A. Gomez
- Division of Pediatric Orthopaedics, Children’s Hospital at Montefiore Medical Center, Medical Arts Pavilion, Bronx, New York, USA,Correspondence should be sent to Jaime A. Gomez, Medical Arts Pavilion, 3400 Bainbridge Avenue, Bronx, NY 10467, USA. E-mail:
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20
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St-Georges M, Teles AR, Rabau O, Saran N, Ouellet JA, Ferland CE. Adolescent idiopathic scoliosis: evaluating perioperative back pain through a simultaneous morphological and biomechanical approach. BMC Musculoskelet Disord 2020; 21:466. [PMID: 32677928 PMCID: PMC7367237 DOI: 10.1186/s12891-020-03462-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/24/2020] [Indexed: 11/18/2022] Open
Abstract
Background Adolescent idiopathic scoliosis (AIS) has been associated with diminished postural stability and a greater prevalence of back pain. Currently, the literature is lacking information on the effect of spinal fusion on both postural stability and its association with back pain. Our objectives were to evaluate the postsurgical effect of spinal morphological changes on static standing balance and assess the influence of these alterations on reported pain throughout the perioperative period. Methods Twenty consecutive AIS patients schedule to undergo spinal fusion surgery were recruited and followed prospectively at the Shriners Hospitals for Children-Canada. Data was collected at the preoperative, 6 weeks and 6 months postoperative visits. Spinal morphology data was collected through 3D reconstructed simultaneous standing biplanar radiographs using the SterEOS software. Postural balance was assessed through Moticon© sensor insoles and analyzed through their software. The data was simultaneously collected as part of the Global Biomechanical and morphological Assessment. Pain was evaluated through self-reported questionnaires. Results Morphological curve parameters were significantly reduced after surgery. Balance parameters did not change significantly throughout the perioperative period with the exception of the Center of Pressure of the left foot medial/lateral transient shift (P = 0.017) at 6 weeks. Of note, preoperative balance parameters were associated with the degree of right thoracic Cobb angles (P = 0.029 R = 0.528). Pain scores significantly improved 6 weeks and 6 months after the surgery. Pain intensity diminished in the thoracic and lumbar spine but worsen in the neck region at the 6 weeks and 6 months postoperative time points (P = 0.044). Greater residual Cobb angle difference between Mid thoracic and Thoracolumbar/Lumbar curves was associated with greater pain severity at 6 weeks postop (P < 0.005). In addition, greater residual thoracic deformity was associated with significant pain severity 6 months after surgery (P < 0.05). Conclusions Improved spinal morphology of postsurgical AIS patients has no significant impact on their static standing balance. Suggesting that other factors apart from the spinal morphology may contribute to AIS patients’ balance during stance. Although balance did not influence pain severity, spinal morphology and its correction appear to have influenced the intensity and location of back pain.
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Affiliation(s)
- Maxime St-Georges
- McGill Scoliosis and Spine Research Group, Montreal, Canada.,Shriners Hospitals for Children-Canada, 1003, boul. Décarie, Montreal, Quebec, H4A 0A9, Canada.,Department of Experimental Surgery, McGill University, Montreal, Canada
| | - Alisson R Teles
- McGill Scoliosis and Spine Research Group, Montreal, Canada.,Shriners Hospitals for Children-Canada, 1003, boul. Décarie, Montreal, Quebec, H4A 0A9, Canada.,Integrated Program in Neurosciences, McGill University, Montreal, Canada
| | - Oded Rabau
- McGill Scoliosis and Spine Research Group, Montreal, Canada.,Shriners Hospitals for Children-Canada, 1003, boul. Décarie, Montreal, Quebec, H4A 0A9, Canada.,Department of Surgery, Division of Orthopedics, McGill University, Montreal, Canada
| | - Neil Saran
- McGill Scoliosis and Spine Research Group, Montreal, Canada.,Shriners Hospitals for Children-Canada, 1003, boul. Décarie, Montreal, Quebec, H4A 0A9, Canada.,Department of Surgery, Division of Orthopedics, McGill University, Montreal, Canada
| | - Jean A Ouellet
- McGill Scoliosis and Spine Research Group, Montreal, Canada.,Shriners Hospitals for Children-Canada, 1003, boul. Décarie, Montreal, Quebec, H4A 0A9, Canada.,Department of Experimental Surgery, McGill University, Montreal, Canada.,Department of Surgery, Division of Orthopedics, McGill University, Montreal, Canada
| | - Catherine E Ferland
- McGill Scoliosis and Spine Research Group, Montreal, Canada. .,Shriners Hospitals for Children-Canada, 1003, boul. Décarie, Montreal, Quebec, H4A 0A9, Canada. .,Department of Experimental Surgery, McGill University, Montreal, Canada. .,Integrated Program in Neurosciences, McGill University, Montreal, Canada. .,Department of Anesthesia, McGill University, Montreal, Canada.
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21
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Godzik J, Frames CW, Smith Hussain V, Olson MC, Kakarla UK, Uribe JS, Lockhart TE, Turner JD. Postural Stability and Dynamic Balance in Adult Spinal Deformity: Prospective Pilot Study. World Neurosurg 2020; 141:e783-e791. [PMID: 32535057 DOI: 10.1016/j.wneu.2020.06.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We sought to evaluate dynamic balance and postural stability in patients with adult spinal deformity (ASD) compared with published age-matched normative data. METHODS Eleven patients with ASD were prospectively enrolled. Postural stability was tested using static and dynamic posturography; patients stood on a movable platform with an integrated force plate and performed standardized sensory organization testing (SOT), evaluating the influence of sensory processing on postural stability under 6 conditions, and motor control testing, assessing reflexive postural reactions to an external perturbation. Patient performance was compared with that of published age-matched controls. Quality of life metrics included scores on the Scoliosis Research Society-22 questionnaire, SF-36, and Morse Fall Scale. Correlations between postural stability and radiographic measurements were performed. RESULTS ASD patients demonstrated significantly lower SOT scores (P ≤ 0.03) in 5 of 6 conditions tested and greater latency of limb movement during backward translation (P = 0.04) compared with controls. Lower SOT scores were associated with a history of falls. ASD patients who self-reported falling in the previous 6 months, when compared with nonfallers, demonstrated significantly lower SOT scores (P = 0.04) and significantly lower Scoliosis Research Society-22 self-image subscores (P = 0.003). Thoracic kyphosis and mediolateral sway (predictor of falls) were positively correlated in the eyes-open and eyes-closed conditions (P ≤ 0.04). CONCLUSIONS ASD patients demonstrated impaired postural stability, diminished sensory integration, and delayed response to external perturbations compared with normal control data. Postural stability and quality of life metrics correlated with self-reported falls. These findings suggest that ASD patients have abnormal postural stability and may be at elevated risk of falls.
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Affiliation(s)
- Jakub Godzik
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Christopher W Frames
- School of Biological and Health Systems Engineering, Biological Design Program, Arizona State University, Tempe, Arizona
| | - Victoria Smith Hussain
- School of Biological and Health Systems Engineering, Biological Design Program, Arizona State University, Tempe, Arizona
| | - Markey C Olson
- School of Biological and Health Systems Engineering, Biological Design Program, Arizona State University, Tempe, Arizona
| | - U Kumar Kakarla
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Juan S Uribe
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Thurmon E Lockhart
- School of Biological and Health Systems Engineering, Biological Design Program, Arizona State University, Tempe, Arizona
| | - Jay D Turner
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
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22
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Abstract
STUDY DESIGN A case-control study. OBJECTIVE This study aimed to investigate the potential role of PIEZO2 gene in the development of AIS. SUMMARY OF BACKGROUND DATA Mutations of PIEZO2 gene have been reported to be associated with progressive scoliosis and impaired proprioception. Previous studies showed that patients with AIS may have impaired proprioception. However, there is lack of knowledge concerning the mechanism underlying the proprioception of AIS patients and the role of PIEZO2 gene in the etiology of AIS. METHODS Proprioception tests were performed in both AIS patients and age-matched healthy controls. Based on the falling risk scores, AIS patients were divided into impaired proprioception group and unimpaired proprioception group. Paraspinal muscle was collected from 34 AIS patients during surgery. The tissue expression of PIEZO2 was compared between the impaired group and the unimpaired group. In addition, the average number of muscle fibers in the muscle spindle was compared between the two groups. RESULTS Proprioception test showed that patients had significantly higher falling index (41.7 ± 16.5 vs. 11.3 ± 8.3, P = 0.004). In addition, the expression of PIEZO2 gene was remarkably decreased in the impaired group (0.51 ± 0.24 vs. 1.00 ± 0.33, P = 0.04). The average number of muscle fibers in the muscle spindle was significantly decreased in AIS patients of the impaired group than those of the unimpaired group (2.2 ± 1.3 vs. 3.5 ± 2.1, P = 0.04). PIEZO2 expression level was remarkably correlated with the average number of muscle fibers in the muscle spindle (r = 0.352, P = 0.04). CONCLUSION Proprioception is remarkably impaired in patients with AIS. Abnormal expression of PIEZO2 may play a role in AIS via altered proprioception and number of muscle fibers in the muscle spindles. Further investigation is warranted to illustrate the mechanism regulating PIEZO2 expression in AIS. LEVEL OF EVIDENCE 4.
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23
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Laratta JL, Glassman SD, Atanda AA, Dimar JR, Gum JL, Crawford CH, Bratcher K, Carreon LY. The Berg balance scale for assessing dynamic stability and balance in the adult spinal deformity (ASD) population. JOURNAL OF SPINE SURGERY 2019; 5:451-456. [PMID: 32042995 DOI: 10.21037/jss.2019.09.15] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Adult spinal deformity (ASD) is a prevalent condition in individuals over the age of 65; leading to impaired standing balance and abnormal gait patterns. This functional impairment may be due to the fixed sagittal or coronal malalignment; associated spinal stenosis or deconditioning. The Berg balance scale (BBS) was developed to measure balance by assessing the performance of functional tasks. The purpose of this study is to determine if BBS is a useful metric for evaluating functional status in ASD patients. Methods ASD patients who required fusion from the thoracic spine to the pelvis from 2014 to 2016 were enrolled and asked to complete the BBS prior to and six months after surgery. BBS were obtained by a certified physical therapist. Standard demographic; radiographic and surgical data were collected. The Oswestry disability index (ODI), EuroQOL-5D and numeric rating scales (0 to 10) for back and leg pain were assessed at baseline and post-intervention. Results Of 21 patients enrolled; 19 completed pre- and post-surgery BBS. The mean age was 59.8±13.3 years with 14 females. There was a statistically significant improvement in all outcome scores and radiographic parameters after surgery; but no difference in BBS. Only one patient had a BBS score low enough to be considered a medium fall risk. There was no difference in the pre-op BBS scores in the four patients that had revision surgery compared to those that did not. Conclusions In this small pilot study; BBS did not appear to be associated with measures of clinical and radiographic improvement in ASD patients. The test was also potentially problematic in that it has a ceiling effect and required significant time with a trained physical therapist for administration. Continued effort to identify a viable measure of balance dysfunction in ASD patients is warranted.
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Affiliation(s)
- Joseph L Laratta
- Norton Leatherman Spine Center, Louisville, KY, USA.,Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Steven D Glassman
- Norton Leatherman Spine Center, Louisville, KY, USA.,Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | | | - John R Dimar
- Norton Leatherman Spine Center, Louisville, KY, USA.,Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Jeffrey L Gum
- Norton Leatherman Spine Center, Louisville, KY, USA.,Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, KY, USA
| | - Charles H Crawford
- Norton Leatherman Spine Center, Louisville, KY, USA.,Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, KY, USA
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Ma Q, Wang L, Zhao L, Wang Y, Chen M, Wang S, Lv Z, Luo Y. Coronal Balance vs. Sagittal Profile in Adolescent Idiopathic Scoliosis, Are They Correlated? Front Pediatr 2019; 7:523. [PMID: 31998666 PMCID: PMC6965157 DOI: 10.3389/fped.2019.00523] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 12/03/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Clinical evaluation of the postural balance in adolescent idiopathic scoliosis has been evaluated by coronal and sagittal parameters. The relationship between coronal and sagittal parameters has not been fully studied in adolescent idiopathic scoliosis. Objective: This study aimed to evaluate the relationship between coronal and sagittal parameters in idiopathic scoliosis. Methods: One hundred and three patients of Adolescent Idiopathic Scoliosis (AIS) were recruited. Radiographs were evaluated for the following spine and pelvic measurements. Coronal parameters including thoracic Cobb angle (TC), lumbar Cobb angle (LC), global coronal balance (GCB), apical translation of the major curve (AT), and coronal pelvic tilt (CPT) were analyzed. Sagittal parameters including thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were analyzed. A canonical correlation analysis was performed between all of the coronal parameters and sagittal parameters. Results: One hundred and three patients were recruited (male 15, female 88; aged 12.5 ± 1.5 years). Compared with the published age-matched normal population, TK, PI, LL, and SS were not statistically different in the normal group. However, PT was significantly increased in patent groups (P = 0.003). Canonical correlation analysis showed strong correlation between coronal parameters and sagittal parameters, F (20, 313) = 2.44, p = 0.001. SVA was not correlated with any coronal parameter. Conclusions: Children with AIS showed an increased pelvic tilt sign. In this study, TC, LC, GCB, AT, CPT, TK, LL, SVA, PI, PT, and SS contributed to the postural balance. In AIS, coronal balance is contributed to sagittal balance.
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Affiliation(s)
- Qichao Ma
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Wang
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Lihua Zhao
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yicheng Wang
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mengjie Chen
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Sun Wang
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zhibao Lv
- Department of General Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Luo
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
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25
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Le Berre M, Pradeau C, Brouillard A, Coget M, Massot C, Catanzariti JF. Do Adolescents With Idiopathic Scoliosis Have an Erroneous Perception of the Gravitational Vertical? Spine Deform 2019; 7:71-79. [PMID: 30587324 DOI: 10.1016/j.jspd.2018.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/28/2018] [Accepted: 05/05/2018] [Indexed: 10/27/2022]
Abstract
STUDY DESIGN Multicenter, case-control study. OBJECTIVES Demonstrate altered perception of verticality in AIS compared with matched controls. SUMMARY OF BACKGROUND DATA The cause of adolescent idiopathic scoliosis (AIS) remains to be found. AIS is associated with neurosensorial anomalies, in particular, altered control of orthostatic posture. During kinetic activity, the upright posture, in humans, is determined in reference to the gravitational vertical (GV). We hypothesized that in AIS, there is a discordance in the perception of the GV and the true GV. In AIS, the longitudinal axis of the body would thus be misoriented because of an erroneous perception of the GV. METHODS Thirty adolescents with right thoracic AIS (age 14.23 ± 1.75 years; Cobb angle 31.97°± 12.83°) and 30 controls matched for age (13.93 ± 1.85 years), body mass index, Tanner stage, and handedness were compared for subjective visual vertical (SVV) measured in static and dynamic (optokinetic stimulation) conditions, and subjective postural vertical (SPV). RESULTS There was no difference in the two groups, AIS and controls, for SVV. The SPV was significantly different between the two groups (p = .00023). The SPV was shifted to the right for most of the AIS patients (2.13°± 2.22°) compared with controls (-0.08°±1.40°). There was a significant correlation between SPV and clinical frontal tilt in the AIS patients. CONCLUSION Our findings demonstrate that patients with right thoracic AIS have an erroneous perception of the GV. In most AIS patients, SPV was shifted to the right, with no alteration of the SVV. AIS might be the consequence of a reoriented longitudinal body axis aligned with an erroneous vertical reference. The underlying mechanism might involve dysfunction of trunk graviceptors. The primary or secondary nature of this dysfunction remains an open question.
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Affiliation(s)
- Morgane Le Berre
- Physical Medicine and Rehabilitation Department, Swynghedauw University Hospital Center, Lille, France
| | - Charles Pradeau
- Physical Medicine and Rehabilitation Department, Swynghedauw University Hospital Center, Lille, France
| | | | - Monique Coget
- Spine department, SSR pediatric center Marc Sautelet, Villeneuve-d'Ascq, France
| | - Caroline Massot
- Physical Medicine and Rehabilitation Department, Saint Philibert University Hospital Center, Lomme 59462, France
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Fernandes ACG, Zamberlan-Amorim NE, Zanchetta S. Association between the Unterberger-Fukuda test and vectoelectronystagmography. REVISTA CEFAC 2018. [DOI: 10.1590/1982-0216201820213917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to study and characterize anteroposterior and angular deviations in the Unterberger-Fukuda Test (UFT) in relation to the results of the caloric tests in patients complaining of dizziness or vertigo. Methods: 44 subjects-men and women between 20 and 79 years of age-who had symptoms of vertigo or dizziness and had been referred for vectoelectronystagmography were examined. The exclusion criteria were gait difficulties arising from orthopedic and/or spinal disorders, and syndromes or neurological diseases that affect balance. Two procedures were performed: vectoelectronystagmography and UFT. Results: the caloric test showed that 25.00% of the patients had hyporeflexia-the most frequent result. In the open-eyes UFT, only 2.30% presented altered results in anteroposterior displacement. In the closed-eyes test, the equivalent value was 31.80%. Anteroposterior deviation showed a greater correlation with age than the angular one. Abnormal results in the caloric test were associated with the UFT. Conclusion: the results of the closed-eyes UFT were associated with the caloric test. Anteroposterior deviation was correlated with age, while angular deviation was not.
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Pasha S, Baldwin K. Are we simplifying balance evaluation in adolescent idiopathic scoliosis? Clin Biomech (Bristol, Avon) 2018; 51:91-98. [PMID: 29277028 DOI: 10.1016/j.clinbiomech.2017.11.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 11/27/2017] [Accepted: 11/27/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Clinical evaluation of the postural balance in adolescent idiopathic scoliosis has been measured by sagittal vertical axis and frontal balance. The impact of the scoliotic deformity in three planes on balance has not been fully investigated. METHODS 47 right thoracic and left lumbar curves adolescent idiopathic scoliosis and 10 non-scoliotic controls were registered prospectively. 13 spinopelvic postural parameters were calculated from the 3-dimantional reconstructions of X-rays. 7 balance variables describing the position and sway of the center of pressure were recorded using a pressure mat. A regression analysis was used to predict sagittal vertical axis and frontal balance from the 7 balance variables. A canonical correlation analysis was performed between all the postural parameters and balance variables and the significant associations between the postural and balance variables were determined. FINDINGS sagittal vertical axis and frontal balance were not significantly associated with the position or sway of the center of pressure (p>0.05). Canonical correlation analysis showed significant associations between the postural variables in the 3 planes and center of pressure position (R2=0.81) and sway (R2=0.62), p<0.05. INTERPRETATION Frontal Cobbs, apical rotations, distal kyphosis, pelvic incidence, sacral slope, sagittal vertical axis, and frontal balance contributed to the postural balance in the cohort. The compensatory role of the pelvis and distal kyphosis in sagittal plane was underlined. Multidimensional analyses between the postural and balance variables showed the alignment of the thoracic, lumbar, and pelvis in the 3 planes, in addition to the global head-pelvic position impact on adolescent idiopathic scoliosis balance.
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Affiliation(s)
- Saba Pasha
- Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Keith Baldwin
- Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States
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28
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Asymmetrical trunk movement during walking improved to normal range at 3 months after corrective posterior spinal fusion in adolescent idiopathic scoliosis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 27:388-396. [PMID: 29218483 DOI: 10.1007/s00586-017-5369-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 10/29/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the effects of posterior spinal fusion (PSF) and curve type on upper body movements in Adolescent Idiopathic Scoliosis (AIS) patients during gait. METHODS Twenty-four girls (12-18 years) with AIS underwent PSF. 3D-Gait-analyses were performed preoperatively, at 3 months and 1 year postoperatively. Mean position (0° represents symmetry) and range of motion (ROM) of the trunk (thorax-relative-to-pelvis) in all planes were assessed. Lower body kinematics and spatiotemporal parameters were also evaluated. RESULTS Mean trunk position improved from 7.0° to 2.9° in transversal plane and from 5.0° to - 0.8° in frontal plane at 3 months postoperative (p < 0.001), and was maintained at 1 year. Trunk ROM in transverse plane decreased from 9.6° to 7.5° (p < 0.001) after surgery. No effects of PSF were observed on the lower body kinematics during the gait cycle. Patients with a double curve had a more axial rotated trunk before and after surgery (p = 0.013). CONCLUSION In AIS patients, during gait an evident asymmetrical position of the trunk improved to an almost symmetric situation already 3 months after PSF and was maintained at 1 year. Despite a reduction of trunk ROM, patients were able to maintain the same walking pattern in the lower extremities after surgery. This improvement of symmetry and maintenance of normal gait can explain the rapid recovery and well functioning in daily life of AIS patients, despite undergoing a fusion of large parts of their spine.
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