Effect of a spinal brace on postural control in different sensory conditions in adolescent idiopathic scoliosis: a preliminary analysis

The acute effects of brace use on lower extremity performance in individuals with adolescent idiopathic scoliosis

BACKGROUND

Braces have been a popular treatment option for scoliosis among healthcare professionals for many years. However, the effect of braces on scoliosis treatment remains a subject of ongoing debate and research.

AIMS

Our study aimed to evaluate the effects of wearing a spinal brace on vertical jump, postural control, reach distance, and fall risk in patients with Adolescent Idiopathic Scoliosis (AIS).

METHODS

We included 33 patients with AIS aged between 10 to 18 years old in our cross-sectional study. Patients were randomly subjected to vertical jump test, standing long jump test, timed up and go test, postural control, and forward reach test, while wearing and not wearing the scoliosis brace, respectively.

RESULTS

Our findings revealed that patients wearing scoliosis braces had significantly lower vertical jumps (p = .001), standing long jumps (p < .001), and forward reach distances with their dominant (p = .002) and non-dominant limbs (p = .007) compared to those who did not wear the brace. However, there was no significant difference in postural control and timed up and go test between the two groups (p > .05).

CONCLUSIONS

Our study suggests that wearing a scoliosis brace may negatively affect an individual's vertical and standing long jumps, and forward reach distances. However, wearing or not wearing the brace had no significant effect on postural control and timed stand-up test. Long-term follow-up studies are needed to evaluate the overall effectiveness of scoliosis braces in treating AIS.

A machine learning approach to identify important variables for distinguishing between fallers and non-fallers in older women

Falls are a significant ongoing public health concern for older adults. At present, few studies have concurrently explored the influence of multiple measures when seeking to determine which variables are most predictive of fall risks. As such, this cross-sectional study aimed to identify those functional variables (i.e. balance, gait and clinical measures) and physical characteristics (i.e. strength and body composition) that could best distinguish between older female fallers and non-fallers, using a machine learning approach. Overall, 60 community-dwelling older women (≥65 years), retrospectively classified as fallers (n = 21) or non-fallers (n = 39), attended three data collection sessions. Data (281 variables) collected from tests in five separate domains (balance, gait, clinical measures, strength and body composition) were analysed using random forest (RF) and leave-one-variable-out partial least squares correlation analysis (LOVO PLSCA) to assess variable importance. The strongest discriminators from each domain were then aggregated into a multi-domain dataset, and RF, LOVO PLSCA, and logistic regression models were constructed to identify the important variables in distinguishing between fallers and non-fallers. These models were used to classify participants as either fallers or non-fallers, with their performance evaluated using receiver operating characteristic (ROC) analysis. The study found that it is possible to classify fallers and non-fallers with a high degree of accuracy (e.g. logistic regression: sensitivity = 90%; specificity = 87%; AUC = 0.92; leave-one-out cross-validation accuracy = 63%) using a combination of 18 variables from four domains, with the gait and strength domains being particularly informative for screening programmes aimed at assessing falls risk.

PosturAll: A Posture Assessment Software for Children

From an early age, people are exposed to risk factors that can lead to musculoskeletal disorders like low back pain, neck pain and scoliosis. Medical screenings at an early age might minimize their incidence. The study intends to improve a software that processes images of patients, using specific anatomical sites to obtain risk indicators for possible musculoskeletal problems. This project was divided into four phases. First, markers and body metrics were selected for the postural assessment. Second, the software's capacity to detect the markers and run optimization tests was evaluated. Third, data were acquired from a population to validate the results using clinical software. Fourth, the classifiers' performance with the acquired data was analyzed. Green markers with diameters of 20 mm were used to optimize the software. The postural assessment using different types of cameras was conducted via the blob detection method. In the optimization tests, the angle parameters were the most influenced parameters. The data acquired showed that the postural analysis results were statistically equivalent. For the classifiers, the study population had 16 subjects with no evidence of postural problems, 25 with mild evidence and 16 with moderate-to-severe evidence. In general, using a binary classification with the train/test split validation method provided better results.

Does in-brace correction affect coronal spinal and thoracic cage parameters in individuals with idiopathic scoliosis? A retrospective cohort study

The aim of the study is to identify the effects of in-brace correction on coronal spinal and thoracic cage parameters in individuals with idiopathic scoliosis (IS). The coronal spinal parameters [Cobb angle, apical vertebral rotation (AVR), lateral trunk shift, coronal alignment, biacromial slope and pelvic asymmetry] and the thoracic cage parameters [T1- 12 height, T1-S1 height, thoracic transverse diameter, and apical vertebral body-rib ratio (AVB-R)] of 89 child and adolescent patients were measured on posterior-anterior full-spine radiographs at pre-brace and in-brace conditions using Surgimap software. The initial in-brace correction (IBC) was calculated as a percentage decrease in the Cobb angle on the in-brace radiographs. The mean IBC rate for the primary curve was 37% (range = 10-100%). In the in- brace condition, the Cobb angle (p<0.001), AVR (p<0.001) and lateral trunk shift (p<0.001) decreased significantly; no statistically significant difference was found in the biacromial slope (p=0.713) and the coronal alignment (p=0.074). The T1-12 height and the T1-S1 height increased significantly (p<0.001) whereas the thoracic transverse diameter and the AVB-R decreased significantly (p<0.001). Unlike IBC rate was below 30% as IBC rate was above 30%, the T1-12 height (p<0.001) increased and the AVB-R decreased (p<0.001). The bracing improved the lateral trunk shift, the AVB-R, the thoracic and spine heights, but decreased the thoracic transverse diameter. The thoracic cage parameters may be better when the IBC rate is above 30%.

Spinal Manual Therapy for Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective

We conducted this meta-analysis to provide better evidence of the efficacy of manual therapy (MT) on adolescent idiopathic scoliosis (AIS).

Methods

All RCTs of MT for the management of patients with AIS were included in the present study. The treatment difference between the experimental and control group was mainly MT. The outcomes consisted of the total effective rate, the Cobb angle, and Scoliosis Research Society-22 (SRS-22) questionnaire score. Electronic database searches were conducted from database inception to July 2022, including the Cochrane Library, PubMed, Web of Science, Embase, Wanfang Data, CNKI, and VIP. The pooled data were analyzed using RevMan 5.4 software.

Results

Four RCTs with 213 patients in the experimental group were finally included. There are 2 studies of standalone MT in the experimental group and 3 studies of MT with identical conservative treatments in the control group. Three trials reported total effective rate, and a statistically significant difference was found (P = 0.004). Three trials reported Cobb angle, and a statistical difference was found (P = 0.01). Then, sensitivity analysis showed that there was a significant difference in the additional MT subgroup (P < 0.00001) while not in the standalone MT subgroup (P = 0.41). Three trials reported SRS-22 scores (P = 0.55) without significant differences.

Conclusion

There is insufficient data to determine the effectiveness of spinal manipulation limited by the very low quality of included studies. High-quality studies with appropriate design and follow-up periods are warranted to determine if MT may be beneficial as an adjunct therapy for AIS. Currently, there is no evidence to support spinal manipulation.

Kinesiophobia and its association with treatment choice in individuals with idiopathic scoliosis

BACKGROUND

Previous studies have reported increased kinesiophobia in adults with degenerative scoliosis or adolescents who have undergone spinal surgery. However, little is known about the phenomenon of kinesiophobia among adolescents with idiopathic scoliosis (IS).

OBJECTIVES

The aim of this study was to investigate levels of kinesiophobia and its association with treatment choice in IS.

METHODS

The study included 98 IS patients with a mean age of 14 years and 20 healthy controls. Participants with IS were divided into groups based on treatment conditions, as follows: (1) untreated (n= 33); (2) treated with exercise (n= 32); and (3) treated with a brace (n= 33). Kinesiophobia was measured using the Tampa Scale for Kinesiophobia (TSK). Comparisons were made between four groups.

RESULTS

Untreated participants with IS were found to have greater kinesiophobia than healthy controls (p< 0.001). Participants treated with a brace (p= 0.046) and exercise (p= 0.064) had similar kinesiophobia levels as the healthy control group.

CONCLUSIONS

Kinesiophobia was found to be higher in adolescents with IS compared to healthy peers. Brace or exercise treatment both had a positive impact on kinesiophobia. These findings should be considered when organizing rehabilitation programs to achieve the best results for adolescents with IS.

Sensory, voluntary, and motor postural control in children and adolescents with mucopolysaccharidosis

OBJECTIVES

This study aimed to investigate automatic and voluntary motor control performances, which have an important function in maintaining balance, in children and adolescents with mucopolysaccharidosis (MPS).

METHODS

The records of 70 patients were retrospectively analyzed. The results of Computerized Dynamic Posturography (CDP) performed according to the age and development of the individuals were examined. The results of 10 children and adolescents with MPS (mean age: 9.43 ranging from 6 to 14; four males and six females) who completed the sensory analysis, Weight-Bearing Squat Test, and Adaptation Test were retrieved from the database of the CDP. Nine healthy children and adolescents with typical development (mean age: 9.63 ranging from 6 to 14; four males and five females) were included as the control group.

RESULTS

In the sensory analysis test, there was a statistically significant difference between the two groups in the visual ratio parameter. In the adaptation test, there was a statistically significant difference between the two groups in the toes up and toes down trials. There was no statistically significant difference between the groups in the Weight-Bearing Squat test at 0° knee extension and various knee flexions.

CONCLUSIONS

Children and adolescents with MPS should be directed to the appropriate exercise and therapy programs to develop postural and balance control, which have a significant effect on their quality of life and the ability to independently perform daily activities of living. In addition to routine hearing assessments for patients with MPS, other objective tests used in the differential diagnosis of balance and vestibular system should also be implemented.

The effect of orthotic interventions on balance performance in adolescent idiopathic scoliosis: A systematic literature review

BACKGROUND

Spinal bracing is one form of conservative treatment used in the treatment of adolescent idiopathic scoliosis (AIS).

AIM

The aim of this review was therefore to evaluate the effect of brace treatment on balance in subjects with AIS.

METHOD

The search strategy was based on the Population Intervention Comparison Outcome (PICO). PubMed, Scopus, ISI web of knowledge, Ovid, the Cochrane library (CENTRAL) and Google scholar databases and also the reference lists of relevant articles were searched for articles of clinical trials with level of evidence of three or more of AIS that underwent spinal bracing treatment.

RESULTS

Ten studies, investigating a total of 282 subjects with AIS, met the inclusion criteria. AIS subjects were characterized by a significant increase in the excursion of their center of pressure position compared with healthy subjects. AIS subjects are able to control their quiet standing balance via muscle co-contraction and proprioceptive stimulation, but following a short period of brace wear, no further improvement in balance parameters has been observed.

CONCLUSION

There is a requirement to follow up the use and wear of orthoses and also studies with high quality in subjects with AIS.

Case Report: Conservative Treatment of Adolescent Idiopathic Scoliosis Can Alter the Perception of Verticality. A Preliminary Study

Adolescent idiopathic scoliosis (AIS) is a lateral curvature of the spine of at least 10° Cobb's angle of unknown etiology. Some studies have found that patients with AIS have a Visual Verticality (VV) perception similar to healthy controls. This study aimed to analyze VV perception and postural balance differences in patients with AIS depending on the management, either based on observation or conservative treatment. Eighteen patients with AIS were included in this study. Nine patients were managed based on observation. The other nine underwent conservative treatment, such as bracing or exercise. Subjective Visual Vertical (SVV) and posturographic parameters were measured and analyzed. In the SVV test, patients who underwent treatment showed poor constant error in absolute values and mean absolute error, with statistically significant differences (p < 0.05). Only the Romberg Quotient for sway area was within the limits of statistical significance for posturographic parameters, with a lower value for patients under observation. This study found worse perception of verticality in patients receiving some type of conservative treatment than patients receiving only observation; whereas posturography showed similar values in both observation and treatment groups. Our results can be interpreted as the effect of treatment on the previous verticality perception adapted to the curvature.

In-brace alterations of pulmonary functions in adolescents wearing a brace for idiopathic scoliosis

BACKGROUND

Despite the common use of braces to prevent curve progression in idiopathic scoliosis, their functional effects on respiratory mechanics have not been widely studied.

OBJECTIVE

The objective was to determine the effects of bracing on pulmonary function in idiopathic scoliosis.

METHODS

A total of 27 adolescents with a mean age of 14.5 ± 1.5 years and idiopathic scoliosis were included in the study. Pulmonary function evaluation included vital capacity, forced expiratory volume, forced vital capacity, maximum ventilator volume, peak expiratory flow, and respiratory muscle strengths, measured with a spirometer, and patient-reported degree of dyspnea. The tests were performed once prior to bracing and at 1 month after bracing (while the patients wore the brace).

RESULTS

Compared with the unbraced condition, vital capacity, forced expiratory volume, forced vital capacity, maximum ventilator volume, and peak expiratory flow values decreased and dyspnea increased in the braced condition. Respiratory muscle strength was under the norm in both unbraced and braced conditions, while no significant difference was found for these parameters between the two conditions.

CONCLUSION

The spinal brace for idiopathic scoliosis tended to reduce pulmonary functions and increase dyspnea symptoms (when wearing a brace) in this study. Special attention should be paid in-brace effects on pulmonary functions in idiopathic scoliosis.

CLINICAL RELEVANCE

Bracing seems to mimic restrictive pulmonary disease, although there is no actual disease when the brace is removed. This study suggests that bracing may result in a deterioration of pulmonary function when adolescents with idiopathic scoliosis are wearing a brace.

Treatment of bracing for adolescent idiopathic scoliosis patients: a meta-analysis

PURPOSE

A meta-analysis was conducted to compare the efficacy and safety of bracing and other treatments in adolescent idiopathic scoliosis (AIS) patients.

METHODS

PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for randomized controlled trials that investigated bracing and other treatments for AIS. The Mantel-Haenszel method with fixed-effects or random-effects model was used to calculate the relative risks and 95% confidence intervals (CIs). The results of heterogeneity, sensitivity analysis, and publication bias were analyzed.

RESULTS

Seven studies that met the eligibility criteria with 791 participants were included. The results of meta-analysis suggested significant differences between bracing and observation groups in successful outcomes [OR 3.58, 95% CI (1.92, 6.68), P < 0.0001; P for heterogeneity = 0.008, I² = 65%], quality of life [MD = 2.13, 95% CI (0.51, 3.75), P = 0.01; P for heterogeneity = 0.89, I² = 0%], and adverse events [OR 5.31, 95% CI (2.42, 11.66), P < 0.0001; P for heterogeneity = 0.78, I² = 0%].

CONCLUSION

The findings of this meta-analysis suggested that bracing is efficient and safe for the treatment of AIS. These slides can be retrieved under Electronic Supplementary Material.

Core stabilization exercises versus scoliosis-specific exercises in moderate idiopathic scoliosis treatment

BACKGROUND

There are several kinds of scoliosis-specific and general physiotherapeutic exercise methods used in scoliosis rehabilitation. But there is need for comparable studies on the effectiveness of different exercise approaches for the treatment of adolescent idiopathic scoliosis.

OBJECTIVES

Comparison of the effects of combined core stabilization exercise and bracing treatment with Scientific Exercises Approach to Scoliosis and bracing treatment in patients with moderate adolescent idiopathic scoliosis.

METHODS

Thirty females with adolescent idiopathic scoliosis, who have moderate curves (20°-45°), were randomly divided into two groups. In addition to brace wearing for 4 months, one group received core stabilization exercise therapy, while the other received scientific exercises approach to scoliosis exercise therapy. The outcome measures were based on Cobb angle, angle of trunk rotation, body symmetry, cosmetic trunk deformity, and quality of life.

RESULTS

Thoracic and lumbar Cobb angles and trunk rotation angles, body symmetry, and cosmetic trunk deformity improved for both groups. Quality of life did not change in either group. The pain domain of the Scoliosis Research Society-22 questionnaire improved in the core stabilization group only.

CONCLUSION

Both treatment conditions including core stabilization with bracing and scientific exercises approach to scoliosis with bracing had similar effects in the short-term treatment of moderate adolescent idiopathic scoliosis.

CLINICAL RELEVANCE

This study showed that when scientific exercises approach to scoliosis (SEAS) and core stabilization (CS) exercises were administered with equal intensity, the effects of the two treatment protocols including CS and bracing and SEAS and bracing were similar in the treatment of patients with moderate adolescent idiopathic scoliosis (AIS).

Postural control of individuals with spinal fusion for adolescent idiopathic scoliosis

BACKGROUND

The purpose of the study was to assess the postural stability and complexity of postural control for moderately physically active individuals with spinal fusion for adolescent idiopathic scoliosis at two years post-operation.

METHODS

Limit of stability test and sensory organization test were conducted for 10 moderately physically-active participants with spinal fusion and 10 controls pair-matched for mass, height and physical activity level. During the limit of stability test, participants were instructed to lean the center of gravity as far as possible toward 8 predetermined directions and the maximum excursion and direction control were analyzed. During the sensory organization test, participants were instructed to maintain as still as possible in six test conditions and equilibrium scores and sway area of center of pressure were analyzed. Multi-scale entropy of center of pressure was calculated to quantify sway complexity.

FINDINGS

Most postural stability outcomes of spinal fusion participants were comparable to controls except for significantly reduced equilibrium scores (p = 0.039, partial η² = 0.217). Moreover, spinal fusion participants exhibited tendencies of reduced direction control (p = 0.053) during the limit of stability test and greater sway area (p = 0.052) during the sensory organization test.

INTERPRETATION

Although the center of gravity control might be affected, spinal fusion individuals who were moderately physically active likely progressively learned to adapt postoperatively to their fused spine to meet the postural demands required when performing physical movements. We suggest that spinal fusion is a satisfactory treatment in regard to the recovery of postural stability.

Quality of life and patient satisfaction in bracing treatment of adolescent idiopathic scoliosis

BACKGROUND

Bracing is used as a valid non-surgical treatment for adolescent idiopathic scoliosis (AIS) to avoid progression of the deformity and thereby surgery. The effect of bracing treatment on quality of life of patients with AIS has been a topic of interest in the international literature. The aim of this study was to evaluate the quality of life and patient satisfaction during bracing treatment for AIS of a pediatric hospital.

MATERIAL AND METHOD

We assessed a total of 43 non-consecutive female patients (mean age at questionnaire, 13 years and 1 month and 10 years and 8 months to 14 years and 5 months; mean period of usage of brace, 1 year and 7 months), with adolescent idiopathic scoliosis (AIS), older than 10 years of age until skeletal maturity, with a Risser sign less than 3 and scoliosis between 20 and 45°, treated with thoracolumbosacral orthosis (TLSO) for a period longer than 6 months, and without other comorbidities or previous surgeries, were evaluated. The patients were administered a previously validated to Spanish questionnaire on quality of life (Brace Questionnaire (BrQ); Grivas TB et al.). BrQ is a validated tool and is considered a disease-specific instrument; its score ranges from 20 to 100 points, and higher BrQ scores are associated with better quality of life.

RESULTS

The patients reported using the brace for a mean of 17.6 h daily and for a mean period of 1 year and 7 months at the time of the study. Overall, 72% of the study population reported to be in some way psychologically affected by the brace wearing, 56% felt their basic motor activities were affected, 54% felt socialization with their environment was affected, 46% considered their quality of life deteriorated due to pain, and 40% reported conflicts in the school environment.

CONCLUSION

Patients with AIS treated with bracing reported a negative impact (53.5% overall) on quality of life and treatment satisfaction in terms of psychological, motor, social, and school environment aspects. An interdisciplinary approach would be important for the integrated psychosocial care of these patients.

Effectiveness of basic body awareness therapy in adolescents with idiopathic scoliosis: A randomized controlled study1

BACKGROUND

In scoliosis, curve progresses due to muscle imbalance and poor posture. Basic body awareness therapy (BBAT) aims to improve posture, coordination, and balance by increasing body awareness, which may help decrease deformities.

OBJECTIVE

This study aimed to investigate effects of Basic body awareness therapy (BBAT) on curve magnitude, trunk asymmetry, cosmetic deformity, and quality of life in adolescent idiopathic scoliosis (AIS) patients.

METHODS

Twenty female AIS patients were randomly assigned to BBAT and traditional exercises (TEs) groups. The BBAT group received BBAT and traditional exercises (TEs), while the TEs group received only TEs. The following assessments were included: Cobb angles using X-ray, angle of trunk rotation (ATR) using scoliometer, trunk asymmetry using the Posterior Trunk Symmetry Index (POTSI), cosmetic deformity using the Walter Reed Visual Assessment Scale (WRVAS), and quality of life using the SRS-22 test. Measurements were conducted at baseline examination and ten weeks later. Patients were instructed to wear their brace 23 h daily. Results were analyzed using the Wilcoxon rank-sum test to compare repeated measurements and Mann-Whitney U test to compare the groups.

RESULTS

The BBAT group had greater improvement in the thoracic Cobb angle than the TEs group. Cosmetic deformity improved in both groups, whereas body asymmetry improved in only the BBAT group. SRS-22 scores were unchanged in both groups.

CONCLUSIONS

BBAT as an additive to bracing and TEs improve curve magnitude, body symmetry and trunk deformity.

A Short Overview of the Effects of Kinesio Taping for Postural Spine Curvature Disorders

Spine curvature disorders are very common in the population. Several therapeutic methods have been implemented over time. Kinesio Taping (KT) is a solution that is utilized for several purposes. This narrative review aims to discuss KT methodology as a valid solution for spinal curvature disorders, especially for structured and non-structured spine deviations. The matter is poorly discussed in the current literature. Nevertheless, KT seems to indirectly influence posture and spine curvature disorders through peripheral and central nervous system stimulation, but further investigations are needed to demonstrate these unknown effects clearly. The present review provides a valuable contribution to the existing literature and may represent a starting point and a useful guide for further studies in this field of research.

Analysis of sensory system aspects of postural stability during quiet standing in adolescent idiopathic scoliosis patients

Background

The aim of this study was to quantitatively analyze quite standing postural stability of adolescent idiopathic scoliosis (AIS) patients in respect to three sensory systems (visual, vestibular, and somatosensory).

Method

In this study, we analyzed the anterior-posterior center of pressure (CoP) signal using discrete wavelet transform (DWT) between AIS patients (n = 32) and normal controls (n = 25) during quiet standing.

Result

The energy rate (∆E_EYE%) of the CoP signal was significantly higher in the AIS group than that in the control group at levels corresponding to vestibular and somatosensory systems (p < 0.01).

Conclusions

This implies that AIS patients use strategies to compensate for possible head position changes and spinal asymmetry caused by morphological deformations of the spine through vestibular and somatosensory systems. This could be interpreted that such compensation could help them maintain postural stability during quiet standing. The interpretation of CoP signal during quiet standing in AIS patients will improve our understanding of changes in physical exercise ability due to morphological deformity of the spine. This result is useful for evaluating postural stability before and after treatments (spinal fusion, bracing, rehabilitation, and so on).

The Turkish version of the Brace Questionnaire in brace-treated adolescents with idiopathic scoliosis

BACKGROUND

Evaluation of the effects of brace treatment on quality of life in adolescent idiopathic scoliosis is important.

OBJECTIVES

To analyze the validity and reliability of the Turkish version of the Brace Questionnaire.

STUDY DESIGN

Cohort study, evaluation of reliability and validity of the Turkish version of the Brace Questionnaire.

METHODS

Twenty-eight patients undergoing brace treatment for adolescent idiopathic scoliosis (median age: 14.6 years) were included in the study. The Brace Questionnaire was translated into Turkish and administered to the patients twice at an interval of 5 days. Reliability was assessed using the test-retest method (Pearson's correlation coefficient); internal consistency was analyzed using Cronbach's alpha. Validity was assessed by correlating the Brace Questionnaire with the Bad Sobernheim Stress Questionnaire-Brace and Scoliosis Research Society-22 questionnaire.

RESULTS

The mean Cobb angles were 31.1° ± 8.3° and 29.7° ± 9° for thoracic and lumbar regions, respectively. Cronbach's alpha was 0.94. Intraclass correlation coefficient was 0.95 in test-retest reliability analysis. The correlations between Brace Questionnaire and Bad Sobernheim Stress Questionnaire-Brace and Scoliosis Research Society-22 were r = 0.67 and r = 0.64, respectively.

CONCLUSION

The Turkish version of the Brace Questionnaire to measure the effects of brace treatment on quality of life in adolescent idiopathic scoliosis was found to have good validity, excellent reliability, and high internal consistency. Clinical relevance We recommend routine use of the Brace Questionnaire in scoliosis patients to evaluate brace-related quality of life and relevant factors and to support the individual when necessary during such treatment.

The effects of exercise on perception of verticality in adolescent idiopathic scoliosis

PURPOSE

Visual and proprioceptive cues are important for body orientation to maintain correct posture. This study investigated the effects of exercise training on subjective visual, postural, and haptic perception of verticality in patients with scoliosis.

SUBJECTS AND METHODS

Thirty-two female adolescents with moderate idiopathic scoliosis were randomly allocated to "Core Stabilization Exercise (CSE)," "Body Awareness," or "Traditional Exercise (TE)" groups. Each group completed a 1-hour supervised program, two days per week for 10 weeks while continuing to wear spinal braces. Perceptual visual, postural, and haptic estimates were assessed before and after treatment.

RESULTS

Subjective visual vertical perception only improved in the awareness group. Subjective visual horizontal perception, postural vertical perception, total postural perception scores, total haptic perception scores, and haptic perception 45° to the right were significantly improved in the stabilization and awareness groups. For the 60° right and 60° left postural perception parameters, as well as the 45° left haptic perception parameters, perception improved only in the stabilization group. No improvement was observed in the traditional group.

CONCLUSION

Improvements in visual, postural, and haptic verticality perception within the stabilization exercise training and Basic Body Awareness group treatment suggest the addition of these exercise methods for the treatment of idiopathic scoliosis to improve internal body orientation.

Changes in Postural Sway After a Single Global Postural Reeducation Session in University Students: A Randomized Controlled Trial

OBJECTIVE

The purpose of this study was to assess the effectiveness of a single session of global postural reeducation (GPR) in postural sway in young adult university students who use data visualization screens.

METHODS

A randomized controlled trial with 2 parallel groups was performed. Sixty-four subjects were randomized in the experimental group (12 men and 20 women) who underwent the GPR session, and a control group (13 men and 19 women) that did not receive any intervention was included. Center of pressure (COP) was assessed using a stabilometric platform, with eyes open and eyes closed before, immediately after, 48 hours after, and 7 days after intervention in both groups.

RESULTS

In the interaction of time and gender, statistically significant differences were found for the area covered by COP (P = .020) and for the standard deviation (SD) in the mediolateral axis (P = .035). Considering the complete interaction time, gender, and group, statistically significant differences were found (P = .015) for the anteroposterior rate covered by COP and the SD in the anteroposterior axis (P = .033). In eyes closed condition, the intersubject analysis showed statistically significant differences for the interaction between group and gender for the variable mediolateral SD (P = .043). Considering the interaction of time with group, statistically significant differences were found for full length covered by COP (P = .017).

CONCLUSIONS

Changes in postural sway were observed after a single GPR session, mainly at 48 hours, with different behaviors between men and women.

Acute effects of spinal bracing on scapular kinematics in adolescent idiopathic scoliosis

BACKGROUND

Bracing is the most common nonsurgical treatment for adolescent idiopathic scoliosis. Spinal braces affect glenohumeral and scapulothoracic motion because they restrict trunk movements. However, the potential spinal-bracing effects on scapular kinematics are unknown. The present study aimed to investigate the acute effects of spinal bracing on scapular kinematics in adolescent idiopathic scoliosis.

METHODS

Scapular kinematics, including scapular internal/external rotation, posterior/anterior tilting, and downward/upward rotation during scapular plane elevation, were evaluated in 27 in-brace and out-of-brace adolescent idiopathic scoliosis patients with a three-dimensional electromagnetic tracking system. Data on the position and orientation of the scapula at 30°, 60°, 90°, and 120° humerothoracic elevation were used for statistical comparisons. The paired t-test was used to assess the differences between the mean values of in-brace and out-of-brace conditions.

FINDINGS

The in-brace condition showed significantly increased (P<0.05) scapular anterior tilting and decreased internal rotation in the resting position on the convex and concave sides; increased scapular downward rotation at 120° humerothoracic elevation on the convex side and at 30°, 60°, 90°, and 120° humerothoracic elevation on the concave side; increased scapular anterior tilt at 30°, 60°, 90°, and 120° humerothoracic elevation on the convex and concave sides; and decreased (P<0.05) maximal humerothoracic elevation of the arm.

INTERPRETATION

Spinal bracing affects scapular kinematics. Observed changes in scapular kinematics with brace may also affect upper extremity function for adolescents with idiopathic scoliosis. Therefore, clinicians should include assessments of the glenohumeral and scapulothoracic joints when designing rehabilitation protocols for patients with adolescent idiopathic scoliosis.

The effectiveness of core stabilization exercise in adolescent idiopathic scoliosis: A randomized controlled trial

BACKGROUND

Core stabilization training is used to improve postural balance in musculoskeletal problems.

OBJECTIVES

The purpose of this study was to investigate the effectiveness of stabilization training in adolescent idiopathic scoliosis.

STUDY DESIGN

A randomized controlled trial, pretest-posttest design.

METHODS

In total, 25 subjects with adolescent idiopathic scoliosis were randomly divided into two groups: stabilization group ( n = 12) and control group ( n = 13). The stabilization group received core stabilization in addition to traditional rehabilitation, and the control group received traditional rehabilitation for 10 weeks. Assessment included Cobb's angle on radiograph, apical vertebral rotation in Adam's test, trunk asymmetry (Posterior Trunk Symmetry Index), cosmetic trunk deformity (Trunk Appearance Perception Scale), and quality of life (Scoliosis Research Society-22 questionnaire).

RESULTS

Inter-group comparisons showed significantly greater improvements in the mean change in lumbar apical vertebral rotation degree and the pain domain of Scoliosis Research Society-22 in the stabilization group than those in the control group ( p < 0.05). No significant differences were observed for other measurements between the groups; however, trends toward greater improvement were observed in the stabilization group.

CONCLUSION

Core stabilization training in addition to traditional exercises was more effective than traditional exercises alone in the correction of vertebral rotation and reduction of pain in adolescent idiopathic scoliosis. Clinical relevance Stabilization exercises are more effective in reducing rotation deformity and pain than traditional exercises in the conservative rehabilitation of adolescent idiopathic scoliosis. These improvements suggest that stabilization training should be added to rehabilitation programs in adolescent idiopathic scoliosis.

Static balance according to hip joint angle of unsupported leg during one-leg standing

[Purpose] This study aimed to determine static balance according to hip joint angle of the unsupported leg during one-leg standing. [Subjects and Methods] Subjects included 45 healthy adult males and females in their 20s. During one-leg standing on the non-dominant leg, the position of the unsupported leg was classified according to hip joint angles of point angle was class. Static balance was then measured using a force plate with eyes open and closed. The total length, sway velocity, maximum deviation, and velocity on the mediolateral and anteroposterior axes of center of pressure were measured. [Results] In balance assessment with eyes open, there were significant differences between groups according to hip joint angle, except for maximum deviation on the anteroposterior axis. In balance assessment with eyes closed, there were significant differences between total length measurements at 0° and 30°, 60° and between 30° and 90°. There were significant differences between sway velocity measurements at 0° and 30° and between 30° and 90°. [Conclusion] Thus, there were differences in static balance according to hip joint angle. It is necessary to clearly identify the hip joint angle during one-leg standing testing.