1
|
Büyükturan Ö, Kaya MH, Alkan H, Büyükturan B, Erbahçeci F. Comparison of the efficacy of Schroth and Lyon exercise treatment techniques in adolescent idiopathic scoliosis: A randomized controlled, assessor and statistician blinded study. Musculoskelet Sci Pract 2024; 72:102952. [PMID: 38631273 DOI: 10.1016/j.msksp.2024.102952] [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: 08/11/2023] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is the most common vertebral disorder in adolescence. OBJECTIVES The purpose of this study was to compare the effectiveness of Schroth and Lyon exercise methods on Cobb angle (CA), angle of trunk rotation (ATR), quality of life (QoL), and perceived trunk appearance in patients with AIS. METHODS The 31 participants diagnosed (diagnosis age = 12.2 ± 0.9) with AIS by a physician following the Lenke criteria and subsequently referred to the outpatient clinic were enrolled in the study. All participants were randomly assigned between the Schroth group (SG) and Lyon group (LG) for 6 months of supervised and home treatment. The participants' CA, ATR, Scoliosis Research Society-22 (SRS-22), and Walter-Reed Visual Assessment Scale (WRVAS) were assessed as a baseline, and again following the treatment by the same researcher who remained blinded to the study. RESULTS In 2-way mixed-design repeated-measures ANOVA analysis, when the change in time was analyzed between the groups (Group × Time [interaction]), a statistical difference was found more significant in SG for the CA-thoracic (F = 103.1, p < .01, 95% CI = 4.1; 2.0 to 6.2), CA-lumbar (F = 19.1, p < .01, 95% CI = 1.7; 1.0 to 2.4), ATR (F = 64.1, p < .01, 95% CI = 1.7; 1.2 to 2.3), and WRVAS (F = 169.5, p < .01, 95% CI = 6.5; 3.2 to 9.9) parameters. The LG was only more significantly improved in the SRS-22 total score (F = 15.7, p < .01, 95% CI = -0.9; -0.2 to -1.6). CONCLUSION In the study, The Schroth exercises gave more favorable results than Lyon exercises in terms of CA-T, CA-L, ATR and WRVAS in the conservative treatment of AIS, while Lyon exercises gave more favorable results in terms of QoL. Additionally, according to the results of this study, it was found that the QoL of participants in SG decreased after treatment compared to baseline.
Collapse
Affiliation(s)
- Öznur Büyükturan
- Kırşehir Ahi Evran University, School of Physical Therapy and Rehabilitation, Kırşehir, Turkiye
| | | | - Halil Alkan
- Muş Alpaslan University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muş, Turkiye
| | - Buket Büyükturan
- Kırşehir Ahi Evran University, School of Physical Therapy and Rehabilitation, Kırşehir, Turkiye
| | - Fatih Erbahçeci
- Hacettepe University, Faculty of Physiotherapy and Rehabilitation, Department of Musculoskeletal Rehabilitation, Ankara, Turkiye
| |
Collapse
|
2
|
Peng C, Li D, Guo T, Li S, Chen Y, Zhao L, Mi J. Efficacy of Different Exercises on Mild to Moderate Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-analysis. Am J Phys Med Rehabil 2024; 103:494-501. [PMID: 38113028 DOI: 10.1097/phm.0000000000002389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
PURPOSE The aims of this study are to evaluate the effectiveness of different exercise interventions on patients with adolescent idiopathic scoliosis and to provide evidence-based exercise prescriptions for this population. METHODS The PubMed, Embase, Cochrane Library, Web of Science, CNKI, Chinese Biomedical Literature Database (CBM), VIP, and Wanfang Data Knowledge Service Platform were searched until January 2023. The data were pooled and a meta-analysis was conducted. RESULTS A total of 19 studies were conducted with 778 participants. The Schroth exercises group (mean difference = -3.48, 95% confidence interval = -4.73 to -2.23, P < 0.00001) and strength training group (mean difference = -3.43, 95% confidence interval = -4.06 to -2.80, P < 0.00001) had better recovery of the Cobb angle than the other groups. The Cobb angle rehabilitation effect was good in the time of less than 60-min group. In addition, there was no significant difference found between the different intervention periods groups ( P > 0.05). CONCLUSIONS Schroth exercise and strength training significantly improved Cobb angle of adolescent idiopathic scoliosis patients; exercising for less than 60 mins is effective for Cobb angle rehabilitation, but prolonging exercise time cannot improve training effectiveness; 12 wks of exercise significantly improved Cobb angle, but prolonged training periods did not have a significant impact.
Collapse
Affiliation(s)
- Cheng Peng
- From the China Athletics College, Beijing Sport University, Beijing, China (CP); Physical Education College, Beijing Normal University, Beijing, China (DL); School of Competitive Sports, Beijing Sport University, Beijing, China (TG, SL, YC, JM); and Sport Science School, Beijing Sport University, Beijing, China (LZ)
| | | | | | | | | | | | | |
Collapse
|
3
|
Chen J, Xu T, Zhou J, Han B, Wu Q, Jin W, Zhang X. The Superiority of Schroth Exercise Combined Brace Treatment for Mild-to-Moderate Adolescent Idiopathic Scoliosis: A Systematic Review and Network Meta-Analysis. World Neurosurg 2024; 186:184-196.e9. [PMID: 38531472 DOI: 10.1016/j.wneu.2024.03.103] [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] [Received: 03/14/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE The current study aimed to assess and rank the comparative efficacy of different nonoperative treatments on Cobb angle, angle of trunk rotation, and quality of life for mild-to-moderate adolescent idiopathic scoliosis. METHODS A comprehensive search of databases, including Medline, The Cochrane Library, PubMed, EMBASE, and Web of Science spanning all previous years up to January 1, 2024. The included studies were evaluated for literature quality according to Cochrane Handbook criteria, and a network meta-analysis was performed using STATA 14.0 statistical software. RESULTS Twenty randomized controlled trials met all inclusion criteria and were analyzed. Schroth exercise and scoliosis-specific exercise combined with brace treatments had a significant positive effect on Cobb angle and quality of life. For angle of trunk rotation, Schroth exercise and Schroth exercise combined with brace treatments prove more effective compared to the control group. On surface-under-the-cumulative-ranking-curve analysis, Schroth exercise combined with brace treatment had the highest likelihood for reducing Cobb angle (P-score = 0.899), angle of trunk rotation (0.82), and improving quality of life (0.828). CONCLUSIONS Although most conservative treatments had benefits for mild-to-moderate adolescent idiopathic scoliosis, the most optimal programs were those that included (1) at least 10 weeks of approximately 60-minute Schroth exercise sessions twice a week and (2) wearing the brace for 23 hours every day throughout the treatment period.
Collapse
Affiliation(s)
- Jiping Chen
- School of Physical Education, Shandong University, Jinan, China
| | - Tianwen Xu
- School of Physical Education, Shandong University, Jinan, China
| | - Jianfan Zhou
- School of Physical Education, Shandong University, Jinan, China
| | - Bing Han
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Qingxu Wu
- School of Physical Education, Shandong University, Jinan, China
| | - Wei Jin
- School of Physical Education, Shandong University, Jinan, China
| | - Xianliang Zhang
- School of Physical Education, Shandong University, Jinan, China.
| |
Collapse
|
4
|
Kisa EP, Tarakcı E, Leblebici G, Ozdincler AR, Kasapcopur O. Exercise programs for scoliosis in juvenile idiopathic arthritis: a randomized-controlled study. Rheumatol Int 2024; 44:441-449. [PMID: 37668835 DOI: 10.1007/s00296-023-05439-7] [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] [Received: 07/07/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023]
Abstract
By improving core strength and stability, children with JIA can experience increased endurance, reduced pain, and improved posture. No study was found that investigated the effectiveness of 3-Dimension (3D) exercises in JIA. This study aimed to compare the effectiveness of structured 3D exercises with that of a conventional exercise program specially planned for children with JIA who have scoliosis. This was a prospective, randomized-controlled study. Structured 3D scoliosis exercises for Group 1 (n: 25) and conventional exercises for the Group 2 (n: 25) were applied for 24 weeks. The angle of trunk rotation (ATR) by scoliometer, scoliosis angle by Cobb angle, pain by a numerical rating scale (NRS), respiratory functions by spirometry, and perception of cosmetic deformity by The Walter Reed visual assessment scale (WRVAS) were evaluated. ATR, Cobb angle, and pain in Group I showed significant improvement compared to Group II. While the sub-parameters of WRVAS and increased significantly in both groups, the improvement in Group I was found to be greater between the groups. While FVC (%) and FEV1 (%) results within the group were significant in both groups. 3D exercises and conventional exercises are an effective and feasible method in the treatment of scoliosis in these children. Despite the curative effect of both methods, 3D exercises have been proven in this study to be more effective on Cobb angle, ATR, WRAS, and respiratory parameters.
Collapse
Affiliation(s)
- Eylul Pinar Kisa
- Division of Physiotherapy and Rehabilitation, Biruni University, Faculty of Health Science, Istanbul, Turkey.
| | - Ela Tarakcı
- Division of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpaşa, Faculty of Health Science, Istanbul, Turkey
| | - Gokce Leblebici
- Division of Physiotherapy and Rehabilitation, Istanbul Medeniyet University, Faculty of Health Science, Istanbul, Turkey
| | - Arzu Razak Ozdincler
- Division of Physiotherapy and Rehabilitation, Biruni University, Faculty of Health Science, Istanbul, Turkey
| | - Ozgur Kasapcopur
- Department of Pediatric Rheumatology, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
5
|
Romano M, Minozzi S, Bettany-Saltikov J, Zaina F, Chockalingam N, Kotwicki T, Maier-Hennes A, Arienti C, Negrini S. Therapeutic exercises for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev 2024; 2:CD007837. [PMID: 38415871 PMCID: PMC10900302 DOI: 10.1002/14651858.cd007837.pub3] [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: 02/29/2024]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a pathology that changes the three-dimensional shape of the spine and trunk. While AIS can progress during growth and cause cosmetic issues, it is usually asymptomatic. However, a final spinal curvature above the critical threshold of 30° increases the risk of health problems and curve progression in adulthood. The use of therapeutic exercises (TEs) to reduce the progression of AIS and delay or avoid other, more invasive treatments is still controversial. OBJECTIVES To evaluate the effectiveness of TE, including generic therapeutic exercises (GTE) and physiotherapeutic scoliosis-specific exercises (PSSE) in treating AIS, compared to no treatment, other non-surgical treatments, or between treatments. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, four other databases, and two clinical trials registers to 17 November 2022. We also screened reference lists of articles. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing TE with no treatment, other non-surgical treatments (braces, electrical stimulation, manual therapy), and different types of exercises. In the previous version of the review, we also included observational studies. We did not include observational studies in this update since we found sufficient RCTs to address our study aims. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodology. Our major outcomes were progression of scoliosis (measured by Cobb angle, trunk rotation, progression, bracing, surgery), cosmetic issues (measured by surface measurements and perception), and quality of life (QoL). Our minor outcomes were back pain, mental health, and adverse effects. MAIN RESULTS We included 13 RCTs (583 participants). The percentage of females ranged from 50% to 100%; mean age ranged from 12 to 15 years. Studies included participants with Cobb angles from low to severe. We judged 61% of the studies at low risk for random sequence generation and 46% at low risk for allocation concealment. None of the studies could blind participants and personnel. We judged the subjective outcomes at high risk of performance and detection bias, and the objective outcomes at high risk of detection bias in six studies and at low risk of bias in the other six studies. One study did not assess any objective outcomes. Comparing TE versus no treatment, we are very uncertain whether TE reduces the Cobb angle (mean difference (MD) -3.6°, 95% confidence interval (CI) -5.6 to -1.7; 2 studies, 52 participants). Low-certainty evidence indicates PSSE makes little or no difference in the angle of trunk rotation (ATR) (MD -0.8°, 95% CI -3.8 to 2.1; 1 study, 45 participants), may reduce the waist asymmetry slightly (MD -0.5 cm, 95% CI -0.8 to -0.3; 1 study, 45 participants), and may result in little to no difference in the score of cosmetic issues measured by the Spinal Appearance Questionnaire (SAQ) General (MD 0.7 points, 95% CI -0.1 to 1.4; 1 study, 16 participants). PSSE may result in little to no difference in self-image measured by the Scoliosis Research Society - 22 Patient Questionnaire (SRS-22) (MD 0.3 points, 95% CI -0.3 to 0.9; 1 study, 16 participants) and improve QoL slightly measured by SRS-22 Total score (MD 0.3 points, 95% CI 0.1 to 0.4; 2 studies, 61 participants). Only Cobb angle results were clinically meaningful. Comparing PSSE plus bracing versus bracing, low-certainty evidence indicates PSSE plus bracing may reduce Cobb angle (-2.2°, 95% CI -3.8 to -0.7; 2 studies, 84 participants). Comparing GTE plus other non-surgical interventions versus other non-surgical interventions, low-certainty evidence indicates GTE plus other non-surgical interventions may reduce Cobb angle (MD -8.0°, 95% CI -11.5 to -4.5; 1 study, 80 participants). We are uncertain whether PSSE plus other non-surgical interventions versus other non-surgical interventions reduces Cobb angle (MD -7.8°, 95% CI -12.5 to -3.1; 1 study, 18 participants) and ATR (MD -8.0°, 95% CI -12.7 to -3.3; 1 study, 18 participants). PSSE plus bracing versus bracing alone may make little to no difference in subjective measurement of cosmetic issues as measured by SAQ General (-0.2 points, 95% CI -0.9 to 0.5; 1 study, 34 participants), self-image score as measured by SRS-22 Self-Image (MD 0.1 points, 95% CI -0.3 to 0.5; 1 study, 34 participants), and QoL measured by SRS-22 Total score (MD 0.2 points, 95% CI -0.1 to 0.5; 1 study, 34 participants). None of these results were clinically meaningful. Comparing TE versus bracing, we are very uncertain whether PSSE allows progression of Cobb angle (MD 2.7°, 95% CI 0.3 to 5.0; 1 study, 60 participants), changes self-image measured by SRS-22 Self-Image (MD 0.1 points, 95% CI -1.0 to 1.1; 1 study, 60 participants), and QoL measured by SRS-22 Total score (MD 3.2 points, 95% CI 2.1 to 4.2; 1 study, 60 participants). None of these results were clinically meaningful. Comparing PSSE with GTE, we are uncertain whether PSSE makes little or no difference in Cobb angle (MD -3.0°, 95% CI -8.2 to 2.1; 4 studies, 192 participants; very low-certainty evidence). PSSE probably reduces ATR (clinically meaningful) (MD -3.0°, 95% CI -3.4 to -2.5; 2 studies, 138 participants). We are uncertain about the effect of PSSE on QoL measured by SRS-22 Total score (MD 0.26 points, 95% CI 0.11 to 0.62; 3 studies, 168 participants) and on self-image measured by SRS-22 Self-Image and Walter Reed Visual Assessment Scale (standardised mean difference (SMD) 0.77, 95% CI -0.61 to 2.14; 3 studies, 168 participants). Further, low-certainty evidence indicates that 38/100 people receiving GTE may progress more than 5° Cobb versus 7/100 receiving PSSE (risk ratio (RR) 0.19, 95% CI -0.67 to 0.52; 1 study, 110 participants). None of the included studies assessed adverse effects. AUTHORS' CONCLUSIONS The evidence on the efficacy of TE is currently sparse due to heterogeneity, small sample size, and many different comparisons. We found only one study following participants to the end of growth showing the efficacy of PSSE over TE. This result was weakened by adding studies with short-term results and unclear preparation of treating physiotherapists. More RCTs are needed to strengthen the current evidence and study other highly clinically relevant outcomes such as QoL, psychological and cosmetic issues, and back pain.
Collapse
Affiliation(s)
- Michele Romano
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | | | - Tomasz Kotwicki
- Department of Spine Disorders and Pediatric Orthopedics, University of Medical Sciences, Poznan, Poland
| | | | | | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| |
Collapse
|
6
|
Zhang P, Shen X, Zhang L, Wang S, Wu Q. Effect of sling exercise combined with Schroth therapy on adolescents with mild idiopathic scoliosis: A twelve-week randomized controlled trial. J Back Musculoskelet Rehabil 2024; 37:379-388. [PMID: 38043003 DOI: 10.3233/bmr-230102] [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: 12/04/2023]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is the most common structural deformity of the spine during adolescence, which could cause varying degrees of physical and mental damage to patients. Schroth therapy and sling exercise are widely used in the treatment of patients with AIS currently, and have shown the significant therapeutic effect relatively. OBJECTIVE To observe the efficacy of sling exercise combined with Schroth therapy on adolescents with mild idiopathic scoliosis (MIS). METHODS Sixty patients with AIS were randomly divided into the Schroth+sling group (n= 31) and the Schroth group (n= 29). Patients in both groups received Schroth therapy, and sling exercise was added in the Schroth+sling group. Before and after 12 weeks of treatment, the Cobb angle, angle of trunk rotation (ATR), Scoliosis Research Society-22 (SRS-22) scale score and averaged electromyography (AEMG) of bilateral paraspinal muscles were evaluated. RESULTS After the treatment, Cobb angle, ATR in both groups were decreased compared with those before (P< 0.001), and the decrease in the Schroth+sling group was more obvious (P< 0.05). The AEMG of bilateral paraspinal muscles and the total score, posture, mental health of SRS-22 of the two groups improved compared with those before treatment (P< 0.05), and the Schroth+sling group had a significant improvement than the Schroth group (P< 0.05). CONCLUSION Schroth therapy improved the degree of scoliosis, torticollis, quality of life, and bilateral paraspinal strength on adolescents with mild idiopathic scoliosis. The effect was more pronounced when the sling exercise was included in the treatment regimens.
Collapse
Affiliation(s)
- Peng Zhang
- Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jingsu, China
- Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jingsu, China
| | - Xiangyu Shen
- School of Physical Education and Sports, Soochow University, Suzhou, Jiangsu, China
- Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jingsu, China
| | - Lin Zhang
- Shanghai University of Sport, Shanghai, China
| | - Sheng Wang
- Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jingsu, China
| | - Qinfeng Wu
- Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, Jingsu, China
| |
Collapse
|
7
|
Chen Y, Zhang Z, Zhu Q. The effect of an exercise intervention on adolescent idiopathic scoliosis: a network meta-analysis. J Orthop Surg Res 2023; 18:655. [PMID: 37667353 PMCID: PMC10476432 DOI: 10.1186/s13018-023-04137-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/25/2023] [Indexed: 09/06/2023] Open
Abstract
PURPOSE To explore the effect of exercise intervention on adolescent idiopathic scoliosis (AIS), various exercise forms were compared and the sequence of the possibility of improving the effect of each exercise form was sorted out. We expect that our findings will provide clinicians and patients with more effective treatments and references. METHOD A thorough search was done on CNKI, Wanfang, WOS, Cochrane library, Embase, PubMed, Scopus and obtained the publication time from the database establishment to May 6, 2023. The relevant contents of the literature that passed the screening criteria were extracted, including relevant information about the sample, first author, intervention measures, intervention time, and outcome indicators. Analysis was performed by Review Manager 5.4 and Stata17.0. RESULT The study finally included 12 articles with 538 samples. After comparison, it was found that exercise interventions to reduce Cobb's angle were more effective than conventional therapies and reached a statistically significant difference. Compared with conventional therapy, core strength training, Physiotherapeutic Scoliosis-Specific Exercise (PSSE), yoga, Schroth, and sling reduced the Cobb angle by an average of 3.82 degrees, 3.79 degrees, 4.60 degrees, 3.63 degrees, and 3.30 degrees, respectively. However, the therapeutic effects on AIS did not show statistically significant differences between the exercise interventions. According to the SUCRA value and the cumulative probability, the MeanRank of improving the AIS effect by various sports intervention measures as follows: yoga (2.2), core strength training (2.8), PSSE (2.8), Schroth exercise (3.2), and sling exercise (4.0). CONCLUSION Exercise intervention can significantly improve AIS. There was no significant difference in the improvement effect of AIS among different exercise forms. Yoga may have the best effect on AIS improvement.
Collapse
Affiliation(s)
- Yonghuan Chen
- Department of Physical Education, Pukyong National University, Busan, South Korea
- School of Physical Education, Zhengzhou University, Zhengzhou, China
| | - Zhendong Zhang
- School of Physical Education, Zhengzhou Sias University, Zhengzhou, Henan, China
| | - Qiuhan Zhu
- School of Physical Education, Zhengzhou University, Zhengzhou, China.
| |
Collapse
|
8
|
Akeda K, Hasegawa T, Kawaguchi K, Yamada J, Takegami N, Fujiwara T, Sudo A. Daily Physical Training Improved Coronal Imbalance of Adult Degenerative Scoliosis: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1443. [PMID: 37629733 PMCID: PMC10456769 DOI: 10.3390/medicina59081443] [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: 07/26/2023] [Revised: 08/06/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: Adult (de novo) degenerative scoliosis (ADS) develops through degenerative changes in the lumbar spine, leading to spinal malalignment, which usually progresses with age. Strong evidence for non-operative care in patients with ADS is lacking, and whether physical exercise can improve the scoliosis curve remains unknown. Materials and Methods: We present a case of early stage ADS in which the coronal imbalance was improved by daily training. A 65-year-old female patient complained of lower back pain (LBP) and bilateral leg pain. She was diagnosed with early stage ADS with lumbar degenerative spondylolisthesis by imaging. She completed six months of daily physical training, including swimming, aerobic bikes, stretching, yoga, and Taijiquan. Results: Her LBP and neurological symptoms improved, and coronal-spinal balance was restored, which was maintained for four years by continued daily physical training. Conclusions: This is the first case of a 65-year-old ADS patient whose coronal balance was significantly restored through daily physical training. Substantial physical training focused on trunk muscle strength is important for spinal stabilization and for improving spinal malalignment in patients with early stage ADS.
Collapse
Affiliation(s)
- Koji Akeda
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Japan; (T.H.); (K.K.); (J.Y.); (N.T.); (T.F.); (A.S.)
| | | | | | | | | | | | | |
Collapse
|
9
|
An JK, Berman D, Schulz J. Back pain in adolescent idiopathic scoliosis: A comprehensive review. J Child Orthop 2023; 17:126-140. [PMID: 37034188 PMCID: PMC10080242 DOI: 10.1177/18632521221149058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/10/2022] [Indexed: 04/11/2023] Open
Abstract
Purpose Adolescent idiopathic scoliosis (AIS) is a common spinal deformity that affects millions of children worldwide. A variety of treatment algorithms exist for patients based on radiographic parameters such as the Cobb angle and the Risser stage. However, there has been a growing focus on nonradiographic outcomes such as back pain, which can cause functional disability and reduced quality of life for patients. In spite of this, back pain in AIS is poorly characterized in the literature. We aimed to summarize various factors that may influence back pain in AIS and the impact of different treatment methods on pain reduction. Methods A comprehensive systematic review was undertaken using the PubMed and Cochrane database. Keywords that were utilized and combined with "Adolescent Idiopathic Scoliosis" included, "back pain," "treatment," "biomechanics," "biochemistry," "epidemiology," and "biopsychosocial." The literature was subsequently evaluated and deemed relevant or not relevant for inclusion. Results A total of 93 articles were ultimately included in this review. A variety of contradictory literature was present for all sections related to epidemiology, underlying biomechanics and biochemistry, biopsychosocial factors, and treatment methodologies. Conclusion Back pain in AIS is common but remains difficult to predict and treat. The literature pertaining to causative factors and treatment options is heterogeneous and inconclusive. Longer-term prospective studies combining biopsychosocial intervention in conjunction with existing curve correction techniques would be meaningful.
Collapse
Affiliation(s)
- Juhyung K An
- College of Medicine, SUNY Downstate
Health Sciences University, Brooklyn, NY, USA
| | - Daniel Berman
- Department of Orthopedic Surgery,
Montefiore Medical Center, Bronx, NY, USA
- Daniel Berman, Apt 18L, 353 East 83rd
Street, New York, NY 10028, USA.
| | - Jacob Schulz
- Department of Orthopedic Surgery,
Montefiore Medical Center, Bronx, NY, USA
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Dimitrijević V, Šćepanović T, Jevtić N, Rašković B, Milankov V, Milosević Z, Ninković SS, Chockalingam N, Obradović B, Drid P. Application of the Schroth Method in the Treatment of Idiopathic Scoliosis: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16730. [PMID: 36554613 PMCID: PMC9779560 DOI: 10.3390/ijerph192416730] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Idiopathic scoliosis can be defined as a complex three-dimensional deformity of the spine and trunk, which occurs in basically healthy children. Schroth scoliosis-specific exercises have shown good results in reducing idiopathic scoliosis progression. This study aimed to critically evaluate the effect size of Schroth's method through a systematic review and meta-analysis. (2) Methods: Four databases were included in the search: PubMed, Cochrane Library, Web of Science, and Google Scholar. The following keywords were used: "Schroth exercise", "idiopathic scoliosis", "Cobb angle", "angle of trunk rotation", and "quality of life". Only articles written in English that met the following criteria were included in our study: subjects who had idiopathic scoliosis, the Schroth method was applied, and Cobb angle or angle of trunk rotation or quality of life as outcomes. (3) Results: Ten randomized controlled trials were included in this study. The effect size of the Schroth exercise ranged from almost moderate to large, for the outcomes used: Cobb angle (ES = -0.492, p ˂ 0.005); ATR (ES = -0.471, p = 0.013); QoL (ES = 1.087, p ˂ 0.001). (4) Conclusions: The current meta-analysis indicates that the Schroth method has a positive effect on subjects with idiopathic scoliosis.
Collapse
Affiliation(s)
- Vanja Dimitrijević
- Faculty of Sports and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Tijana Šćepanović
- Faculty of Sports and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | | | - Bojan Rašković
- Faculty of Sports and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Vukadin Milankov
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
- Institute for Children and Youth Health Care of Vojvodina, 21000 Novi Sad, Serbia
| | - Zoran Milosević
- Faculty of Sports and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Srđan S. Ninković
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
- Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK
| | - Borislav Obradović
- Faculty of Sports and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Patrik Drid
- Faculty of Sports and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| |
Collapse
|
12
|
Dimitrijević V, Viduka D, Šćepanović T, Maksimović N, Giustino V, Bianco A, Drid P. Effects of Schroth method and core stabilization exercises on idiopathic scoliosis: a systematic review and meta-analysis. 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 2022; 31:3500-3511. [PMID: 36229615 DOI: 10.1007/s00586-022-07407-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 08/02/2022] [Accepted: 09/24/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Conservative approaches such as Schroth exercises and core stabilization exercises showed effective results in the treatment of idiopathic scoliosis. This study aimed to critically evaluate the magnitude effect of Schroth and core stabilization exercises using a systematic review and meta-analysis. METHODS This study has been developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The following three databases were searched for articles collection: Web of Science, PubMed, and Google Scholar. The key search terms were: Schroth exercise, core exercise, idiopathic scoliosis, Cobb angle, angle of trunk rotation, and quality of life. The articles included in our study was limited to original articles written only in English that met the following inclusion criteria: (1) Participants with idiopathic scoliosis; (2) Schroth exercises and core stabilization exercises used as interventions; (3) Cobb angle or angle of trunk rotation or quality of life used as outcome measures. RESULTS Thirteen studies were included. Depending on the outcome measured, the magnitude effect of Schroth and core stabilization exercises ranged from small to almost large as follows: Cobb angle (SMD = - 0.376, p ˂ 0.001); angle of trunk rotation (SMD = - 0.268, p = 0.104); quality of life (SMD = 0.774, p = 0.002). By subgroup analysis, Schroth method showed a larger effect size than core stabilization exercises. CONCLUSION The current systematic review and meta-analysis indicates that both Schroth method and core stabilization exercises have a positive effect in subjects with idiopathic scoliosis. Subgroup analysis showed that the Schroth method had a larger effect size than the core stabilization exercises.
Collapse
Affiliation(s)
- Vanja Dimitrijević
- Faculty of Sports and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Dejan Viduka
- Faculty of Applied Management, Economics and Finance in Belgrade, University of Business Academy, Novi Sad, Serbia
| | - Tijana Šćepanović
- Faculty of Sports and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Nebojša Maksimović
- Faculty of Sports and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Valerio Giustino
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli, 6, 90144, Palermo, Italy.
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli, 6, 90144, Palermo, Italy
| | - Patrik Drid
- Faculty of Sports and Physical Education, University of Novi Sad, Novi Sad, Serbia
| |
Collapse
|
13
|
Wang B, Sun Y, Guo X, Cao J, Lu H, Chen W, Chen J, Zhu Q, Zhang C, Zhang M, Zhu F. The efficacy of 3D personalized insoles in moderate adolescent idiopathic scoliosis: a randomized controlled trial. BMC Musculoskelet Disord 2022; 23:983. [PMCID: PMC9661798 DOI: 10.1186/s12891-022-05952-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 11/06/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Bracing and exercise methods were used in scoliosis rehabilitation and proven effective. There was little evidence about the efficacy of insoles on scoliosis.
Objective
This study aimed to investigate the effects of 3D personalized insoles on curve magnitude, postural stability, and quality of life (QOL) in moderate adolescent idiopathic scoliosis (AIS) patients.
Methods
Thirty-six volunteers with adolescent idiopathic scoliosis, who had moderate curves (20°-45°), were randomly divided into the experimental and control groups. The control group received traditional rehabilitation with bracing and exercises, and the experimental group received the insole interventions in addition to traditional rehabilitation. The outcome measures were Cobb angle, angle of trunk rotation (ATR), postural stability, and quality of life (Scoliosis Research Society-22 questionnaire). Measurements were conducted at baseline examination, two months and six months.
Results
After two and six months of treatment, the Cobb angle and ATR in both groups were significantly decreased as compared with the baseline (p < 0.05), but no significant group difference in Cobb angle and ATR was found in the study (p > 0.05). There was a significant difference in the sagittal balance index at six months compared to the control group (p < 0.05), and a significant difference in the coronal balance index was observed at six months compared to baseline in the experimental group (p < 0.05). Quality of life did not change in either group (p > 0.05).
Conclusion
Combining bracing with exercise in patients with moderate AIS is effective. 3D personalized insoles cannot reduce the Cobb angle and angle of trunk rotation of patients with moderate AIS but might have the potential to improve postural stability.
Collapse
|
14
|
Muacevic A, Adler JR. Physiotherapy Interventions for Preventing Spinal Curve Progression in Adolescent Idiopathic Scoliosis: A Systematic Review. Cureus 2022; 14:e30314. [PMID: 36381707 PMCID: PMC9650952 DOI: 10.7759/cureus.30314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/13/2022] [Indexed: 12/02/2022] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is an abnormal curvature of the spine that appears in late childhood or adolescence. The aim of this systematic review was to present and synthesize the most relevant therapeutic advice and evidence on the efficacy of physiotherapy exercises for preventing the growth of spinal curvature caused by adolescent idiopathic scoliosis. "Adolescent idiopathic scoliosis," "exercise," "Cobb angle," and "physiotherapy" were the sole keywords used for the published research. Using these keywords and a combination of them, electronic resources such as PubMed, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), Elton B. Stephens Company (EBSCO) host, and ScienceDirect (Elsevier) were searched. The search was restricted to studies that were conducted in English between 2010 and 15 January 2022 that were controlled, randomized, and non-randomized. Studies were selected based on their titles and abstracts, with the exception of any that did not pertain to the study's goals. The Cobb angle was the important outcome measure. For each intervention, the Cobb angle's mean change score, the difference between the final and baseline scores, was determined. Nine studies were evaluated to be of outstanding quality out of a total of 20 studies that were reviewed for eligibility. With an exercise regimen of at least seven weeks, controls on lowering the Cobb angle in patients with AIS would provide encouraging outcomes. It also shows that bracing can strengthen the Cobb angle compared to exercise in the community. However, long-term orthotic activity ultimately results in trunk resistance and muscle loss in the center of the back. The combination of techniques and treatment methods seems to have better results in treating scoliosis, particularly using exercises involving the Schroth and scientific exercise approach to scoliosis (SEAS).
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
Physiotherapeutic Scoliosis-Specific Exercise Methodologies Used for Conservative Treatment of Adolescent Idiopathic Scoliosis, and Their Effectiveness: An Extended Literature Review of Current Research and Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159240. [PMID: 35954620 PMCID: PMC9368145 DOI: 10.3390/ijerph19159240] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 01/27/2023]
Abstract
Due to the multifactorial etiology of scoliosis, a comprehensive treatment plan is essential for conservative management. Physiotherapeutic scoliosis-specific exercise (PSSE) methods have lately gained popularity for the conservative treatment of scoliosis. The aim of this study was to analyze the PSSE methodologies used for conservative treatment of adolescent idiopathic scoliosis (AIS), as well as their effectiveness. The study was based on an extended literature search conducted in the PubMed, Google Scholar, PEDro, eLABA, and BioMed Central databases. A total of 123 articles were selected for this study (including articles overviewed in systematic reviews and meta-analyses) after applying the inclusion criteria. The study revealed that inappropriate management of AIS could result in serious health problems. Conservative interventions that aid in stabilizing spine curvature and improving esthetics are preferred for scoliosis treatment. Bracing has traditionally been the mainstay of treatment, but growing evidence suggests that PSSE physiotherapy allows effective management of idiopathic adolescent scoliosis. Currently, there are the following PSSE physiotherapy schools in Europe: Schroth, SEAS, BSPTS, FED, FITS, Lyon, Side Shift, and DoboMed. The methodologies of these schools are similar, in that they focus on applying corrective exercises in three planes, developing stability and balance, breathing exercises, and posture awareness. Although high-quality research supporting the effectiveness of PSSE physiotherapy in the treatment of AIS is lacking, existing evidence indicates that PSSE physiotherapy helps to stabilize spinal deformity and improve patients’ quality of life. Among the abovementioned methodologies, Schroth is the most widely studied and has been proven to be effective. However, both SEAS and BSPTS effectively stabilize and even reduce the Cobb angle of scoliosis. Data supporting the validity of other methodologies are very limited. Only the Schroth method significantly reduces the angle of trunk rotation, while both SEAS and Schroth methods greatly improve the quality of life indicators. In any case, the available evidence is insufficient to confirm the advantage of one specific physiotherapy technique over others.
Collapse
|
17
|
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.
Collapse
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.)
| |
Collapse
|
18
|
Dereli EE, Gong S, Çolak TK, Turnbull D. Guidelines for the conservative treatment of spinal deformities - Questionnaire for a Delphi consensus. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1587. [PMID: 34957343 PMCID: PMC8678962 DOI: 10.4102/sajp.v77i2.1587] [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: 06/05/2021] [Accepted: 10/29/2021] [Indexed: 11/11/2022] Open
Abstract
Background Spinal deformity is the oldest disease known to humankind. Many types of treatment methods, including both conservative and surgical, are in use. Objective We aimed to validate a published guideline protocol based on the conservative treatment of spinal deformities. Method A modified Delphi technique was used with a questionnaire sent out to professionals worldwide regarding the conservative treatment of spinal deformities. Results Our study was completed after two rounds. A strong level of agreement of 80% and more (consensus cut-off point) was achieved in most questions in the first round. Some statements were below this margin, and they were sent to the participants via email in the second round for re-evaluation. Consensus was achieved in almost all of the statements in the second round. Only two items did not reach the cut-off point but were close to this value. Conclusion This proposed Guideline Protocol was approved by the participants using the Delphi method and can be used as a valid tool for the conservative treatment of spinal deformities. Clinical implications A conservative treatment guideline in spinal deformity management, will provide consistency in treatment and will facilitate comparability with surgery. It will be useful in determining the cost-effectiveness of treatment and in choosing the right patient for the right method of treatment. This guideline might help in this context, and may also create a systematic method for clinicians to use as a reference in both research and clinical practice.
Collapse
Affiliation(s)
- Elif E Dereli
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Program, Istanbul Bilgi University, Istanbul, Turkey
| | - Shaopeng Gong
- Wuhan Schroth Scoliosis Service Center, Wuhan, Hubei, China
| | - Tuğba Kuru Çolak
- Faculty of Health Sciences, Physiotherapy and Rehabilitation, Marmara University, Istanbul, Turkey
| | - Deborah Turnbull
- School of Health and Social Care, University of Teesside, Middleborough, MA, United States of America.,The London Orthotic Consultancy, Kingston upon Thames, United Kingdom
| |
Collapse
|
19
|
Gámiz-Bermúdez F, Obrero-Gaitán E, Zagalaz-Anula N, Lomas-Vega R. Corrective exercise-based therapy for adolescent idiopathic scoliosis: Systematic review and meta-analysis. Clin Rehabil 2021; 36:597-608. [PMID: 34962437 DOI: 10.1177/02692155211070452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE to analyze the efficacy of Corrective exercise-based therapy in the improvement of deformity and quality of life in adolescent idiopathic scoliosis. DATA SOURCES PubMed Medline, Scopus, Web of Science (WOS), Physiotherapy Evidence Database, CINAHL Complete and SciELO, until June 2021. REVIEW METHODS Randomized controlled trials was selected, including participants diagnosed with adolescent idiopathic scoliosis, in which the experimental group received Corrective exercise-based therapy. Two authors independently searched the scientific literature in the data sources, extracted the data and assessed the risk of bias. A pairwise meta-analysis using the random-effects model was performed. RESULTS Eight randomized controlled trials providing data from 279 adolescent idiopathic scoliosis patients were included. Seven randomized controlled trials including 236 patients showed moderate-quality evidence for a medium effect (SMD = -0.52, 95% CI -0.96 to -0.1), favoring corrective exercise-based therapy for spinal deformity reduction. Corrective exercise-based therapy was better than no intervention (SMD = -0.59, 95% CI -1.18 to -0.01) but similar to other intervention (SMD = -0.2, 95% CI -0.67 to 0.27), and a medium effect was found (SMD = -0.51, 95% CI -0.89 to -0.13) when corrective exercise-based therapy was used with other therapies. Four studies including 151 patients showed low-quality evidence of a large effect of Corrective exercise-based therapy on Scoliosis Research Society measurement (SRS-22) total score improvement (SMD = 1.16, 95% CI 0.36 to 1.95). CONCLUSION In mild and moderate adolescent idiopathic scoliosis patients, corrective exercise-based therapy could be used to reduce spinal deformity and to improve quality of life as isolated treatment or as coadjuvant treatment combined with other therapeutic resources.
Collapse
|
20
|
Won SH, Oh DW, Shen M. An 18-month follow-up study on the effect of a neuromuscular stabilization technique on Cobb's angle in adolescent idiopathic scoliosis: A single-blind, age-matched controlled trial. J Back Musculoskelet Rehabil 2021; 34:87-93. [PMID: 32986652 DOI: 10.3233/bmr-191559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The benefits of spinal realignment and stabilization in scoliosis need to be examined. OBJECTIVE We aimed to investigate the long-term effect of a neuromuscular stabilization technique (NST) on Cobb's angle in patients with adolescent idiopathic scoliosis. METHODS Twenty females recruited from two hospitals participated in this study. On the basis of convenience of location, participants were allocated to either the experimental group (EG) that underwent the NST, or the control group (CG) that received education for a home exercise program. The NST for the EG was performed for an average of 30 min per session, three times a week for six months, and consisted of spinal realignment and stabilization. Then, 12- and 18-month measurements for long-term follow-ups were conducted for the EG. The outcome measure was Cobb's angle. RESULTS Between-group comparison revealed a statistically significant difference at post-test (t=-3.26, p< 0.01) but not pre-test (t=-1.36, p= 0.19). Participants of the EG (-6.20 ± 2.49∘) showed greater differences between pre- and post-test scores compared to participants of the CG (-1.40 ± 0.52∘) (p< 0.05). Within-group comparisons showed a significant difference in both groups (p< 0.05). In the EG, Cobb's angle significantly changed across the follow-up sessions (p< 0.05), indicating more improvements by the 12-month (8.50 ± 4.03∘) and 18-month (6.60 ± 3.89∘) follow-ups. CONCLUSION This study shows that the NST may be a beneficial option to correct spinal alignments in patients with adolescent idiopathic scoliosis.
Collapse
Affiliation(s)
| | - Duck-Won Oh
- Department of Physical Therapy, College of Health and Medical Science, Cheongju University, Cheongju, Korea
| | - Min Shen
- Shanghai Rehabilitation and Vocational Training Center for the Disabled, Shanghai, China
| |
Collapse
|
21
|
Athawale V, Phansopkar P, Darda P, Chitale N, Chinewar A. Impact of Physical Therapy on Pain and Function in a Patient With Scoliosis. Cureus 2021; 13:e15261. [PMID: 34188999 PMCID: PMC8232979 DOI: 10.7759/cureus.15261] [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] [Indexed: 01/20/2023] Open
Abstract
Human spine is a complex and robust structure. Almost all spine deformities contribute to limitations in activities of daily living. Scoliosis is the most common deformity accompanied by rotation and progresses during the growth of an individual. It is classified into three categories: congenital, idiopathic, and neuromuscular. The common secondary causes of scoliosis include cerebral palsy, poliomyelitis, and other neuromuscular conditions. A case of a 23-year-old female with right shoulder pain with a history of adolescent idiopathic scoliosis, which leads to a decrease in self-image and disturbance in activities of daily living, is presented in this report. The assessment, medical history, and rehabilitation protocol are mentioned in this case report. Physical therapy to treat shoulder joints includes thermotherapy and manual therapy targeting pain over the joint and stiffness. The use of thermotherapy, bracing, and strengthening and stretching exercises to prevent further deformity and aggravation of the symptoms is described in this report. We report that there was a significant improvement in muscle strength, relief from pain, spinal mobility, postural control, and decreases in further complications.
Collapse
Affiliation(s)
- Vrushali Athawale
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Pratik Phansopkar
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Palak Darda
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Neha Chitale
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Ashvini Chinewar
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| |
Collapse
|
22
|
Kocaman H, Bek N, Kaya MH, Büyükturan B, Yetiş M, Büyükturan Ö. The effectiveness of two different exercise approaches in adolescent idiopathic scoliosis: A single-blind, randomized-controlled trial. PLoS One 2021; 16:e0249492. [PMID: 33857180 PMCID: PMC8049223 DOI: 10.1371/journal.pone.0249492] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/16/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The purpose of this study was to compare the efficacy of two different types of exercise methods in patients with adolescent idiopathic scoliosis. METHODS In total, 28 subjects with adolescent idiopathic scoliosis with a mild curve magnitude (10°-26°) were randomly divided into two groups: the Schroth group (n = 14) and the core group (n = 14). The patients in the Schroth group were treated with supervised Schroth exercises, and the patients in the core group were treated with supervised core stabilization exercises; both groups performed the exercises for three days per week for a total of 10 weeks, and both were given additional traditional exercises to perform. Assessment included Cobb angle (Radiography), trunk rotation (Adam's test), cosmetic trunk deformity (Walter Reed Visual Assessment Scale), spinal mobility (Spinal Mouse), peripheral muscle strength (Biodex System 4-Pro), and quality of life (Scoliosis Research Society-22 questionnaire). RESULTS It was found that patients in the Schroth group showed greater improvement in Cobb angles, thoracic trunk rotation angle, cosmetic trunk deformity, spinal mobility, and quality of life than those in the core group (p<0.05), except for in lumbar trunk rotation angle. Peripheral muscle strength improvement was greater in the core group than in the Schroth group (p<0.05). CONCLUSION Schroth exercises are more effective than core stabilization exercises in the correction of scoliosis and related problems in mild adolescent idiopathic scoliosis, and core stabilization exercises are more effective than Schroth exercises in the improvement of peripheral muscle strength. TRIAL REGISTRATION NCT04421157.
Collapse
Affiliation(s)
- Hikmet Kocaman
- Department of Physiotherapy and Rehabilitation, Prosthetics-Orthotics Physiotherapy, Karamanoglu Mehmetbey University, Karaman, Turkey
| | - Nilgün Bek
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey
| | | | - Buket Büyükturan
- School of Physical Therapy and Rehabilitation, Ahi Evran University, Kırşehir, Turkey
| | - Mehmet Yetiş
- Department of Orthopedics and Traumatology, Faculty of Medicine, Ahi Evran University, Kırşehir, Turkey
| | - Öznur Büyükturan
- School of Physical Therapy and Rehabilitation, Ahi Evran University, Kırşehir, Turkey
| |
Collapse
|
23
|
The effects of exercise therapy on adolescent idiopathic scoliosis: An overview of systematic reviews and meta-analyses. Complement Ther Med 2021; 58:102697. [PMID: 33636298 DOI: 10.1016/j.ctim.2021.102697] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 02/04/2021] [Accepted: 02/20/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Exercise therapy was suggested as an appealing treatment option for Adolescent Idiopathic Scoliosis (AIS) patients with less side effects, lower economic costs, and more psychological benefits. Nevertheless, no unanimous findings about the efficacy of exercise therapy have been obtained from previous systematic reviews and/or meta-analyses. OBJECTIVE To provide an overview of previous systematic reviews and/or meta-analyses on the effectiveness of exercise therapy on AIS treatment. METHODS Systematic searches in Medline, Eric, CINAHL, Embase, SPORTDiscus, PsycINFO, and the Cochrane Library for systematic reviews and/or meta-analyses of randomized controlled trials (RCTs), non-randomized comparison studies (NRS) or observational studies using exercise as an intervention, and with outcome measures including Cobb angle, angle of trunk rotation (ATR), and quality of life. The methodological quality of the review articles was evaluated by A Measurement Tool to Assess Systematic Reviews (AMSTAR) checklist. RESULTS Ten systematic reviews and meta-analyses were included. The quality of most of the review articles is moderate with a mean score of 6/11 on the AMSTAR scale. Overall, there is increasing evidence showing the efficacy of exercise therapy on reducing the Cobb angle and angle of trunk rotation, and improving perceived quality of life. CONCLUSION Exercise therapy was found to have potential benefits to treat physiological and psychological aspects of AIS patients. However, the findings were not conclusive given that some reviews relied on data from the trials with potential risk of bias and significant heterogeneity. More high-quality research is still needed to verify these findings.
Collapse
|
24
|
Li X, Shen J, Liang J, Zhou X, Yang Y, Wang D, Wang S, Wang L, Wang H, Du Q. Effect of core-based exercise in people with scoliosis: A systematic review and meta-analysis. Clin Rehabil 2020; 35:669-680. [PMID: 33356498 PMCID: PMC8076838 DOI: 10.1177/0269215520975105] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To systematically assess the effectiveness of core-based exercise for correcting a spinal deformity and improving quality of life in people with scoliosis. DATA SOURCES The PubMed, Embase, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Web of Science databases were searched from inception up to September 30, 2020. METHODS Clinical controlled trials were eligible if they compared the effectiveness of core-based exercise to other nonsurgical interventions in people with scoliosis. The revised Cochrane risk of bias assessment tool for randomized trials and the methodological index for non-randomized studies scale were used to assess the risk of bias. The outcomes included the Cobb angle, the angle of trunk rotation and quality of life. RevMan 5.3 was used, and intergroup differences were determined by calculating mean differences (MD) and 95% confidence intervals (CIs). RESULTS After screening 1348 studies, nine studies with 325 participants met the inclusion criteria. The exercise group had significantly lower Cobb angles (MD = -2.08, 95% CI: -3.89 to -0.28, P = 0.02) and significantly better quality of life as measured by the Scoliosis Research Society-22 questionnaire (MD = 0.25, 95% CI: 0.02 to 0.49, P = 0.03) than the control groups. However, no significant difference was observed regarding the angle of trunk rotation between groups (MD = -0.69, 95% CI: -2.61 to 1.22, P = 0.48). Furthermore, no serious adverse events were reported. The overall quality of evidence ranged from low to very low. CONCLUSION Core-based exercise may have a beneficial role in reducing the Cobb angle and improving quality of life in people with scoliosis in the short term. PROSPERO REGISTRATION NUMBER CRD42020160509 (Available at http://www.crd.york.ac.uk/prospero/).
Collapse
Affiliation(s)
- Xin Li
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,School of Kinesiology, Shanghai University of Sport, Shanghai, People's Republic of China
| | - Jie Shen
- School of Kinesiology, Shanghai University of Sport, Shanghai, People's Republic of China
| | - Juping Liang
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Xuan Zhou
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yuqi Yang
- Shanghai University of Medicine & Health Sciences, Shanghai, People's Republic of China
| | - Dexuan Wang
- Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Shanshan Wang
- Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Lixia Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, People's Republic of China
| | - Hong Wang
- Shanghai University of Medicine & Health Sciences, Shanghai, People's Republic of China
| | - Qing Du
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Department of Rehabilitation, Chongming Branch of Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| |
Collapse
|
25
|
Effects of a Personalized Exercise Rehabilitation Device on Dynamic Postural Balance for Scoliotic Patients: A Feasibility Study. ELECTRONICS 2020. [DOI: 10.3390/electronics9122100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Scoliosis, which is defined as a 3-dimensional spine deformity, may be caused by new-onset degenerative changes that occur well after skeletal maturity and exhibit an asymmetrical postural balance pattern more common to adult deformity than adolescent scoliosis. The aim of this study was to verify whether an exercise program using a personalized exercise rehabilitation device can influence the dynamic postural balance of scoliotic patients. The personalized exercise rehabilitation device was designed to increase the efficacy of 3D postural correction for different curve patterns. 20 subjects were instructed to perform the personalized exercise program that consists of axial elongation, derotation, deflexion, facilitation and stabilization. The results of this study showed that the differences in clinical variables associated with imbalanced posture between the convex and concave side decreased after performing the personalized exercise. Consequentially, a well-designed and manufactured exercise rehabilitation device could be helpful for improving postural balance. Furthermore, the paper suggests that specific exercises using a personalized exercise rehabilitation device can provide the most appropriate exercise therapy and positively correct the asymmetrical postural balance patterns for scoliotic patients.
Collapse
|
26
|
Smit TH. Adolescent idiopathic scoliosis: The mechanobiology of differential growth. JOR Spine 2020; 3:e1115. [PMID: 33392452 PMCID: PMC7770204 DOI: 10.1002/jsp2.1115] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/02/2020] [Indexed: 12/16/2022] Open
Abstract
Adolescent idiopathic scoliosis (AIS) has been linked to neurological, genetic, hormonal, microbial, and environmental cues. Physically, however, AIS is a structural deformation, hence an adequate theory of etiology must provide an explanation for the forces involved. Earlier, we proposed differential growth as a possible mechanism for the slow, three-dimensional deformations observed in AIS. In the current perspective paper, the underlying mechanobiology of cells and tissues is explored. The musculoskeletal system is presented as a tensegrity-like structure, in which the skeletal compressive elements are stabilized by tensile muscles, ligaments, and fasciae. The upright posture of the human spine requires minimal muscular energy, resulting in less compression, and stability than in quadrupeds. Following Hueter-Volkmann Law, less compression allows for faster growth of vertebrae and intervertebral discs. The substantially larger intervertebral disc height observed in AIS patients suggests high intradiscal pressure, a condition favorable for notochordal cells; this promotes the production of proteoglycans and thereby osmotic pressure. Intradiscal pressure overstrains annulus fibrosus and longitudinal ligaments, which are then no longer able to remodel and grow, and consequently induce differential growth. Intradiscal pressure thus is proposed as the driver of AIS and may therefore be a promising target for prevention and treatment.
Collapse
Affiliation(s)
- Theodoor H. Smit
- Department of Orthopaedic SurgeryAmsterdam Movement Sciences, Amsterdam University Medical CentresAmsterdamNetherlands
- Department of Medical BiologyAmsterdam University Medical CentresAmsterdamNetherlands
| |
Collapse
|
27
|
Fan Y, Ren Q, To MKT, Cheung JPY. Effectiveness of scoliosis-specific exercises for alleviating adolescent idiopathic scoliosis: a systematic review. BMC Musculoskelet Disord 2020; 21:495. [PMID: 32718339 PMCID: PMC7385878 DOI: 10.1186/s12891-020-03517-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/20/2020] [Indexed: 12/27/2022] Open
Abstract
Background Adolescent idiopathic scoliosis (AIS) is the most common pediatric spinal deformity with reported complications including pain, mental health concern and respiratory dysfunction. The scoliosis-specific exercise (SSE) is prescribed throughout pubertal growth to slow progression although effects are unclear. This review aims to establish the effectiveness of SSE for alleviating AIS in terms of reducing Cobb angle, improving trunk asymmetry and quality of life (QoL). Additionally, it aims to define the effects of age, skeletal maturity, curve magnitude and exercise compliance on the outcomes of SSE. Methods A systematic reviewed was conducted to net SSE articles. Searched databases included PubMed, MEDLINE, Cochrane Library, Scopus, CINAHL and Google scholar. The quality of study was critically appraised according to the PEDro scale. Results A total of ten trials with an average PEDro score of 6.9/10 were examined in this study. Two randomized controlled trials (RCTs) and two clinical controlled trials suggested that SSE alone and with bracing or traditional exercise had clinical significance in reducing Cobb angle more than 5°. One RCT specifically implicated no comparable effects between bracing and SSE in prevention of curve progression for moderate scoliosis. There was insufficient evidence to support the positive effects of SSE on improving truck asymmetry (n = 4) and QoL (n = 3). Five studies evaluated the interaction effects of age (n = 2), skeletal maturity (n = 1) and curve magnitude (n = 2) with SSE in reducing Cobb angle yet without drawing any firm conclusions. Conclusions Insufficient evidence is available to prove that SSE with or without other conservative treatments can reduce Cobb angle, improve trunk balance and QoL. The interaction effects of age, skeletal maturity, curve magnitude, and exercise compliance with SSE in reducing Cobb angle are not proven. Future studies should investigate the relationship of influencing factors and SSE in treating AIS but not only testing its effectiveness. Trial registration INPLASY202050100.
Collapse
Affiliation(s)
- Yunli Fan
- Department of Orthopaedics and Traumatology, The University of Hong Kong - Shenzhen Hospital, 1 Haiyuan 1st Road, Futian District, Shenzhen, Guangdong, China.,Department of Physiotherapy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong province, China.,Department of Orthopaedics and Traumatology, The University of Hong Kong, 5/F Professional Block, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China
| | - Qing Ren
- Department of Orthopaedics and Traumatology, The University of Hong Kong, 5/F Professional Block, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China
| | - Michael Kai Tsun To
- Department of Orthopaedics and Traumatology, The University of Hong Kong - Shenzhen Hospital, 1 Haiyuan 1st Road, Futian District, Shenzhen, Guangdong, China.,Department of Orthopaedics and Traumatology, The University of Hong Kong, 5/F Professional Block, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China
| | - Jason Pui Yin Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong - Shenzhen Hospital, 1 Haiyuan 1st Road, Futian District, Shenzhen, Guangdong, China. .,Department of Orthopaedics and Traumatology, The University of Hong Kong, 5/F Professional Block, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China.
| |
Collapse
|
28
|
Sarkisova N, Andras LM, Yang J, Zaslow TL, Edison BR, Tolo VT, Skaggs DL. Side Plank Pose Exercises for Adolescent Idiopathic Scoliosis Patients. Glob Adv Health Med 2019; 8:2164956119887720. [PMID: 31723480 PMCID: PMC6831967 DOI: 10.1177/2164956119887720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/20/2019] [Accepted: 10/18/2019] [Indexed: 11/29/2022] Open
Abstract
Background Fishman et al. reported that side plank poses asymmetrically strengthened the
convex side of the curve and decreased primary Cobb angle by 49% among
compliant patients with adolescent idiopathic scoliosis (AIS). Methods AIS patients with curves of 10° to 45° were randomized into the front plank
(control) or side plank group. The side plank was performed with their curve
convex down. A weekly survey monitored compliance, defined by completing
poses 4 or more times a week. Results A total of 64 patients were enrolled; 34% (22 of 64) of patients (mean
age = 13 years) were compliant. In the control group, there were 11
compliant patients with 6 undergoing brace treatment. At enrollment, they
had a mean Cobb angle of 30° (range: 14°–40°) and mean scoliometer reading
of 13°. At 6 months, they had a mean Cobb angle of 30° (range: 14°–42°) and
mean scoliometer of 12°. In the side plank group, there were 11 compliant
patients with 5 undergoing brace treatment. At enrollment, they had a mean
Cobb angle of 32° (range: 21°–44°) and mean scoliometer reading of 12°. At
6 months, they had a mean Cobb angle of 31° (range: 17°–48°) and a mean
scoliometer reading of 13°. There were no significant changes in either the
control or side plank group in regards to primary Cobb angle (control:
P = .53, side plank: P = .67) or
scoliometer (control: P = .22, side plank:
P = .45). Conclusion There were no significant changes in primary Cobb angle or scoliometer after
6 months of side plank exercises. In contrast to a prior study, there was no
improvement in curve magnitude in AIS patients performing side plank
exercises.
Collapse
Affiliation(s)
- Natalya Sarkisova
- Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, California
| | - Lindsay M Andras
- Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, California
| | - Joshua Yang
- Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, California
| | - Tracy L Zaslow
- Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, California
| | - Bianca R Edison
- Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, California
| | - Vernon T Tolo
- Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, California
| | - David L Skaggs
- Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, California
| |
Collapse
|
29
|
Yagci G, Yakut Y. Core stabilization exercises versus scoliosis-specific exercises in moderate idiopathic scoliosis treatment. Prosthet Orthot Int 2019; 43:301-308. [PMID: 30628526 DOI: 10.1177/0309364618820144] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
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).
Collapse
Affiliation(s)
- Gozde Yagci
- 1 Faculty of Health Sciences, School of Physical Therapy and Rehabilitation Sciences, Orthotics and Biomechanics Department, Hacettepe University, Ankara, Turkey
| | - Yavuz Yakut
- 2 Physiotherapy and Rehabilitation Department, Hasan Kalyoncu University, Gaziantep, Turkey
| |
Collapse
|
30
|
Effectiveness of scoliosis-specific exercises for adolescent idiopathic scoliosis compared with other non-surgical interventions: a systematic review and meta-analysis. Physiotherapy 2019; 105:214-234. [DOI: 10.1016/j.physio.2018.10.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 10/12/2018] [Indexed: 12/15/2022]
|
31
|
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.
Collapse
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
| |
Collapse
|
32
|
Alayat MSM, Abdel-Kafy EM, Abdelaal AM. H-reflex changes in adolescents with idiopathic scoliosis: a randomized clinical trial. J Phys Ther Sci 2017; 29:1658-1663. [PMID: 28932008 PMCID: PMC5599841 DOI: 10.1589/jpts.29.1658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 06/19/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To detect H-reflex asymmetry and investigate the effect of direction sensitive exercise therapy protocol among patients with thoracolumbar and/or lumbar scoliosis. [Subjects and Methods] Fifty patients (10-17 years), Cobb's angle 10-20 degrees with thoracolumbar and lumbar scoliosis participated in the study. Soleus H-reflex was tested on both sides during prone lying position and standing position. Patients were randomly assigned into two groups. Group I received direction sensitive exercise therapy while the participants in group II received traditional exercise. Exercises were applied three times per week for twelve successive weeks. [Results] There were significant differences indicating asymmetry in the H-reflex amplitude on concave side. Cobb's angle significantly decreased and the H-reflex amplitude on concave side as well as H concave/convex ratios in both lying and standing significantly increased in both groups. Direction sensitive exercise therapy showed a more significant increase in the measured outcomes than traditional exercises therapy protocol. [Conclusion] H-reflex test was effective in discovering the asymmetry between concave and convex sides. Based on H-reflex test, direction-sensitive exercise therapy was more effective than traditional exercises in decreasing Cobb's angle and increasing H-reflex values as well as H/H percent in concave side in patients with adolescent idiopathic scoliosis.
Collapse
Affiliation(s)
| | - Ehab Mohamed Abdel-Kafy
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al-Qura University: Mecca 21955, Saudi Arabia
| | - Ashraf Mohamed Abdelaal
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al-Qura University: Mecca 21955, Saudi Arabia
| |
Collapse
|
33
|
Comparison of segmental spinal movement control in adolescents with and without idiopathic scoliosis using modified pressure biofeedback unit. PLoS One 2017; 12:e0181915. [PMID: 28753636 PMCID: PMC5533341 DOI: 10.1371/journal.pone.0181915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 06/13/2017] [Indexed: 11/19/2022] Open
Abstract
Background Postural rehabilitation emphasizing on motor control training of segmental spinal movements has been proposed to effectively reduce the scoliotic spinal deformities in adolescent idiopathic scoliosis (AIS). However, information regarding the impairments of segmental spinal movement control involving segmental spinal stabilizers in adolescent idiopathic scoliosis remains limited. Examination of segmental spinal movement control may provide a window for investigating the features of impaired movement control specific to spinal segments that may assist in the development of physiotherapeutic management of AIS. Objectives To compare segmental spinal movement control in adolescents with and without idiopathic scoliosis using modified pressure biofeedback unit. Methods Segmental spinal movement control was assessed in twenty adolescents with idiopathic scoliosis (AISG) and twenty healthy adolescents (CG) using a modified pressure biofeedback unit. Participants performed segmental spinal movements that primarily involved segmental spinal stabilizing muscles with graded and sustained muscle contraction against/off a pressure cuff from baseline to target pressures and then maintained for 1 min. Pressure data during the 1-minute maintenance phase were collected for further analysis. Pressure deviation were calculated and compared between groups. Results The AISG had significantly greater pressure deviations for all segmental spinal movements of cervical, thoracic, and lumbar spine than the CG. Conclusion Pressure biofeedback unit was feasible for assessing segmental spinal movement control in AIS. AISG exhibited poorer ability to grade and sustain muscle activities for local movements of cervical, thoracic, and lumbar spine, suggesting motor control training of segmental spinal movements involving segmental spinal stabilizing muscles on frontal, sagittal, and transverse planes were required.
Collapse
|
34
|
Ko KJ, Kang SJ. Effects of 12-week core stabilization exercise on the Cobb angle and lumbar muscle strength of adolescents with idiopathic scoliosis. J Exerc Rehabil 2017; 13:244-249. [PMID: 28503541 PMCID: PMC5412502 DOI: 10.12965/jer.1734952.476] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 04/15/2017] [Indexed: 11/22/2022] Open
Abstract
To identify the effects of core stabilization exercise on the Cobb angle and lumbar muscle strength of adolescent patients with idiopathic scoliosis. Subjects in the present study consisted of primary school students who were confirmed to have scoliosis on radiologic examination performed during their visit to the National Fitness Center in Seoul, Korea. Depending on whether they participated in a 12-week core stabilization exercise program, subjects were divided into the exercise (n=14, age 12.71±0.72 years) or control (n=15, age 12.80±0.86 years) group. The exercise group participated in three sessions of core stabilization exercise per week for 12 weeks. The Cobb angle, flexibility, and lumbar muscle strength tests were performed before and after core stabilization exercise. Repeated-measure two-way analysis of variance was performed to compare the treatment effects between the exercise and control groups. There was no significant difference in thoracic Cobb angle between the groups. The exercise group had a significant decrease in the lumbar Cobb angle after exercise compared to before exercise (P<0.001). The exercise group also had a significant increase in lumbar flexor and extensor muscles strength after exercise compared to before exercise (P<0.01 and P<0.001, respectively). Core stabilization exercise can be an effective therapeutic exercise to decrease the Cobb angle and improve lumbar muscle strength in adolescents with idiopathic scoliosis.
Collapse
Affiliation(s)
- Kwang-Jun Ko
- Department of Sports Medicine, National Health Fitness Center, Seoul, Korea
| | - Seol-Jung Kang
- Department of Physical Education, Changwon National University, Changwon, Korea
| |
Collapse
|