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Aktan-Ilgaz D, Sahiner H, Eraslan L, Gursen C, Guney-Deniz H. Effectiveness of bracing combined with exercise-based treatment of adolescent idiopathic scoliosis: Assessing the synergistic benefits: A systematic review. Prosthet Orthot Int 2024:00006479-990000000-00267. [PMID: 39298633 DOI: 10.1097/pxr.0000000000000362] [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: 08/02/2023] [Accepted: 03/29/2024] [Indexed: 09/22/2024]
Abstract
The purpose of this study was to evaluate evidence on the effectiveness of combined bracing and exercise on adolescent idiopathic scoliosis (AIS). From inception to April 28, 2022, PubMed and Web of Science searched for randomized clinical and nonrandomized prospective studies reporting Cobb angle (CA), angle of trunk rotation (ATR), quality of life (QoL), and pulmonary function (PF) in AIS patients treated with exercise and braces (10 years-skeletal maturity). Two authors analyzed and extracted data for this review. The PEDro scale was used to assess the risk of bias (RoB). Therapy protocols and basic data have been collected. Each CA, ATR, QoL, and PF study's evidence and strength were also included. A total of 12 studies with 714 patients with AIS were included. Five studies used a control group with exercises and 7 with braces. The results showed that exercise-brace can decrease CA and ATR and increase QoL and PF with AIS; however, the strength of conclusion for all outcomes was moderate. In this review, 4 studies were categorized as low RoB, 3 as moderate RoB, and 5 as high RoB. Level of evidence analysis revealed that 12 studies were classified as level of evidence B. The current studies do not sufficiently support the effects of exercise and brace therapy on CA, ATR, QoL, and PF in patients with AIS.
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Affiliation(s)
- Deniz Aktan-Ilgaz
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Sport Physiotherapy and Rehabilitation, Ankara, Turkey
- Alpha Med Orthosis and Prostetics Center, Istanbul, Turkey
| | - Hande Sahiner
- Alpha Med Orthosis and Prostetics Center, Istanbul, Turkey
| | - Leyla Eraslan
- Ankara Medipol University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Ceren Gursen
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Sport Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Hande Guney-Deniz
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Musculoskeletal Physiotherapy and Rehabilitation, Ankara, Turkey
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Fernandes IP, Gomes MVP, Andrade RM, Schmidt AV, Ribeiro AP, Magalhães MO. Translation, cross-cultural adaptation and clinimetric properties of the Brazilian Portuguese version of the Brace Questionnaire. Spine Deform 2024; 12:1337-1343. [PMID: 38689179 PMCID: PMC11343812 DOI: 10.1007/s43390-024-00883-2] [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: 02/01/2024] [Accepted: 04/05/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE To perform a cross-cultural adaptation and validation of the Brazilian-Portuguese versions of the Brace Questionnaire in adolescent idiopathic scoliosis. METHODS A forward-backward translation process was employed to produce a Brazilian Portuguese version of the Brace Questionnaire, followed by comprehensive cross-cultural adaptation stages. The measurements of internal consistency and test-retest reliability were assessed by Cronbach's a and intraclass correlation coefficient (ICC), respectively. The Pearson's correlation coefficient was used to analyze the concurrent validity by comparison with the Scoliosis Research Society-22r questionnaire. RESULTS A total of 84 scoliosis patients (age 13.4 ± 2.0 years, thoracic Cobb angle 33.3° ± 13.8°, and lumbar Cobb angle 29.8° ± 14.3°) were included. The Brace Questionnaire showed excellent internal consistency (Cronbach α = 0.93) and moderate reliability (ICC = 0.86). The correlations between the Brace Questionnaire and Scoliosis Research Society-22 were r = 0.66; p = 0.011. In addition, it was found that the Brazilian version of the Brace Questionnaire does not have ceiling and floor effects. CONCLUSIONS The Brazilian-Portuguese adaptation of the brace questionnaire shows excellent reliability and can be a valid tool for psychometric assessment in adolescent idiopathic scoliosis.
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Affiliation(s)
- Isabela Pedrosa Fernandes
- Faculty of Physical and Occupational Therapy, Institute of Health Sciences, Federal University of Pará (UFPA), Belém, Brazil
| | - Marcella Veronnica Pereira Gomes
- Post Graduation Program in Human Movement Sciences, Universidade Federal do Pará (UFPA), R. Augusto Corrêa, 01, Belém, PA, 66075-110, Brazil
| | | | | | - Ana Paula Ribeiro
- Laboratório de Biomecânica e Reabilitação Musculoesquelética, Health Science Post-Graduate Department, University Santo Amaro, São Paulo, Brazil
| | - Mauricio Oliveira Magalhães
- Post Graduation Program in Human Movement Sciences, Universidade Federal do Pará (UFPA), R. Augusto Corrêa, 01, Belém, PA, 66075-110, Brazil.
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Stein K, Holzgreve F, Keil F, Diaremes P, Groneberg DA, Wanke EM, Zabar O, Ohlendorf D. Improvement of pulmonary function parameters in female patients with adolescent idiopathic scoliosis by Schroth rehabilitative therapy. Heliyon 2024; 10:e34758. [PMID: 39166021 PMCID: PMC11333894 DOI: 10.1016/j.heliyon.2024.e34758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 05/13/2024] [Accepted: 07/16/2024] [Indexed: 08/22/2024] Open
Abstract
Objective This study investigates if an inpatient rehabilitation therapy (brace therapy and Schroth therapy) for six weeks contributes to an improvement in lung function of the patients. Design Retrospective study. Setting Scoliosis rehabilitation clinic "Asklepios Katharina-Schroth-Klinik" (Bad Sobernheim, Germany). Participants In 253 female patients a lung function examination was performed at entry and at the end of their inpatient rehabilitation stay. Of these, 61 patients underwent Schroth therapy (group 1); 192 patients underwent the combination of brace and Schroth therapy (group 2). Intervention Lung function parameters under the influence of Schroth and Schroth and brace therapy within a rehabilitative stay. Main measures The parameters of IVC (inspiratory vital capacity), FVC (forced vital capacity), FEV1 (forced expiratory volume in 1 s) and the Tiffeneau index (FEV/FVC) related to patient-specific reference values were evaluated with regard to potential ventilation disorders. Results There were significant improvements for IVC +2.56 %, FVC +3.99 %, FEV1 +2.36 % for the first stay (IVC and FVC 2nd, 3rd stay). The comparison of patients with vs. without additional brace therapy showed no significances. For the long-term analysis the parameters approached the reference values of age-matched, healthy female subjects. The greater the Cobb angle in the thoracic region, the significantly worse almost each of the measured parameters are. Conclusion An inpatient rehabilitation therapy contributes to an improvement in lung function (IVC, FVC and FEV1). A second, and even a third, follow-up stay still led to a measurable improvement in lung function, albeit to a lesser extent.
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Affiliation(s)
- Kyra Stein
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, Frankfurt/Main, Germany
| | - Fabian Holzgreve
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, Frankfurt/Main, Germany
| | - Fee Keil
- Institute of Neuroradiology, Goethe-University, Frankfurt/Main, Germany
| | - Panagiotis Diaremes
- Clinic for Orthopaedics (Friedrichsheim), University Hospital Frankfurt, Goethe University Frankfurt/Main, Frankfurt/Main, Germany
| | - David A. Groneberg
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, Frankfurt/Main, Germany
| | - Eileen M. Wanke
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, Frankfurt/Main, Germany
| | - Omar Zabar
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, Frankfurt/Main, Germany
- Asklepios Katharina-Schroth-Clinic, Orthopedics, Bad Sobernheim, Germany
| | - Daniela Ohlendorf
- Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, Frankfurt/Main, Germany
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Unuvar BS, Yilmaz K, Celik F. Answer to the letter to the editor of Weiss HR concerning "the acute effects of brace use on lower extremity performance in individuals with adolescent idiopathic scoliosis" by Unuvar BS, Yilmaz K, and Celik F (Ir J Med Sci. 2023). Ir J Med Sci 2024; 193:1863-1864. [PMID: 38386275 DOI: 10.1007/s11845-024-03639-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 02/13/2024] [Indexed: 02/23/2024]
Affiliation(s)
- Bayram Sonmez Unuvar
- Faculty of Health Sciences, Department of Audiology, KTO Karatay University, Konya, Turkey.
| | - Kamil Yilmaz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, KTO Karatay University, Konya, Turkey
| | - Fatih Celik
- Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Çetinkaya İ, Kuru Çolak T, Saka S, Korkmaz MF. Respiratory function and respiratory muscle strength in adolescent idiopathic scoliosis. Spine Deform 2024; 12:635-641. [PMID: 38329601 DOI: 10.1007/s43390-024-00819-w] [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: 06/02/2023] [Accepted: 12/30/2023] [Indexed: 02/09/2024]
Abstract
PURPOSE It was aimed to analyze the relationship of the respiratory functions, respiratory muscle strength, magnitude of the curvature, angle of trunk rotation (ATR) and brace-wearing duration in patients with adolescent idiopathic scoliosis (AIS). METHODS Sixty patients with AIS (43 females), with maximum Cobb angles between 20° and 66° were included in the study. ATR values were measured with a scoliometer. Respiratory function parameters (forced vital capacity [FVC], forced expiratory volume in one second [FEV1], FEV1/FVC ratio, peak expiratory flow [PEF]) and respiratory muscle strengths (maximum inspiratory pressure [MIP] and maximum expiratory pressure [MEP]) were measured by combined spirometry. RESULTS There was a negative significant correlation between maximum Cobb angle and ATR with respiratory function parameters except for PEF and FEV1/FVC (r = -0.258-0.441; p = <0.001-0.047). There was a moderate negative correlation between ATR with MIP (cmH2O) (r = -0.377; p = 0.003) and MEP (cmH2O) (r = -0.362; p = 0.005). On the other hand, no correlation was found between brace-wearing duration with respiratory functions, maximum Cobb angle and brace-wearing duration with respiratory muscle results. CONCLUSION The results of this study showed that, respiratory functions were normal or mildly affected, and respiratory muscle strengths were weak in AIS. Increased Cobb angle and ATR negatively affected respiratory function; increased ATR was associated with decreased inspiratory and expiratory muscle strength. It is extremely important to carefully evaluate the respiratory system and to know the variables that affect respiratory functions and respiratory muscle strength in achieving optimum recovery in the holistic treatment of individuals with scoliosis.
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Affiliation(s)
- İrem Çetinkaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Haliç University, 5. Levent Mahallesi, 15 Temmuz Şehitler Caddesi, No: 14/12, 34060, Eyüpsultan, Istanbul, Turkey.
| | - Tuğba Kuru Çolak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Seda Saka
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Haliç University, 5. Levent Mahallesi, 15 Temmuz Şehitler Caddesi, No: 14/12, 34060, Eyüpsultan, Istanbul, Turkey
| | - Mehmet Fatih Korkmaz
- Department of Orthopedics and Traumatology, Prof. Dr. Süleyman Yalçın City Hospital, İstanbul Medeniyet University, Istanbul, Turkey
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Heegaard M, Tøndevold N, Dahl B, Andersen TB, Gehrchen M, Ohrt-Nissen S. The influence of night-time bracing on curve progression is not affected by curve magnitude in adolescent idiopathic scoliosis: a study of 299 patients. Acta Orthop 2024; 95:108-113. [PMID: 38347730 PMCID: PMC10863495 DOI: 10.2340/17453674.2024.39965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/06/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND AND PURPOSE The efficacy of bracing larger curves in adolescent idiopathic scoliosis (AIS) patients is uncertain. We aimed to assess the influence of night-time bracing in AIS patients with main curves exceeding 40° Cobb angle at brace initiation. METHODS We reviewed AIS patients treated with nighttime braces between 2005 and 2018. Patients with curves ≥ 25° and estimated growth potential were included. Patients were monitored with radiographs from brace initiation until brace weaning at skeletal maturity. Patients were grouped based on curve magnitude at initial evaluation: a control group (25-39°) and a large-curves group (≥ 40°). Progression was defined as > 5° increase. RESULTS We included 299 patients (control group, n = 125; large-curves group, n = 174). In the control group, 65 (52%) patients progressed compared with 101 (58%) in the large-curves group (P = 0.3). The lower-end vertebra (LEV) shifted distally post-bracing in 41 (23%) patients in the largecurves group. Patients with progressive large curves were younger (age 13.2 [SD 1.5] vs. 13.9 [SD 1.1], P = 0.009) and more premenarchal (n = 36 [42%] vs. n = 6 [9%], P < 0.001) compared with non-progressive large curves. CONCLUSION Progression risk in patients with curves exceeding 40° treated with night-time bracing is similar to smaller curves. The LEV moved distally in almost one-fourth of the larger curves, possibly affecting fusion levels in cases of surgery.
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Affiliation(s)
- Martin Heegaard
- Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Niklas Tøndevold
- Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Benny Dahl
- Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Thomas B Andersen
- Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Martin Gehrchen
- Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Søren Ohrt-Nissen
- Spine Unit, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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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.
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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.
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Vigouroux M, Newman G, Amja K, Hovey RB. "He told me my pain was in my head": mitigating testimonial injustice through peer support. FRONTIERS IN PAIN RESEARCH 2023; 4:1125963. [PMID: 37283705 PMCID: PMC10239879 DOI: 10.3389/fpain.2023.1125963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/09/2023] [Indexed: 06/08/2023] Open
Abstract
Introduction Women with disabilities are exposed to sexism and ableism, earn less income, and work in exceptionally challenging conditions compared to women without disabilities and men with or without disabilities. Adolescent girls living with scoliosis may begin experiencing this compounding bias during their encounters with healthcare from the moment they start noticing differences in their bodies. Being significantly more likely than boys to progress to a curve angle where painful treatment such as bracing or spinal fusion surgery is required, adolescent girls living with scoliosis are therefore more likely to experience chronic pain. The long-term impact of pain and pain-related stigma includes lower educational attainments, decreased vocational functionality, and social impairments in adults after having experienced chronic pain in adolescence. Approach In this article, the authors will explore the effects and mechanisms of gender-specific peer support in disrupting this trajectory to adverse outcomes. Through individual interviews consisting of open-ended questions, the researchers gathered narrative data from Curvy Girls members, a community-based peer support group for girls and young women living with scoliosis. The data was analyzed using an applied philosophical hermeneutics approach, with intersectionality and testimonial injustice as their framework. Findings They found that the study participants had their pain narratives reinterpreted by the adults in their lives, including their parents and healthcare practitioners, leading them to question and doubt their own experiences. Discussion These negative outcomes were mitigated through the peer support they received and offered from Curvy Girls. Participants reported having gained confidence and a sense of belonging after they joined this group, allowing them to better cope with their condition more effectively in different facets of their lives.
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Affiliation(s)
- Marie Vigouroux
- Department of Integrated Studies in Education, Faculty of Education, McGill University, Montreal, QC, Canada
- Institute for Gender, Sexuality and Feminist Studies, Faculty of Arts, McGill University, Montreal, QC, Canada
| | | | - Kristina Amja
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Richard Bruce Hovey
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
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Rezaeian Z, Andalib A, Bokaee F, Poorpooneh Najafabadi M, Yeowell G, Sadeghi-Demneh E. The efficacy of trunk bracing with an instrumented corrective exercise on spinal deformity, pulmonary function, trunk muscle endurance and quality of life in adolescent idiopathic scoliosis: Protocol for a parallel-groups clinical study (Preprint). JMIR Res Protoc 2022; 12:e43265. [PMID: 36989018 PMCID: PMC10131677 DOI: 10.2196/43265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis is a 3D spine distortion with an unidentified etiology. It results in noticeable trunk deformity, decreased muscle strength and endurance at the trunk, changes in chest volume, breathing issues, and ultimately a decline in the quality of life. Trunk bracing and corrective exercises make up most of the treatment of patients with scoliosis when their deformity is between 20° and 45°, and they have not yet attained skeletal maturity. Evidence suggests that spinal deformity in people with scoliosis may result from improper motor control. Automatic response training is an exercise therapy technique that can modify the pattern of trunk muscle control for supporting the spinal column in normal alignment. An apparatus called a cantilever device is required for this type of exercise, which facilitates training at home. In spite of research showing the benefit of braces and therapeutic exercise in adolescents with scoliosis, less emphasis has been given to the impact of home-based training, especially when this intervention is paired with braces. OBJECTIVE We aim to compare the efficacy of bracing and a conventional exercise program to a combination treatment that includes trunk bracing and exercises with a cantilever device performed at home on the degree of spine curvature, pulmonary function, trunk muscular endurance, and quality of life. METHODS This study was a 2-arms parallel-group clinical study. A total of 16 adolescents with idiopathic scoliosis and single lumbar and thoracolumbar curves of 20°-45° were recruited and randomly assigned into 2 groups. Group A received a combination of trunk bracing and exercise using an instrument known as a "cantilever." Group B (controls) received trunk bracing and a conventional exercise program (without a tool). The study outcomes were the Cobb angle of the scoliotic curve, pulmonary function, the endurance of the trunk muscles, and quality of life. The study outcomes were measured at 2 time points: before the intervention (T1) and 12 weeks following the start of the intervention (T2; at this time, the intervention period has been completed). Multivariate analysis of variance was used to test between- and within-group differences. RESULTS Recruitment for this study began in fall 2022 and is expected to be completed by the end of summer 2023. CONCLUSIONS We studied the efficacy of a combined trunk bracing program and postural response exercises using a cantilever device in treating adolescent idiopathic scoliosis and compared it with trunk bracing and conventional home exercises. Exercises performed at home using a cantilever device are anticipated to raise the endurance of trunk muscles, which will help reduce trunk deformity, enhance pulmonary function, and improve the quality of life of participants. TRIAL REGISTRATION Iranian Registry of Clinical Trials IRCT20220330054371N1; https://www.irct.ir/trial/62811. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/43265.
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Affiliation(s)
- Zeinab Rezaeian
- Department of Orthotics and Prosthetics, Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Andalib
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fateme Bokaee
- Department of Physiotherapy, Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Ebrahim Sadeghi-Demneh
- Department of Orthotics and Prosthetics, Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Pulmonary function in children and adolescents with untreated idiopathic scoliosis: a systematic review with meta-regression analysis. Spine J 2022; 22:1178-1190. [PMID: 34963629 DOI: 10.1016/j.spinee.2021.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/21/2021] [Accepted: 12/20/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT One of the controversies in untreated idiopathic scoliosis is the influence of curve size on respiratory function. Whereas scoliosis patients with curves over 90 to 100 degrees are agreed to be at risk for cardiorespiratory failure in later life, the impairment of curves below 90 degrees is generally considered mild. Although various studies showed that pulmonary function is affected in patients with scoliosis, quantification of the relation between curve size and pulmonary function is lacking. PURPOSE This systematic review with meta-regression analysis aims to characterize the relation between pulmonary function tests and scoliosis severity in children and adolescents with idiopathic scoliosis. STUDY DESIGN Systematic review with meta-regression analysis. METHODS Pubmed, Embase, Cochrane, and CINAHL were systematically searched until November 3, 2020, for original articles that reported (1) severity of scoliosis quantified in Cobb angle, and (2) pulmonary function tests in children and adolescents with untreated idiopathic scoliosis. Exclusion criteria were other types of scoliosis, non-original data, post-treatment data, and case reports. All study designs were included, and relevant study details and patient characteristics were extracted. The primary outcome was the effect of Cobb angle on pulmonary function as expressed by the slope coefficient of a linear meta-regression analysis. RESULTS A total of 126 studies, including 8,723 patients, were retrieved. Meta-regression analysis revealed a statistically significant inverse relation between thoracic Cobb angle and absolute and predicted forced vital capacity in 1 second, forced vital capacity, vital capacity, and total lung capacity. For these outcomes, the slope coefficients showed a decrease of 1% of the predicted pulmonary function per 2.6 to 4.5 degrees of scoliosis. A multivariable meta-regression analysis of potential confounders (age, year of publication, and kyphosis) hardly affected the majority of the outcomes. CONCLUSION This meta-regression analysis of summary data (means) from 126 studies showed an inverse relationship between the thoracic Cobb angle and pulmonary function. In contrast to previous conclusions, the decline in pulmonary function appears to be gradual over the full range of Cobb angles between <20 and >120 degrees. These findings strengthen the relevance of minimizing curve progression in children with idiopathic scoliosis.
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Exploration of Contributory Factors to an Unpleasant Bracing Experience of Adolescent Idiopathic Scoliosis Patients a Quantitative and Qualitative Research. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050635. [PMID: 35626812 PMCID: PMC9139334 DOI: 10.3390/children9050635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/15/2022] [Accepted: 04/24/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND To obtain a better understanding of the wearing habits and preferences of Adolescent Idiopathic Scoliosis (AIS) patients undergoing rigid brace treatment, we examine what factors contribute to patients' perceived discomfort during the treatment. METHODS Seventeen AIS patients treated with a rigid brace were recruited. We asked them to complete a questionnaire and participate in an interview study. Finally, we measure the interface corrective force and perceived discomfort with the participants for different positions and assess the correlation. RESULTS Our survey reveals that participants scored the lowest in the domains of environmental factors, psycho-spiritual factors, satisfaction, and self-image. Appearance anxiety, physical and psychological discomfort and inconvenience were the three most frequently mentioned problems in the interviews on participants' daily bracing experiences. A significant, moderately positive relationship between corrective force and discomfort level was found only when participants were lying on their left side, but not in any of the other positions. No significant correlation between treatment length and perceived discomfort was found. CONCLUSIONS Future work should focus on reducing the psychological burden and the inconvenience of wearing a brace, rather than on reducing physical discomfort resulting from the corrective force.
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A 10-Week Program of Combined Hippotherapy and Scroth's Exercises Improves Balance and Postural Asymmetries in Adolescence Idiopathic Scoliosis: A Randomized Controlled Study. CHILDREN (BASEL, SWITZERLAND) 2021; 9:children9010023. [PMID: 35053648 PMCID: PMC8774272 DOI: 10.3390/children9010023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/24/2021] [Accepted: 12/07/2021] [Indexed: 01/12/2023]
Abstract
Introduction: The most frequent type of spine abnormality throughout adolescence was adolescent idiopathic scoliosis (AIS). Hippotherapy improved posture, balance and gait of different musculoskeletal conditions. Therefore, this study aims to see how hippotherapy combined with Schroth exercises affected postural asymmetry and dynamic balance in AIS compared to traditional physiotherapy (Schroth exercises) alone. Materials and methods: In this randomized controlled trial, fifty-two patients with AIS (10–18 years, 37 girls and 15 boys) participated. They were arbitrarily allocated into two groups: experimental (19 female/8 male; aged 14.74 ± 1.79 years; Cobb angle 18.59 ± 2.66 degrees) and control (18 female/7 male; aged 15.04 ± 1.81 years; Cobb angle 19.32 ± 2.69 degrees) groups. Both groups received Schroth exercises for 10 weeks, three days/week. The experimental group additionally received hippotherapy training. Pre-treatment and post-treatment assessment for the scoliotic, kyphotic angle, pelvic obliquity, pelvic torsion and vertical spinal rotation and the anteroposterior, mediolateral and overall stability indices were assessed using the formetric system 4D and Biodex Balance System, respectively. Results: After intervention, both groups illustrated significant improvements in all examined variables (p < 0.05). The experimental group illustrated significant improvements in scoliotic angle, kyphotic angle, pelvic obliquity, pelvic torsion and vertical spinal rotation and the stability indices compared to the control group (p < 0.05). Conclusion: In adolescence idiopathic scoliosis, hippotherapy training combined with Schroth exercises improves posture asymmetry and balancing ability more effectively than Schroth exercises alone.
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León-Morillas F, de Oliveira-Sousa SL, Andrade-Ortega JA, Ibáñez-Vera AJ, Lomas-Vega R, Zagalaz-Anula N. The Type of Conservative Management Could Be Related to the Strength of the Inspiratory Muscles of Adolescents with Idiopathic Scoliosis—A Case Series. CHILDREN 2021; 8:children8111002. [PMID: 34828715 PMCID: PMC8619345 DOI: 10.3390/children8111002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 10/26/2021] [Accepted: 11/01/2021] [Indexed: 11/16/2022]
Abstract
Adolescent idiopathic scoliosis (AIS) is a lateral curvature of the spine with a Cobb angle of at least 10° with an unknown etiology. It is recognized that AIS may affect respiratory function. This study aims to describe and compare respiratory function in a case series of patients with scoliosis who underwent different types of therapeutic management: no intervention, orthotic brace, and global postural reeducation (GPR). Fifteen AIS patients were included in this study (seven no intervention, four orthotic brace and four GPR). Lung function and inspiratory muscle strength were measured and analyzed, as well as sociodemographic, clinical, and anthropometric variables. Significant correlations were observed between height (cm) and maximum inspiratory pressure (MIP) reference (cmH2O) and forced vital capacity (FVC) (liters) (r = 0.650 and r = 0.673, respectively; p < 0.01); weight (Kg) and MIP reference (cmH2O) (r = 0.727; p < 0.01); and Main curve degrees (Cobb angle) and FVC% (r = −0.648; p < 0.01). The AIS cases that underwent GPR treatment presented a greater MIP (% predictive) compared to the no intervention and brace cases (201.1% versus 126.1% and 78.4%, respectively; p < 0.05). The results of this case series show a possible relation whereby patients undergoing treatment with the GPR method have greater inspiratory muscle strength compared to the no intervention and brace cases. Studies with larger samples and prospective designs must be performed to corroborate these results.
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Affiliation(s)
- Felipe León-Morillas
- Department of Physiotherapy, Catholic University of Murcia UCAM, Avenida de los Jerónimos, 30107 Murcia, Spain;
| | | | - Juan Alfonso Andrade-Ortega
- Department of Physical Medicine and Rehabilitation, Complejo Hospitalario de Jaen, Avenue of Madrid, 23001 Jaén, Spain;
| | - Alfonso Javier Ibáñez-Vera
- Department of Health Sciences, University of Jaen, Campus de las Lagunillas, 23071 Jaén, Spain; (R.L.-V.); (N.Z.-A.)
- Correspondence: ; Tel.: +34-953-213-519
| | - Rafael Lomas-Vega
- Department of Health Sciences, University of Jaen, Campus de las Lagunillas, 23071 Jaén, Spain; (R.L.-V.); (N.Z.-A.)
| | - Noelia Zagalaz-Anula
- Department of Health Sciences, University of Jaen, Campus de las Lagunillas, 23071 Jaén, Spain; (R.L.-V.); (N.Z.-A.)
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Immediate Effects of Sforzesco ® Bracing on Respiratory Function in Adolescents with Idiopathic Scoliosis. Healthcare (Basel) 2021; 9:healthcare9101372. [PMID: 34683052 PMCID: PMC8535408 DOI: 10.3390/healthcare9101372] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/01/2022] Open
Abstract
The thoraco-lumbar bracing is an effective management of adolescent idiopathic scoliosis (AIS). Studies have shown that brace wearing reduces lung volume. Whether or not the Sforzesco brace, frequently used in Italy, affects lung volume has not been investigated. We studied the immediate effect of Sforzesco bracing on lung volumes in 11 AIS patients (10 F, 1 M; aged 13.6 ± 1.6 yrs) mean Cobb angle 26 ± 4.49 degrees. Lung function variables and the perceived respiratory effort were recorded twice, before and 5 min after bracing. The one-way analysis of variance repeated measures, and multiple comparison tests, showed that means of unbraced variables were not significantly different from the corresponding means of predicted values, whereas means under brace were significantly lower (p < 0.05) compared to both predicted and baseline values of respiratory variables. In addition, a significant correlation (p < 0.0001) was found between unbraced and braced values, and linear regression equations were calculated. A significant but clinically unimportant increase in perceived effort was observed under the brace. In conclusion, data indicate that lung function is not impaired in moderate AIS and that wearing the Sforzesco brace causes an immediate, predictable reduction of lung volumes. Data also suggest that the respiratory discomfort during brace wearing could not be due to respiratory function defects.
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Yurt Y, Yatar İ, Malkoç M, Yakut Y, Mıhçıoğlu S, Koltak C. The effect of brace treatment on pulmonary functions in adolescent idiopathic scoliosis: An 8-month follow-up study. J Back Musculoskelet Rehabil 2021; 34:887-893. [PMID: 34151821 DOI: 10.3233/bmr-200195] [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 instant effect of a brace on pulmonary functions of patients with adolescent idiopathic scoliosis (AIS) is known. However, the permanent effects of its regular use are still unclear. OBJECTIVE This study aimed to determine whether a brace in patients with AIS had a permanent effect on respiratory functions. METHODS Fifteen patients with a mean age of 13.2 ± 1.6 years, and a major Cobb angle of 25.8∘± 7.7∘ participated in this study. Lung volumes and respiratory muscle strength were measured with and without thoracolumbosacral brace, at the end of first month and follow-up period after the patients started using the brace for 23 hours daily. RESULTS When the brace was on, the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), ratio of FEV1/FVC, peak expiratory flow, and forced expiratory flow between 25% and 75% of vital capacity values were found to be lower at both first month and follow-up. After the follow-up, the measurement results did not differ from the results of the first month. CONCLUSIONS The brace had a momentary restrictive effect on patients with AIS. However, it did not cause a permanent change in pulmonary functions after the 8-month follow-up.
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Affiliation(s)
- Yasin Yurt
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Eastern Mediterranean University, Mersin, Turkey
| | - İlker Yatar
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Eastern Mediterranean University, Mersin, Turkey
| | - Mehtap Malkoç
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Eastern Mediterranean University, Mersin, Turkey
| | - Yavuz Yakut
- Institute of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Serpil Mıhçıoğlu
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Eastern Mediterranean University, Mersin, Turkey
| | - Cansu Koltak
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Eastern Mediterranean University, Mersin, Turkey
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Potts MA. Letter to the editor regarding: In-brace alterations of pulmonary functions in adolescents wearing a brace for idiopathic scoliosis. Prosthet Orthot Int 2021; 45:102. [PMID: 33146073 DOI: 10.1177/0309364620967510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Zhang Z, Ma X, Yin J, Shu L, Gao R, Ma J, Zhou X. Alterations of sagittal alignment and thoracic cage parameters after long-term bracing in adolescents with idiopathic scoliosis. Orthop Traumatol Surg Res 2020; 106:1257-1262. [PMID: 33023844 DOI: 10.1016/j.otsr.2020.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 05/24/2020] [Accepted: 06/02/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Sagittal alignment and thoracic cage parameters are correlated with the surgery success rate and life quality of adolescents with idiopathic scoliosis (AIS). However, the effects of the long-term bracing on sagittal and thoracic cage parameters have not been clearly recognized. HYPOTHESIS Long-term brace treatment could compromise sagittal balance and thoracic development in patients with AIS. PATIENTS AND METHODS Two hundred and seventy-five patients with AIS were included in this study. The radiographs when AIS was diagnosed and 2 years after Chêneau bracing treatment were collected. Sagittal, cervical, pelvic, and thoracic cage parameters were evaluated. In addition, 32 patients finishing brace treatment with complete radiograph data were selected from included 275 patients and the data of CL, TK and LL at five different time points was collected. RESULTS CL (average: from 14.13° to 8.94°, p=0.012), TK (average: from 24.35° to 19.02°, p=0.001) and LL (average: from 38.44° to 32.13°, p=0.004) underwent observably decline after two-year brace treatment. No statistically significant alteration of pelvic parameters was shown. The vertical parameters of thoracic cage including T1-12 height, left and right thorax height and thoracic transverse diameter increased significantly. Thoracic anteroposterior diameter at the T7 vertebral level (average: from 11.49 to 10.57cm, p=0.001) and diaphragm level (average: from 11.89 to 10.74cm, p=0.001) decreased significantly after bracing. DISCUSSION CL, TK and LL decreased after long-term bracing treatment, which lead to the aggravation of "flat back" in AIS patients. In addition, the thoracic anteroposterior diameters declined after two-year bracing, which may result from reduced TK and contribute to further pulmonary function impairment. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Zheng Zhang
- Department of orthopedics, second affiliated hospital of second military medical university, Changzheng hospital, 415, Fengyang road, 200003 Shanghai, People's Republic of China
| | - Xiao Ma
- Department of orthopedics, second affiliated hospital of second military medical university, Changzheng hospital, 415, Fengyang road, 200003 Shanghai, People's Republic of China
| | - Jia Yin
- Department of orthopedics, second affiliated hospital of second military medical university, Changzheng hospital, 415, Fengyang road, 200003 Shanghai, People's Republic of China
| | - Lun Shu
- Department of orthopedics, second affiliated hospital of second military medical university, Changzheng hospital, 415, Fengyang road, 200003 Shanghai, People's Republic of China
| | - Rui Gao
- Department of orthopedics, second affiliated hospital of second military medical university, Changzheng hospital, 415, Fengyang road, 200003 Shanghai, People's Republic of China
| | - Jun Ma
- Department of orthopedics, second affiliated hospital of second military medical university, Changzheng hospital, 415, Fengyang road, 200003 Shanghai, People's Republic of China.
| | - Xuhui Zhou
- Department of orthopedics, second affiliated hospital of second military medical university, Changzheng hospital, 415, Fengyang road, 200003 Shanghai, People's Republic of China.
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Akazawa T, Kotani T, Sakuma T, Nakayama K, Iijima Y, Torii Y, Iinuma M, Kuroya S, Asano K, Ueno J, Yoshida A, Murakami K, Minami S, Orita S, Inage K, Shiga Y, Nakamura J, Inoue G, Miyagi M, Saito W, Eguchi Y, Fujimoto K, Takahashi H, Ohtori S, Niki H. Pulmonary Function Improves in Patients with Adolescent Idiopathic Scoliosis who Undergo Posterior Spinal Fusion Regardless of Thoracoplasty: A Mid-Term Follow-Up. Spine Surg Relat Res 2020; 5:22-27. [PMID: 33575491 PMCID: PMC7870321 DOI: 10.22603/ssrr.2020-0077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/29/2020] [Indexed: 11/05/2022] Open
Abstract
Introduction The purpose of the present study was to determine, in a mid-term follow-up 5 years or more after surgery, the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and expiratory flow in patients with adolescent idiopathic scoliosis (AIS) who underwent posterior spinal fusion (PSF) with or without thoracoplasty. Methods The subjects were 134 patients with AIS who underwent PSF between 2004 and 2013. Forty-five patients agreed to participate in the study. We divided the patients into two groups as follows: 24 patients who underwent PSF with thoracoplasty from 2004 to 2010 in the TP group and 21 patients who underwent PSF without thoracoplasty from 2011 to 2013 in the non-TP group. We evaluated whole spine X-ray imaging and pulmonary function tests (PFTs) in these patients. PFTs measured FVC, FEV1, peak expiratory flow (PEF), maximum expiratory flow at 50% FVC (V50), maximum expiratory flow at 25% FVC (V25), and the ratio of V50 to V25 (V50/V25). Results The main thoracic curves were 53.6 ± 10.1° before surgery, 19.8 ± 7.6° 1 week after surgery, 22.3 ± 8.3° 2 years after surgery, and 23.3 ± 7.6° at the most recent observation. Compared with preoperative values, FVC, FEV1, and % FEV1 were improved significantly at the most recent observation. No significant difference was observed between % FVC before surgery and at the most recent observation. Compared with preoperative values, PEF, V50, and V25 were improved significantly at the most recent observation. V50/V25 did not change significantly. The changes in PFT values in the TP group and the non-TP group were compared. No significant differences were observed in FVC, % FVC, FEV1, % FEV1, PEF, V50, or V25. Conclusions Regardless of whether thoracoplasty was performed or not, FVC, FEV1, and expiratory flow were improved 5 years or later after PSF.
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Affiliation(s)
- Tsutomu Akazawa
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.,Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Toshiaki Kotani
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Tsuyoshi Sakuma
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Keita Nakayama
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Yasushi Iijima
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Yoshiaki Torii
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masahiro Iinuma
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shingo Kuroya
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Kota Asano
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Jun Ueno
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Atsuhiro Yoshida
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kenichi Murakami
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shohei Minami
- Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Sumihisa Orita
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuhide Inage
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasuhiro Shiga
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Junichi Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Gen Inoue
- Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masayuki Miyagi
- Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Wataru Saito
- Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yawara Eguchi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuki Fujimoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Orthopaedic Surgery, Konodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Hiroshi Takahashi
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hisateru Niki
- Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
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Yagci G, Demirkiran G, Yakut Y. Response to letter to editor regarding 'In-brace alteration of pulmonary functions in adolescents wearing a brace for idiopathic scoliosis' by Yagci et al. (2019). Prosthet Orthot Int 2020; 44:100-101. [PMID: 32160822 DOI: 10.1177/0309364620910928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Gozde Yagci
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Gokhan Demirkiran
- Hacettepe University, Department of Orthopaedics and Traumatology, Faculty of Medicine, Ankara, Turkey
| | - Yavuz Yakut
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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