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Yerli S, Yinanç SB, Yağcı G, Erbahçeci F, Özçakar L. Thoracolumbar fascia and chronic low back pain in idiopathic lumbar scoliosis: an ultrasonographic study. 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 2024; 33:2469-2475. [PMID: 38653872 DOI: 10.1007/s00586-024-08266-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/29/2024] [Accepted: 04/07/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE The role of thoracolumbar fascia (TLF) in the development of chronic low back pain (CLBP) has growing evidence in the literature. Although CLBP is reported in individuals with idiopathic scoliosis (IS), its relationship with the TLF has yet not been established. This study aims to evaluate the TLF and its relationship with CLBP in IS. METHODS A total of 60 individuals were included in the study. They were divided into three groups as follows: painful scoliosis (n = 20, age: 17.1 ± 3.7 years, Cobb angle: 15-43°), non-painful scoliosis (n = 20, age: 16.4 ± 3.4 years, Cobb angle: 15-45°), and healthy group (n = 20, age: 16.4 ± 4.7 years). Pain was evaluated using the short form of the McGill Pain Questionnaire. TLF thickness was evaluated on the lumbar region using ultrasonography. Trunk range of motion was assessed using a universal goniometer, and flexibility was assessed with sit-and-reach test. RESULTS The thickness of the right TLF was greatest in the painful group, followed by non-painful (p = 0.007) and healthy (p < 0.001) groups. The thickness of the left TLF in the non-painful and painful groups was greater compared to the healthy group (p < 0.001). In the painful group, right TLF thickness was negatively correlated with trunk flexion/extension (r = -0.540, p = 0.014/r = -0.514, p = 0.020) and left rotation (r = -0.499, p = 0.025) but positively correlated with pain (r = 0.562, p = 0.01). CONCLUSIONS Thickening of the TLF was observed in IS, whereby, in the presence of CLBP, it was further intensified. We suggest considering fascial thickening as a potential contributing factor to both pain and limited motion in relevant patients.
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Affiliation(s)
- Sibel Yerli
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
| | - Satuk Buğrahan Yinanç
- Yozgat Bozok University Sarıkaya School of Physiotherapy and Rehabilitation, Yozgat, Turkey
| | - Gözde Yağcı
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Fatih Erbahçeci
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical Medicine and Rehabilitation, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Muccio M, Atun-Einy O, Kafri M, Kaplan SL. Bridging Motor Learning Principles with Physiotherapy Specific Scoliosis Exercises: a Perspective Article. Phys Occup Ther Pediatr 2023; 43:741-758. [PMID: 36922700 DOI: 10.1080/01942638.2023.2186198] [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] [Received: 08/07/2022] [Revised: 12/13/2022] [Accepted: 02/17/2023] [Indexed: 03/18/2023]
Abstract
AIM This perspective paper illustrates the usefulness of explicitly integrating motor learning terminology with evolving therapeutic approaches. Physiotherapy specific scoliosis exercises (PSSEs) include a growing number of approaches to scoliosis management and serve as an example of this integration. METHODS Three quintessential patient cases (a young hypermobile adolescent, a post-pubescent teen, and an adult with childhood diagnosis of scoliosis) serve to contrast the clinical decision-making process for a PSSE plan of care when organized within a motor learning framework. CONCLUSIONS AND IMPLICATIONS As intervention approaches evolve, aligning the unique terminologies from different schools of thought with motor learning constructs would provide a common language for clinicians, academics and researchers to facilitate comparison of approaches and organize intervention care plans. Linking a motor learning framework and terminology to PSSE may facilitate comparison of PSSE treatment approaches by clinicians, academics, and researchers, as well as advance the global quality of care for patients with scoliosis.
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Affiliation(s)
- Marissa Muccio
- Division of PRNY PC, Scoliosis Specialty Center, Totowa, NJ, USA
| | - Osnat Atun-Einy
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Michal Kafri
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Sandra L Kaplan
- Department of Rehabilitation and Movement Science, Rutgers University, Newark, NJ, USA
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Baik SM, Kim SH, Lee JH. A scoping review of the different types of exercise programs proposed for the improvement of postural balance in adolescents with idiopathic scoliosis. J Back Musculoskelet Rehabil 2023; 36:1261-1272. [PMID: 37482978 DOI: 10.3233/bmr-220391] [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: 07/25/2023]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS), which is the most common type of scoliosis, is a progressive disease that occurs in children aged 10-16 years. Abnormal curvature in AIS provokes spinal asymmetry of the upper body alignment and might deteriorate postural balancing and control ability. OBJECTIVE To evaluate the effect of exercise interventions on balance and postural stability in patients with adolescent idiopathic scoliosis. METHODS Embase, Scopus, Pubmed (Medline) and Web of Science databases were searched using the terms idiopathic scoliosis, physiotherapy, and balance. The articles selected were published in English in peer-reviewed journals from 2012 to July 2022. RESULTS Ten studies met the inclusion criteria. The PEDro scale values ranged from 2 to 6 (mean, 3.6), indicating a low level of scientific rigor. In the sample studies, spinal stabilization exercises were most often trialed (n= 3), followed by Schroth's exercise (n= 2), stretching and self-elongation exercise (n= 2), the exercise protocol of Blount and Moe, physiotherapeutic scoliosis-specific exercise, and proprioceptive neuromuscular facilitation exercise (all n= 1). CONCLUSIONS Physical therapists will be able to apply hippotherapy, Schroth exercise, physiotherapy scoliosis-specific exercise, trunk stabilization, proprioceptive neuromuscular facilitation exercise, spinal stabilization exercise, core stabilization exercise, and body awareness therapy to manage balance impairments in patients with adolescent idiopathic scoliosis, and further studies are needed to provide stronger evidence.
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Affiliation(s)
- Seung-Min Baik
- Department of Physical Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju-si, Kangwon-do, Korea
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju-si, Kangwon-do, Korea
| | - Seok-Hyun Kim
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju-si, Kangwon-do, Korea
| | - Ji-Hyun Lee
- Departement of Physical Therapy, Baekseok University, Cheonan-si, Chungcheongnam-do, Korea
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Kučerová K, Šafářová M, Illinger V, Koutná S, Šonská K, Levínská K, Čakrt O. Subjective visual vertical and head position in patients with idiopathic scoliosis. J Vestib Res 2023; 33:187-193. [PMID: 37212080 DOI: 10.3233/ves-230005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Idiopathic scoliosis (IS) is a structural spinal deformity that can affect the position of the head. One of the etiological hypotheses is that it can be caused by dysfunction of the vestibular system, which can cause abnormal perception of subjective visual vertical (SVV). OBJECTIVE This study aimed to evaluate the differences in head position and its possible correlation with the perception of SVV in children with IS. METHODS We examined 37 patients with IS and 37 healthy individuals. The position of the head was evaluated from digital photographs, where we compared the coronal head tilt and the coronal shoulder angle. Measurement of SVV perception was performed using the Bucket method. RESULTS Coronal head tilt values were significantly different between the groups (median 2.3° [interquartile range 1.8-4.2] vs 1.3° [0.9-2.3], p = 0.001; patients vs. controls). There was a significant difference in SVV between the groups (2.33° [1.40-3.25] vs 0.50° [0.41-1.10], p < 0.001; patients vs controls). There was a correlation between the side of head tilt and the side of SVV in patients with IS (χ2 = 5.6, p = 0.02). CONCLUSIONS Patients with IS had a greater head tilt in the coronal plane and impaired SVV perception.
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Affiliation(s)
- Klára Kučerová
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University and Motol UniversityHospital, Prague, Czech Republic
| | - Marcela Šafářová
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University and Motol UniversityHospital, Prague, Czech Republic
| | - Vojtěch Illinger
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University and Motol UniversityHospital, Prague, Czech Republic
| | - Sára Koutná
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University and Motol UniversityHospital, Prague, Czech Republic
| | - Kristýna Šonská
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University and Motol UniversityHospital, Prague, Czech Republic
| | - Kateřina Levínská
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University and Motol UniversityHospital, Prague, Czech Republic
| | - Ondřej Čakrt
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University and Motol UniversityHospital, Prague, Czech Republic
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Stȩpień A, Maślanko K, Rekowski W, Fabian K, Tuz J, Graff K. Analysis of the prevalence of asymmetry and muscle tone disorders in the first year of life among youth with idiopathic scoliosis: A retrospective case-control study. J Back Musculoskelet Rehabil 2022; 35:1003-1011. [PMID: 35431225 DOI: 10.3233/bmr-171075] [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 Not much is known about developmental motor disorders in the first year of life of children diagnosed with idiopathic scoliosis (IS). OBJECTIVE This study aimed to compare the occurrence of asymmetry or muscle tone disorders in the first year of life in adolescents with IS and their healthy counterparts. METHODS The parents of adolescents with IS and without scoliosis completed a survey on the occurrence of asymmetry, abnormal muscle tone, and physiotherapy in their children in the first year of life. Pearson's chi square test and Cramer's coefficient were used. RESULTS The final analysis included 527 surveys completed by parents of adolescents with idiopathic scoliosis (150) and without scoliosis (377). A significantly higher frequency of asymmetry (p= 0.001) and muscle tone disorders (p= 0.001) was noted in adolescents with idiopathic scoliosis. The results also revealed a significant association between scoliosis and asymmetry (p= 0.001), as well as muscle tone (p= 0.001). CONCLUSIONS Developmental asymmetry or improper muscle tone in the first year of life could be considered a potential factor in the development of scoliosis; however, this hypothesis should be confirmed in future studies. Infants diagnosed with developmental disorders require systematic observation.
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Affiliation(s)
- Agnieszka Stȩpień
- Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland
| | | | - Witold Rekowski
- Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland
| | | | - Jacek Tuz
- Physiotherapy Practice Jacek Tuz Certified McKenzie Clinic, Tychy, Poland
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Radwan NL, Ibrahim MM, Mahmoud WS. Comparison of two periods of Schroth exercises for improving postural stability indices and Cobb angle in adolescent idiopathic scoliosis. J Back Musculoskelet Rehabil 2022; 35:573-582. [PMID: 34602457 DOI: 10.3233/bmr-200342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adolescents with idiopathic scoliosis present postural instability when compared with healthy subjects. Although Schroth exercises therapy (SET) is broadly utilized, its effect on postural stability is still not clear. OBJECTIVES To compare the two treatment periods of the SET for improving the postural stability indices and Cobb angle, and to examine the correlation between the Cobb angle and stability indices in adolescent idiopathic scoliosis (AIS). METHODS Twenty girls aged 10-16 years with AIS (study group) and 20 age-matched girls without AIS (control group) were examined. The Biodex Balance System was used to evaluate the overall stability index (OSI), anteroposterior index (APSI), and mediolateral stability index (MLSI) in the study group before SET and one and three months after the therapy. A plain X-ray was used to measure the Cobb angle before and three months after SET. Stability indices and Cobb angle were measured only once for the control group. RESULTS One-way repeated-measures ANOVA revealed that the three-month duration of SET was the most effective for improving OSI, APSI, and MLSI (p< 0.001). The significant proximities of OSI, APSI, and MLSI to the normal values post three months of SET were 29.65%, 24.07, and 20% respectively. The MLSI was robust and correlated with the Cobb angle (r= 0.85) three months post intervention. CONCLUSION Stability indices and Cobb angles were highly improved after three months of SET compared to one month among AIS patients. The MLSI is the most substantial index correlated with the Cobb angle.
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Affiliation(s)
- Nadia L Radwan
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.,Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia
| | - Marwa M Ibrahim
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.,Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia
| | - Waleed S Mahmoud
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia.,Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Catanzariti JF, Coget M, Brouillard A. A perception bias of the gravitational vertical is confirmed in Adolescent Idiopathic Scoliosis. Spine Deform 2022; 10:69-78. [PMID: 34319559 DOI: 10.1007/s43390-021-00390-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/15/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Adolescent Idiopathic Scoliosis (AIS) is the most frequent spine deformity in adolescence. The cause of AIS remains unknown. Several studies show that AIS can be associated with a perception bias of gravitational vertical. In particularly, AIS patients with a right thoracic convexity exhibit deviation of the Subjective Postural Vertical. The origin of this disturbance could be located in trunk proprioceptive graciveptors. We wanted to verify this result with a population of lumbar and thoracolumbar AIS with left convexity. METHODS It was a multicenter, cross-sectional case-control study. Thirty adolescents with left lumbar or thoraco-lumbar AIS (age 14.3 ± 1.7 years; Cobb angle 27.6° ± 6.1°) and 30 controls matched for age (14.0 ± 1.5 years), were compared for Subjective Visual Vertical (SVV) measured in static and dynamic (optokinetic stimulation) conditions, and Subjective Postural Vertical (SPV). RESULTS For SVV, there was no difference in the two groups, for static and dynamic conditions. The SPV was significantly different between the two groups (p < 0.0001). The SPV was shifted to the left for most of the AIS patients (med - 2.4°[- 3.6; - 1.7]) compared with controls (med 0°[- 0.5; 1.7]). Adolescents with AIS perceived verticality with significant greater uncertainty in postural modality than controls (p = 0.017). CONCLUSION Our study confirms a significant directional bias in the orientation of SPV in left lumbar or thoraco-lumbar AIS. This confirmation paves the way to a new physiopathological model focused on trunk proprioception. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Jean-François Catanzariti
- Spine Department, SSR Pediatric Center Marc Sautelet, Villeneuve-d'Ascq, France. .,La Maison de la Scoliose, Villeneuve-d'Ascq, France.
| | - Monique Coget
- Spine Department, SSR Pediatric Center Marc Sautelet, Villeneuve-d'Ascq, France
| | - Anthony Brouillard
- Spine Department, SSR Pediatric Center Marc Sautelet, Villeneuve-d'Ascq, France.,La Maison de la Scoliose, Villeneuve-d'Ascq, France
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Analysis of the Degree of Involvement of the Lower Limb Muscles in the Pathological Process in Adolescents with Idiopathic Scoliosis. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.2.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background. The problem of the effect of adolescent idiopathic scoliosis on the functional condition of the lower limb muscles is still highlighted insufficiently.Aim. Analysis of the degree of involvement of the lower limb muscles in the pathological process in adolescents with idiopathic scoliosis.Methods. A comparative analysis has been made on the results of examination of 209 adolescents: 25 adolescents with idiopathic scoliosis; 170 normal adolescents; 14 adolescents with congenital scoliosis. The moments of force ofthe lower limb muscles were evaluated using dynamometric stands. Electrophysiological characteristics of the lower limb muscles were registered by the method of global and stimulation electroneuromyography.Results. The decrease in the amplitude of voluntary EMG of the femoral muscles in adolescents with idiopathic and congenital scoliosis is accompanied by dropping the moments of force relative to the values of the control group. The leg muscles are characterized by the preservation of the values of force at the level of normal test subjects under the conditions of the reduced voluntary EMG of high frequency. The amplitude of the M-responses of the indicator muscles and the values of the excitation propagation velocity along the motor fibers were also preserved. There are no statistically significant correlations between the amount of the spine deformity, on the one hand, and the values of asymmetry of the characteristics of the muscles in adolescents with idiopathic scoliosis.Conclusion. In adolescents with idiopathic scoliosis the function of femoral muscles is decreased, and there is no relationship between the amount of the spine deformity and the values of asymmetry of the characteristics of the lower limb muscles. The similar character of muscle function changes in adolescents with idiopathic and congenital scoliosis can testify that the cause of the observed changes is not the disease etiology, but the insufficient level of motor activity.
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Zagalaz-Anula N, León-Morillas F, Andradre-Ortega JA, Ibáñez-Vera AJ, de Oliveira-Sousa SL, Lomas-Vega R. Case Report: Conservative Treatment of Adolescent Idiopathic Scoliosis Can Alter the Perception of Verticality. A Preliminary Study. Front Pediatr 2020; 8:609555. [PMID: 33569361 PMCID: PMC7868533 DOI: 10.3389/fped.2020.609555] [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: 09/23/2020] [Accepted: 12/29/2020] [Indexed: 11/24/2022] Open
Abstract
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.
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Affiliation(s)
| | - Felipe León-Morillas
- Health Sciences PhD Program, Catholic University of Murcia (UCAM), Guadalupe, Spain
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Lin S, Yang Y, Qi Q, Wei L, Jing N, Jie Z, Xia L, Shifu X. The Beneficial Effect of Physical Exercise on Cognitive Function in a Non-dementia Aging Chinese Population. Front Aging Neurosci 2019; 11:238. [PMID: 31555125 PMCID: PMC6727612 DOI: 10.3389/fnagi.2019.00238] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/16/2019] [Indexed: 11/13/2022] Open
Abstract
Numerous observational studies have shown that physical exercise promotes cognition in the elderly, however, the results from randomized clinical trials (RCTs) are ambiguous. In addition, potential benefits of exercise in an elderly Chinese population have not been comprehensively addressed. In this study, an investigation was launched which focused on the relationship between physical exercise and cognitive function, blood lipid profiles and brain anatomy in a non-dementia aging Chinese population. A total of 2074 non-dementia elderly subjects were included (self-selected exercise n = 1372; self-selected non-exercise n = 702). Amongst the subjects, 689 volunteered to receive blood lipid tests, 141 undergo brain magnetic resonance imaging (MRI), and 1399 receive a 1 year cognitive evaluation follow-up. The Beijing version of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental States Examination (MMSE) were used to assess cognitive function. A significant difference in cognitive function was observed at the baseline and during the 1-year follow-up between the self-selected exercise and self-selected non-exercise groups, however, no significant differences in blood lipids and brain anatomy was evident. Physical exercise has a beneficial effect on cognition, particularly visuospatial function, and decreases the risk of dementia in a Chinese aging cohort.
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Affiliation(s)
- Sun Lin
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Yang
- Shanghai I-Zhaohu Senior Care Services Co., Ltd., Shanghai, China
| | - Qiu Qi
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Wei
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Nie Jing
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhang Jie
- Key Laboratory of Arrhythmias, Ministry of Education, Shanghai East Hospital, Tong Ji University School of Medicine, Shanghai, China
| | - Li Xia
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao Shifu
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Bilateral asymmetry in kinematic strategies for obstacle-crossing in adolescents with severe idiopathic thoracic scoliosis. Gait Posture 2019; 71:211-218. [PMID: 31078825 DOI: 10.1016/j.gaitpost.2019.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 04/24/2019] [Accepted: 05/02/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Adolescent idiopathic scoliosis (AIS) is the most common three-dimensional spinal deformity pathology during adolescence, often accompanied with sensory integration and proprioception problems, which may lead to abnormal postural control and altered end-point control during functional activities. This paper identifies the effects of AIS on the end-point control and on angular kinematics of the trunk and pelvis-leg apparatus during obstacle-crossing for both the concave- and convex-side limb leading. MATERIALS AND METHODS Sixteen adolescents with severe Lenke 1 AIS (age: 14.9 ± 1.7 years, height: 154.7 ± 5.0 cm) and sixteen healthy controls (age: 14.8 ± 2.7 years, height: 154.9 ± 5.6 cm) each walked and crossed obstacles of 3 heights with either the concave- (AIS-A) or convex-side (AIS-V) limb leading. Angular motions of the trunk, pelvis and lower limbs, and toe-obstacle clearances were measured. Two-way analyses of variance were used to study between-subject (group) and within-subject (limb and height) effects on the variables. Whenever a height effect was found, a polynomial test was used to determine the linear trend. α = 0.05 was set for all tests. RESULTS Patients with AIS significantly reduced pelvic downward list but increased dorsiflexion in both stance and swing ankles at leading limb crossing when compared to controls (p < 0.05). During AIS-A, additional kinematic modifications were observed, i.e., increased stance hip adduction (4.2 ± 0.8°, p = 0.005) and increased swing knee flexion (12.6 ± 1.4°, p = 0.106), with significantly decreased leading toe-clearance (AIS-A: 121.4 ± 6.7 mm, controls: 140.1 ± 5.6 mm, p = 0.031). CONCLUSIONS Patients with AIS adopted an altered kinematic strategy for successful obstacle-crossing. With the concave-side limb leading, more joint kinematic modifications with reduced toe-clearance were found when compared to those during the convex-side limb leading, suggesting an increased risk of tripping. Further studies on the kinematic strategies adopted by different types of AIS will be needed for a more complete picture of the functional adaptations in such patient group.
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