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Kim YG, Kim S, Park JH, Yang S, Jang M, Yun YJ, Cho JS, You S, Jang SH. Explainable Deep-Learning-Based Gait Analysis of Hip-Knee Cyclogram for the Prediction of Adolescent Idiopathic Scoliosis Progression. SENSORS (BASEL, SWITZERLAND) 2024; 24:4504. [PMID: 39065902 PMCID: PMC11280687 DOI: 10.3390/s24144504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/12/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024]
Abstract
Accurate prediction of scoliotic curve progression is crucial for guiding treatment decisions in adolescent idiopathic scoliosis (AIS). Traditional methods of assessing the likelihood of AIS progression are limited by variability and rely on static measurements. This study developed and validated machine learning models for classifying progressive and non-progressive scoliotic curves based on gait analysis using wearable inertial sensors. Gait data from 38 AIS patients were collected using seven inertial measurement unit (IMU) sensors, and hip-knee (HK) cyclograms representing inter-joint coordination were generated. Various machine learning algorithms, including support vector machine (SVM), random forest (RF), and novel deep convolutional neural network (DCNN) models utilizing multi-plane HK cyclograms, were developed and evaluated using 10-fold cross-validation. The DCNN model incorporating multi-plane HK cyclograms and clinical factors achieved an accuracy of 92% in predicting curve progression, outperforming SVM (55% accuracy) and RF (52% accuracy) models using handcrafted gait features. Gradient-based class activation mapping revealed that the DCNN model focused on the swing phase of the gait cycle to make predictions. This study demonstrates the potential of deep learning techniques, and DCNNs in particular, in accurately classifying scoliotic curve progression using gait data from wearable IMU sensors.
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Affiliation(s)
- Yong-Gyun Kim
- Department of Rehabilitation Medicine, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (Y.-G.K.); (S.K.); (J.H.P.)
| | - Sungjoon Kim
- Department of Rehabilitation Medicine, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (Y.-G.K.); (S.K.); (J.H.P.)
| | - Jae Hyeon Park
- Department of Rehabilitation Medicine, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (Y.-G.K.); (S.K.); (J.H.P.)
- Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Guri 11923, Republic of Korea;
| | - Seung Yang
- Department of Pediatrics, Hanyang University College of Medicine, Seoul 04763, Republic of Korea;
| | - Minkyu Jang
- Department of Computer Science, Hanyang University College of Engineering, Seoul 04763, Republic of Korea;
| | - Yeo Joon Yun
- Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Guri 11923, Republic of Korea;
| | - Jae-sung Cho
- Robotics Lab, Research and Development Division of Hyundai Motor Company, Uiwang 16082, Republic of Korea;
| | - Sungmin You
- Fetal-Neonatal Neuroimaging and Developmental Science Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Division of Newborn Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Seong-Ho Jang
- Department of Rehabilitation Medicine, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (Y.-G.K.); (S.K.); (J.H.P.)
- Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Guri 11923, Republic of Korea;
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Ronconi G, Gatto DM, Ariani M, Codazza S, Ingravalle F, Ferriero G, Coraci D, Ferrara PE. Is there any relationship between scoliosis, cervical pain and postural imbalance in Parkinson's disease? A cross-sectional pilot study. Eur J Transl Myol 2024; 34:12354. [PMID: 38634751 PMCID: PMC11264221 DOI: 10.4081/ejtm.2024.12354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/15/2024] [Indexed: 04/19/2024] Open
Abstract
Parkinson's disease (PD) is defined by progressive worsening of gait, posture, and balance, as well as disability in daily life activities, and improvement in chronic musculoskeletal pain, particularly neck pain associated with worsening of balance. The study's goal is to look into the relationship between scoliosis, balance, and cervical pain in Parkinson's disease patients. Cross-sectional, pilot study. The study included 16 Parkinson's patients. Neck cervical pain was measured using the pain visual analogue scale and the short form McGill pain questionnaire, while dynamic balance was assessed using static balance, Tinetti, Berg Balance, and the Short Physical Performance Battery scales (SPPB). Cobb angles are measured on a whole-spine standard X-ray to assess spinal scoliosis.An observational statistical analysis was performed with patients subdivided into two groups: non-scoliosis (NS) and true scoliosis (TS) based on whether they presented a Cobb's angle below or ≥10°. Neck pain was reported by 37% (n=3) of participants in the NS group versus 50% (n=4) in the TS group. Neck pain was more prevalent in patients with a disease duration of less than 48 months (n=6; 75.0% vs n=1; 12.5%; p-value < 0.05). Scoliosis, cervical pain, and postural imbalance are all significant but often overlooked Parkinson's disease complaints.
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Affiliation(s)
| | - Dario Mattia Gatto
- Department of Neurosciences, Sense Organs and Thorax, Catholic University of the Sacred Heart, Rome.
| | - Mariantonietta Ariani
- Department of Neurosciences, Sense Organs and Thorax, Catholic University of the Sacred Heart, Rome.
| | - Sefora Codazza
- University Polyclinic Foundation A. Gemelli IRCCS, Rome.
| | - Fabio Ingravalle
- Hospital Health Management Area, Local Health Authority "Roma 6", Albano Laziale.
| | - Giorgio Ferriero
- Unit of Physical and Rehabilitation Medicine, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy; Department of Biotechnology and Life Sciences, University of Insubria, Varese, Como.
| | - Daniele Coraci
- Department of Neuroscience, Section of Rehabilitation, University of Padova, Padua.
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Ji R, Liu X, Liu Y, Yan B, Yang J, Lee WYW, Wang L, Tao C, Kuai S, Fan Y. Kinematic difference and asymmetries during level walking in adolescent patients with different types of mild scoliosis. Biomed Eng Online 2024; 23:22. [PMID: 38369455 PMCID: PMC10875845 DOI: 10.1186/s12938-024-01211-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 01/22/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS), three-dimensional spine deformation, affects body motion. Previous research had indicated pathological gait patterns of AIS. However, the impact of the curve number on the walking mechanism has not been established. Therefore, this study aimed to compare the gait symmetry and kinematics in AIS patients with different curve numbers to healthy control. RESULTS In the spinal region, double curves AIS patients demonstrated a smaller sagittal symmetry angle (SA) and larger sagittal convex ROM of the trunk and lower spine than the control group. In the lower extremities, the single curve patients showed a significantly reduced SA of the knee joint in the frontal plane, while the double curves patients showed a significantly reduced SA of the hip in the transverse plane. CONCLUSION The curve number indeed affects gait symmetry and kinematics in AIS patients. The double curves patients seemed to adopt a more "careful walking" strategy to compensate for the effect of spinal deformation on sensory integration deficits. This compensation mainly occurred in the sagittal plane. Compared to double curves patients, single curve patients unitized a similar walking strategy with healthy subjects.
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Affiliation(s)
- Run Ji
- School of Biological Science and Medical Engineering, School of Engineering Medicine, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, 100191, China
- Institute of Biomechanics, National Research Center for Rehabilitation Technical Aids, Beijing, 100176, China
| | - Xiaona Liu
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, China
| | - Yang Liu
- Shenzhen Youth Spine Health Center, Shenzhen, 518035, China
| | - Bin Yan
- Department of Spine Surgery, Shenzhen Second People's Hospital, Shenzhen, 518039, China
- Department of Spine Surgery, First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China
- Shenzhen University School of Medicine, Shenzhen, 518060, China
- Shenzhen Youth Spine Health Center, Shenzhen, 518035, China
| | - Jiemeng Yang
- School of Biological Science and Medical Engineering, School of Engineering Medicine, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, 100191, China
- Institute of Biomechanics, National Research Center for Rehabilitation Technical Aids, Beijing, 100176, China
| | - Wayne Yuk-Wai Lee
- Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Ling Wang
- Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, School of Mechanical Engineering, Tianjin University of Technology, Tianjin, 300384, China
- National Demonstration Center for Experimental Mechanical and Electrical Engineering Education, Tianjin University of Technology, Tianjin, China
| | - Chunjing Tao
- School of Biological Science and Medical Engineering, School of Engineering Medicine, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, 100191, China.
| | - Shengzheng Kuai
- Department of Spine Surgery, Shenzhen Second People's Hospital, Shenzhen, 518039, China.
- Department of Spine Surgery, First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, China.
- Shenzhen University School of Medicine, Shenzhen, 518060, China.
- Shenzhen Youth Spine Health Center, Shenzhen, 518035, China.
| | - Yubo Fan
- School of Biological Science and Medical Engineering, School of Engineering Medicine, Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, 100191, China.
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Xu J, Chen M, Wang X, Luo X. Biomechanical changes in adolescent idiopathic scoliosis during walking: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e36528. [PMID: 38065886 PMCID: PMC10713143 DOI: 10.1097/md.0000000000036528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND To clarify the differences in biomechanical characteristics present in adolescent idiopathic scoliosis (AIS) patients during walking. METHODS Cross-sectional studies related to the biomechanical characteristics of AIS were included by searching 7 major databases and analyzed using RevMan 5.4 software. RESULTS There were a total of 15 trials involving 377 AIS patients. The results showed that during walking, AIS had increased pelvic coronal tilt (effect size [ES] = -1.34, 95% confidence intervals [CI] = -2.41 to -0.27, P = .01), knee and ankle sagittal mobility were reduced (ES = -5.22, 95% CI = -7.51 to -2.94, P < .001; ES = -3.58, 95% CI = -5.93 to -1.22, P = .003). The duration of electromyogram activity was prolonged in the gluteus medius (ES = 7.65, 95% CI = 5.33-9.96, P < .001), lumbar square (ES = 10.73, 95% CI = 6.97-14.49, P < .001), and erector spinae (ES = 14.35, 95% CI = 6.94-21.76, P < .001) muscles. The results of subgroup analysis showed that the step length of the concave side of the spine was reduced (ES = -0.36, 95% CI = -0.71 to -0.01, P = .04). CONCLUSION AIS has characteristic biomechanical changes in spatiotemporal, phase kinematics, motor mechanics, and electromyographic signatures. Further comprehensive studies are required in the future to analyze the biomechanical and electromyographic differences among different degrees and types of scoliosis, as well as the differences between the concave and convex sides of scoliosis during walking.
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Affiliation(s)
- Jie Xu
- Department of Sports Medicine, Sichuan Provincial Orthopedics Hospital, Chengdu, China
| | - Meng Chen
- Department of Emergency Medicine, Nanchong Hospital of Traditional Chinese Medicine, Nanchong, China
| | - Xin Wang
- Health Science Center, Peking University, Beijing, China
| | - Xiaobing Luo
- Department of Sports Medicine, Sichuan Provincial Orthopedics Hospital, Chengdu, China
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Tekin S, Yagci G, Topuz S, Demirkiran G. Comparison of gait and sagittal plane arm swing between individuals with adolescent idiopathic scoliosis and healthy individuals. Acta Orthop Belg 2023; 89:727-734. [PMID: 38205767 DOI: 10.52628/89.4.11444] [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: 01/12/2024]
Abstract
Arm swing and energy consumption play an important role in the realization of an effective gait. However, research on arm swing and energy consumption during gait in individuals with adolescent idiopathic scoliosis (AIS) is limited. The aim of this study was to investigate the spatiotemporal characteristics of gait, arm swing angles in the sagittal plane, energy consumption in individuals with AIS, to compare them with their healthy peers in this regard. 26 diagnosed with AIS and 21 healthy were included in this study. Evaluation measures were based on the Cobb angle, axial trunk rotation, trunk symmetry, sagittal curve measurements, spatiotemporal characteristics of gait with the GAITRite electronic walkway, sagittal plane arm swing with two video-camera recordings, and energy consumption. There were a decrease in right- sided sagittal arm swing, an increase in energy consumption, in left-side step time and right-side double support time in the scoliosis group compared to the control group. The other spatiotemporal characteristics of the gait were similar in both groups. The evaluation of arm swing, energy consumption, and gait of individuals with AIS may contribute to the development of rehabilitation programs by better identifying the deficiencies of individuals with AIS.
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Laett CT, Visconti RDR, Meirelles RDSP, Santos LDM, Cossich VRA, Silva SCD. Effect of Spinal Correction Surgery on Lower Limb Strength in Idiopathic Adolescent Scoliosis. Rev Bras Ortop 2023; 58:e912-e916. [PMID: 38077772 PMCID: PMC10708971 DOI: 10.1055/s-0043-1770980] [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: 02/23/2023] [Accepted: 03/27/2023] [Indexed: 08/03/2024] Open
Abstract
Objectives To analyze the lower limb strength in both untreated and surgically treated adolescent idiopathic scoliosis (AIS) patients and examine its correlation with the distance covered in a six-minute walking test (6MWT). Methods A total of 88 participants (n = 30 pre-surgery AIS patients, n = 30 post-surgical AIS patients, and n = 28 control) underwent a 6MWT and a muscle strength assessment. The lower limb strength was measured at the knee joint using the knee extension (KE) and knee flexion (KF) peak torque (PT) measurements. Results The control group covered a greater distance in the TC6 compared to both the pre-surgical (534 ± 67 m) and post-surgical (541 ± 69 m) groups, with a distance of 612 ± 70 m (p < 0.001). No differences were observed in KE PT (pre: 2.1 ± 0.63, post: 2.1 ± 0.7, control: 2.2 ± 0.7 Nm.kg -1 , p = 0.67) or KF PT (pre: 1.0 ± 0.3, post: 1.1 ± 0.3, control: 1.1 ± 0.5 Nm.kg -1 , p = 0.46). A moderate positive correlation was observed between KE PT and 6MWT distance (r = 0.53, p < 0.001), as well as a low positive correlation for KF PT (r = 0.37, p = 0.003) with 6MWT distance. Conclusion This study highlights the importance of lower limb maximal strength in the functionality of AIS patients. Our findings suggest that exercise programs aimed at enhancing lower limb strength, especially the KE, could improve the walking capacity of AIS patients. These results provide useful information for designing purposeful exercise programs for AIS patients with walking deficits.
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Affiliation(s)
- Conrado Torres Laett
- Instituto Nacional de Traumatologia e Ortopedia (INTO), Divisão de Ensino e Pesquisa (DIENP), Programa de Pós-Graduação em Ciências Aplicadas ao Sistema Musculoesquelético, Rio de Janeiro, RJ. Brasil.
- Instituto Nacional de Traumatologia e Ortopedia (INTO), Laboratório de Pesquisa em Fisiologia do Exercício, Divisão de Pesquisa, Rio de Janeiro, RJ, Brasil.
- Instituto Nacional de Traumatologia e Ortopedia (INTO), Laboratório de Pesquisa Neuromuscular, Divisão de Pesquisa, Rio de Janeiro, RJ, Brasil.
| | - Rogério dos Reis Visconti
- Instituto Nacional de Traumatologia e Ortopedia (INTO), Divisão de Ensino e Pesquisa (DIENP), Programa de Pós-Graduação em Ciências Aplicadas ao Sistema Musculoesquelético, Rio de Janeiro, RJ. Brasil.
| | | | - Lenifran de Matos Santos
- Programa de Pós-Graduação em Ciências do Exercício e do Esporte, Universidade Estadual do Rio de Janeiro, RJ, Brasil.
| | | | - Sidnei Cavalcante da Silva
- Instituto Nacional de Traumatologia e Ortopedia (INTO), Divisão de Ensino e Pesquisa (DIENP), Programa de Pós-Graduação em Ciências Aplicadas ao Sistema Musculoesquelético, Rio de Janeiro, RJ. Brasil.
- Instituto Nacional de Traumatologia e Ortopedia (INTO), Laboratório de Pesquisa em Fisiologia do Exercício, Divisão de Pesquisa, Rio de Janeiro, RJ, Brasil.
- Instituto Nacional de Traumatologia e Ortopedia (INTO), Laboratório de Pesquisa Neuromuscular, Divisão de Pesquisa, Rio de Janeiro, RJ, Brasil.
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Suh SW, Kim WS. Lower limb joint burden during walking in adolescent idiopathic scoliosis: investigation of mechanical work during walking. Spine J 2023; 23:1692-1699. [PMID: 37355046 DOI: 10.1016/j.spinee.2023.06.393] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/19/2023] [Accepted: 06/17/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND CONTEXT Adolescent idiopathic scoliosis (AIS) is the most prevalent spinal deformity in adolescents. However, pathophysiology and long-term complications remain unclear. Characteristics of the mechanical work in AIS gait have not been well-studied. PURPOSE This study aimed to elucidate the characteristics of mechanical work in AIS gait. STUDY DESIGN Observational comparison study. PATIENT SAMPLE Participants were composed of two groups: scoliosis group with 68 participants and a control group with 17 participants. OUTCOME MEASURES Spinal deformity and coronal spinal balance in the scoliosis group were assessed with Cobb angle, coronal balance, and apical vertebra translation. Three-dimensional motion analysis during walking was conducted to calculate lower limb joint works and external work on the whole body's center of mass. METHODS Lower limb joint work (JW) and external work on the whole body center of mass (CoM) were compared between the 2 groups with an independent t-test. Inter-limb and intra-limb comparisons of mechanical work were conducted with a paired t-test. The relationships between mechanical work and frontal trunk deformity were investigated in the scoliosis group. RESULTS Walking speed and external work on whole body CoM did not differ between the two groups. Compared to the control group, the scoliosis group showed significantly larger JW on the convex and concave sides. CONCLUSION The scoliosis group showed increased lower limb joint burden and limited trunk function for mechanical work during walking. Investigation of mechanical work during walking provides insight into the biomechanical characteristics of AIS. Therefore, future studies should be conducted to verify mechanical work characteristics which have relevance to the progression of spinal deformity and the development of lower limb complications in AIS.
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Affiliation(s)
- Seung Woo Suh
- Department of Orthopaedic Surgery, School of Medicine, Korea University Guro Hospital, Seoul 10408, Republic of Korea
| | - Woo Sub Kim
- Department of Physical Medicine & Rehabilitation, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu 11759, Republic of Korea.
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Mehta B, Chockalingam N, Shannon T, Jevtic N, Lazic F, Jasani V, Eddison N, Healy A, Needham R. Non-Invasive Assessment of Back Surface Topography: Technologies, Techniques and Clinical Utility. SENSORS (BASEL, SWITZERLAND) 2023; 23:8485. [PMID: 37896577 PMCID: PMC10610923 DOI: 10.3390/s23208485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023]
Abstract
(1) Background: Frequent exposure to ionising radiation is often used to determine the diagnosis of adolescent idiopathic scoliosis (AIS), a lateral curvature of the spine in those aged between 10 and 18 years, and a treatment plan according to Cobb angle. This narrative review outlines the clinical utility of surface topography (ST), a radiation-free imaging modality. (2) Methods: Publicly available databases were searched to yield literature related to ST. Identified articles were classified based on the equipment used and in order of how it was developed, i.e., historical, recent developments, and state-of-the-art developments. (3) Conclusions: ST is a reliable cost-effective non-invasive technique that provides an alternative to radiation-based imaging to aid with the diagnosis and potential screening of AIS. Several scanning methods are available, which allows ST to be used in several clinical environments. Limitations of inter-reliability and differences of apparatus resulting in variations of data have been noted through this narrative review.
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Affiliation(s)
- Bhavna Mehta
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
| | - Thomas Shannon
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
| | - Nikola Jevtic
- ScolioCentar, Novisad, 403916 Novi Sad, Serbia; (N.J.); (F.L.)
| | - Filip Lazic
- ScolioCentar, Novisad, 403916 Novi Sad, Serbia; (N.J.); (F.L.)
| | - Vinay Jasani
- Centre for Biomechanics, University Hospitals of North Midlands NHS Trust, Stoke on Trent ST4 6QG, UK;
| | - Nicola Eddison
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
- Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK
| | - Aoife Healy
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
| | - Robert Needham
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent ST4 2DF, UK; (B.M.); (T.S.); (N.E.); (A.H.); (R.N.)
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Pontes-Silva A. Letter to the Editor Regarding "Deriving a Novel Score for the Stratification of Risk Progression in Early-onset Scoliosis: A Multicenter Initiative" by Dr. André Pontes-Silva. Spine (Phila Pa 1976) 2023; 48:E306. [PMID: 37093082 DOI: 10.1097/brs.0000000000004689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/09/2023] [Indexed: 04/25/2023]
Affiliation(s)
- André Pontes-Silva
- Physical Therapy Department, Federal University of São Carlos, São Carlos, SP, Brazil
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Morimoto T, Yamamoto Y, Suzuki S, Yagi M, Kobayashi T, Mawatari M, Matsumoto M, Watanabe K. Analysis of the sacroiliac joint vacuum phenomenon in adolescent thoracic idiopathic scoliosis (Lenke types 1 and 2). Medicine (Baltimore) 2023; 102:e34487. [PMID: 37653771 PMCID: PMC10470709 DOI: 10.1097/md.0000000000034487] [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: 03/13/2023] [Revised: 06/19/2023] [Accepted: 06/28/2023] [Indexed: 09/02/2023] Open
Abstract
The sacroiliac joint (SIJ) is the largest axial joint in the human body, and the SIJ vacuum phenomenon (SIJ VP) is a common finding in computed tomography studies of the abdomen, pelvis, and lumbosacral spine in adults, with the incidence increasing with age. Adolescent idiopathic scoliosis (AIS) is an abnormal spinal curvature that appears during adolescence and places abnormal stress on the SIJs. This retrospective observational study aimed to investigate the incidence of the SIJ VP in thoracic AIS (Lenke types 1 and 2). Sixty-seven patients with AIS (age: 12-19 years) and 76 controls (age: 11-19 years) were retrospectively analyzed to investigate SIJ VP, subchondral bone cysts, and SIJ degeneration (Eno classification: type 0, no degenerative change; type 1, mild degenerative changes; type 2, substantial degenerative changes; and type 3, ankylosis). SIJ degeneration was defined as type ≥ 2. The association between SIJ VP, cysts, SIJ degeneration, and sagittal/coronal spinopelvic alignment was assessed. SIJ VP (59% vs. 35.5%, P < .01), cysts (32.8% vs. 1.3%, P < .01), and SIJ degeneration (3.2% vs. 2.6%, P = .823) differed significantly between the 2 groups. There were 0 cases of SIJ ankylosis (Eno classification type 3) in both groups. The VP was not correlated with lumbar lordosis, sacral slope, or Cobb angle. All lumbar modifier type C belonged to the VP present group, whereas none to VP absent group. Our results suggest an association between AIS and SIJ VP and SIJ cysts. SIJ VP and SIJ cysts in AIS may be caused and accelerated by abnormal mechanical stress on SIJ due to spinal deformity.
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Affiliation(s)
- Tadatsugu Morimoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Yusuke Yamamoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Nara Medical University, Nara, Japan
| | - Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuru Yagi
- Department of Orthopaedic Surgery, Faculty of Medicine, Nara Medical University, Nara, Japan
| | - Takaomi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Masaaki Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
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da Silveira GE, Andrade RM, Guilhermino GG, Schmidt AV, Neves LM, Ribeiro AP. The Effects of Short- and Long-Term Spinal Brace Use with and without Exercise on Spine, Balance, and Gait in Adolescents with Idiopathic Scoliosis. Medicina (B Aires) 2022; 58:medicina58081024. [PMID: 36013490 PMCID: PMC9413676 DOI: 10.3390/medicina58081024] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Adolescent idiopathic scoliosis (AIS) is a prevalent spinal disorder in adolescents. Previous studies have shown biomechanical changes of the gait in the lower limb of AIS patients. To minimize the progression of scoliotic curvature, a spinal brace is used, which has been shown to be efficient. Usually, a brace is worn strictly for 20–22 h every day. To our knowledge, no study has assessed the short- and long-term effects of spinal brace use with or without an exercise program (6 months) to improve clinical and biomechanical parameters. The aim of our study was to verify the effects of short- and long-term spinal brace use, with or without an exercise program on the spine, body balance, and plantar load distribution during gait in AIS. Materials and Methods: A prospective randomized study was conducted with intention-to-treat analysis in forty-five adolescents diagnosed with AIS undergoing conservative treatment at a center specialized in spinal rehabilitation. Adolescents were evaluated at two stages of intervention: (1) spinal orthopedic brace, with acute use 24 h/day (n = 22) and (2) spinal orthopedic brace, with acute use between 15–18 h/day associated with a specific rehabilitation exercise protocol for six consecutive months (six months and 12 total sessions, n = 23). The evaluated parameters were: spine pain, using a visual analog scale (VAS); Cobb angle measurement using radiograph exams, as well as the Risser sign; and static balance and plantar pressure of the feet during gait, carried out using a pressure platform. Results: AIS patients showed significant improvements in the main scoliotic curvature, with a 12-degree reduction in Cobb angle pre- and post-short-term immediate use of spinal brace and a 5.3 degree correction after six months of spinal brace use in combination with specific exercises (long term). In addition, short- and long-term brace use with an exercise program showed a significant increase in anteroposterior and mediolateral balance and a reduction in plantar overload on the heel during gait, with an effect size between moderate and high. Conclusions: Intervention via the short- or long-term use of a spinal brace combined with specific exercises in adolescents with idiopathic scoliosis proved to be effective for correcting scoliotic curvature. In addition, intervention also showed improvements to the antero-posterior and mediolateral body balance and a reduction in the plantar load on the rearfoot region during gait, demonstrating effective mechanical action on the spine.
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Affiliation(s)
- Guilherme Erdmann da Silveira
- Biomechanics and Musculoskeletal Rehabilitation Laboratory, Health Science Post-Graduate Department, Medicine School, University Santo Amaro, São Paulo 04829-300, SP, Brazil; (G.E.d.S.); (A.V.S.); (L.M.N.)
| | | | | | - Ariane Verttú Schmidt
- Biomechanics and Musculoskeletal Rehabilitation Laboratory, Health Science Post-Graduate Department, Medicine School, University Santo Amaro, São Paulo 04829-300, SP, Brazil; (G.E.d.S.); (A.V.S.); (L.M.N.)
| | - Lucas Melo Neves
- Biomechanics and Musculoskeletal Rehabilitation Laboratory, Health Science Post-Graduate Department, Medicine School, University Santo Amaro, São Paulo 04829-300, SP, Brazil; (G.E.d.S.); (A.V.S.); (L.M.N.)
- Department of Psychiatry, University of Sao Paulo, São Paulo 01246-903, SP, Brazil
| | - Ana Paula Ribeiro
- Biomechanics and Musculoskeletal Rehabilitation Laboratory, Health Science Post-Graduate Department, Medicine School, University Santo Amaro, São Paulo 04829-300, SP, Brazil; (G.E.d.S.); (A.V.S.); (L.M.N.)
- Physical Therapy Department, School of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil
- Correspondence: ; Tel.: +55-11-99139-2168
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Zhang Z, Liu T, Wang Y, Wang Z, Zheng G. Factors Related to Preoperative Coronal Malalignment in Degenerative Lumbar Scoliosis: An Analysis on Coronal Parameters. Orthop Surg 2022; 14:1846-1852. [PMID: 35795967 PMCID: PMC9363746 DOI: 10.1111/os.13379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/29/2022] [Accepted: 05/29/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Recently the effects of coronal malalignment (CM) in degenerative lumbar scoliosis (DLS) have been reported, however, there was few studies on the correlated parameters of coronal alignments at pre‐operation. The aims of this current study were to investigate the associations of coronal parameters with scoliosis and coronal alignment, and to explore the relationships between the coronal pelvic tilt and coronal alignment in DLS. Methods One hundred and sixty‐one DLS patients in our hospital from May 2016 to December 2020 were reviewed and documented. The coronal balance distance (CBD, the offset between the center of C7 and the plumb line drawn from the center of S1), major Cobb (MC), fractional Cobb (FC), L4 coronal tilt, L5 coronal tilt, coronal pelvic tilt, apical rotation, and the vertebras in major curve were measured and documented. CM was considered if the CBD ≥ 30mm. All of those participants were assigned into group A (CBD ≥ 30 mm) and group B (CBD < 30 mm). Comparisons of demographic and radiographic data were performed between groups A and B. Pearson correlation and further multiple regression with stepwise method analysis were used to investigate those coronal parameters correlated to MC and CBD, respectively. Results Thirty‐one patients suffering from CM were assigned into group A, and the rest of 130 patients were assigned to group B accordingly. Then the incidence of CM was about 19.3% (31/161). Patients in group A had less vertebras in the main curve (P = 0.009), however, the apical rotation (P < 0.001) and the L4 coronal tilt (P = 0.007) were much larger. Although the MC (P = 0.426) and FC (P = 0.06) had no difference between the two groups, the match between MC and FC was much smaller (p = 0.021) in group A. The coronal pelvic tilt correlated significantly with FC (r = 0.552, p < 0.001), but mildly with MC (r = −0.366, p < 0.001), L4 coronal tilt (r = 0.348, p < 0.001), and L5 coronal tilt (r = 0.351, p < 0.001), respectively. The CBD correlated strongly with L4 coronal tilt (r = −0.471, p < 0.001) and L5 coronal tilt (r = −0.468, p < 0.001), respectively, but mildly with FC (r = −0.255, p = 0.016). Further multiple regression analysis revealed that only L4 coronal tilt was the independent factor for MC (r2 = 0.549, p < 0.001) and CBD (r2 = 0.221, p < 0.001), respectively. Conclusions The prevalence of CM in DLS patients is about 19% at pre‐operation. With similar major Cobb, the less the vertebras in the major curve, the larger the CBD. L4 coronal tilt may correlate significantly to scoliosis and CBD. Coronal pelvic tilt may be just one of the compensations for the scoliosis deformity but effects CBD directly.
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Affiliation(s)
- Zifang Zhang
- The Spinal Surgery Department of the Affiliated Hospital of Jining Medical University, Jining, China.,The Department of Orthopaedics, The First Medical Center of the Chinese PLA General Hospital, Beijing, China
| | - Tao Liu
- The Department of Orthopaedics, Yanzhou Branch of Affiliated Hospital of Jining Medial University, Jining, China
| | - Yan Wang
- The Department of Orthopaedics, The First Medical Center of the Chinese PLA General Hospital, Beijing, China
| | - Zheng Wang
- The Department of Orthopaedics, The First Medical Center of the Chinese PLA General Hospital, Beijing, China
| | - Guoquan Zheng
- The Department of Orthopaedics, The First Medical Center of the Chinese PLA General Hospital, Beijing, China
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Asymmetrical thoracic-lumbar coordination during trunk rotation between adolescents with and without thoracic idiopathic scoliosis. Spine Deform 2022; 10:783-790. [PMID: 35175573 DOI: 10.1007/s43390-022-00483-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/29/2022] [Indexed: 10/19/2022]
Abstract
STUDY DESIGN Cross-sectional comparative study. PURPOSE To compare thoracic-lumbar kinematic changes and coordination based on coupling angles (CAs) in two different directions of trunk rotation between adolescents with idiopathic scoliosis (AIS) and control subjects. Altered three-dimensional (3D) deviations are often apparent in AIS groups during functional activities, such as gait. However, there is a lack of consistent evidence on coordinated motions during different directions of trunk rotation. METHODS This study included 14 AIS and 17 age-matched control subjects who were all right limb dominant. A motion capture system was utilized to analyze the spinal segment motions. The outcome measures included range of motion (ROM) at the first thoracic (T1), seventh thoracic (T7), and first lumbar (L1) spinous processes as well as the sacral tubercle (S1). The CAs compared in-phase (rotation from right to left) and anti-phase (rotation from left to right) trunk rotations. RESULTS Although there was no significant association with the spinal segments in the control group, the Cobb angle demonstrated significant positive correlations with anti-phase at T7 and L1 as well as in-phase at L1. Regarding the CAs, the groups demonstrated a significant interaction with both phases (F = 4.7, p = 0.04). The AIS group demonstrated positive correlations with ROM during in-phase at L1 and anti-phase at T7 and L1. CONCLUSION The coordination based on the CAs of the lumbar spine relative to the thoracic spine significantly decreased during left to right trunk rotation in the AIS group. These results indicated that the AIS group demonstrated directional dissociation toward the dominant side of lumbar rotation. LEVEL OF EVIDENCE III.
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Eryiğit S, Al Kafee A, Akan A. Analysis of the quadratus lumborum muscle activity on leg length discrepancy: A randomized controlled trial. J Back Musculoskelet Rehabil 2022; 35:525-530. [PMID: 34366317 DOI: 10.3233/bmr-181177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Quadratus lumborum (QL) discrete region extensions might change depending on whether leg length discrepancy (LLD) individually has any extra erector spinae action in the lumbar spine, which can result in serious injury to the lower extremities and lumbar vertebrae. OBJECTIVE This study aims to investigate the effect of QL muscle activity on LLD by using electromyography (EMG) signals. METHODS The study employed a randomized controlled design. A total of 100 right-handed volunteers were included in this study. All participants were assessed manually by tape measurement for LLD. EMG signals were recorded during the resting and maximal isometric contraction positions to determine QL muscle activity. The power spectral density (PSD) methods were applied to compute EMG signals. RESULTS In maximal isometric contraction position, comparing the short right LLD (Right side = 0.00064 ± 0.00001, Left side = 0.00033 ± 0.0006) and short left LLD (Right side = 0.00001 ± 0.00008, Left side = 0.00017 ± 0.0001), it was found that the short right LLD group had significantly increased PSD of EMG values. In resting position, the short right LLD (Right side = 0.0002 ± 0.0073, Left side = 0.00016 ± 0.0065) had significantly increased PSD of EMG compared to the short left LLD (Right side = 0.00004 ± 0.0003, Left side = 0.0001 ± 0.0008) values of the QL muscle activity. The results of both groups were also statistically significant (p< 0.05). CONCLUSIONS The present study showed that it is possible to determine effective experimental interventions for functional LLD using EMG signal analysis of QL muscle activity on an asymptomatic normal population.
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Affiliation(s)
- Sevim Eryiğit
- Department of Biomedical Engineering, Istanbul University, Istanbul, Turkey
| | - Abdullah Al Kafee
- Department of Biomedical Engineering, Istanbul University, Istanbul, Turkey
| | - Aydin Akan
- Department of Electrical and Electronics Engineering, Izmir University of Economics, Izmir, Turkey
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Influence of Etiology and Onset of Deformity on Spatiotemporal, Kinematic, Kinetic, and Electromyography Gait Variables in Patients with Scoliosis-A Prospective, Comparative Study. Spine (Phila Pa 1976) 2021; 46:374-382. [PMID: 33620181 DOI: 10.1097/brs.0000000000003796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective comparative study. OBJECTIVE The aim of this study was to compare the spatiotemporal, kinematic, kinetic and electromyographic (EMG) gait variables in patients with adolescent idiopathic scoliosis (AIS) and congenital scoliosis and to compare these gait variables of scoliosis patients with healthy controls. SUMMARY OF BACKGROUND DATA Earlier studies have solely focussed on the possibility of altered gait patterns in AIS patients; not much light has been shed on the differences in gait patterns in congenital and adolescent scoliosis patients. METHODS Forty scoliosis patients (20 each with AIS and congenital scoliosis) and 20 healthy volunteers were prospectively recruited. After thorough clinical and radiological examination, all patients underwent gait analysis in accordance with standard protocols.The outcome measures included spatiotemporal, kinetic, kinematic and EMG activity. Composite indices for gait analysis-Gait Profile Score (GPS) and Gait Deviation Index (GDI)-were also calculated. Relevant statistical tests were applied to compare the different groups. RESULTS No significant difference was found between the AIS and congenital scoliosis groups with respect to baseline demographic and radiological parameters. The two subgroups of scoliosis patients (AIS and congenital) did not differ significantly with respect to any of the measured gait analysis parameters. However, when compared to the healthy age-matched control group, the scoliosis patients differed significantly with respect to gait speed, stride length, step length, GDI, GPS and peak EMG activation for erector spinae, biceps femoris, semimembranosus, rectus femoris, gastrocnemious, and tibialis anterior. CONCLUSION Our findings confirm the previous findings of literature regarding the alteration in gait patterns in scoliosis patients when compared to normal individuals. However, the lack of difference in gait analysis variables between AIS and congenital scoliosis patients suggests that this alteration in gait is secondary to the existence of the deformity and does not correlate with the onset or etiology of deformity.Level of Evidence: 2.
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B S, M R, S A, C F. Identification of the most relevant intervertebral effort indicators during gait of adolescents with idiopathic scoliosis. Comput Methods Biomech Biomed Engin 2020; 23:664-674. [PMID: 32401544 DOI: 10.1080/10255842.2020.1758075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The intervertebral efforts, i.e., forces and torques, during gait have been recognized as influencing the progression of scoliosis, due to the mechanical modulations according to the Hueter-Volkmann Law. Therefore, these efforts are key variables for posture correction and to control the progression of scoliosis. Using the intervertebral efforts during gait for the clinical follow-ups has never been performed. For this, it would be necessary to identify amongst all these efforts the most relevant ones, which is the objective of this study. A previously developed dynamical model of the human body was used to compute the 3 D intervertebral efforts during the gait of 15 participants with adolescent idiopathic scoliosis (AIS) and 12 typically developed adolescents (TDA). Kolmogorov-Smirnov and Two-sample t-test were applied on the calculated intervertebral efforts and the graphs of intervertebral efforts were studied. Antero-posterior (AP) forces and torques and medio-lateral (ML) forces are the most relevant intervertebral efforts amongst the other efforts in adolescents with AIS during gait. Discussion: Gait analysis in adolescents with AIS based on the relevant intervertebral efforts could be an effective means to follow-up and evaluate the progression of scoliosis during their treatment period. This study highlights the most relevant intervertebral efforts of individuals with AIS during gait. As future work, the identified intervertebral efforts could be implemented in a quantified and visual feedback tool for therapeutic and performance evaluation or interactive sessions in physiotherapy, e.g., via video games for dynamic posture self-correction.
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Affiliation(s)
- Samadi B
- Department of Mechanical Engineering, Polytechnique Montreal, Canada.,bTechnopole in Pediatric Rehabilitation Engineering, Sainte-Justine UHC, Montreal, Canada
| | - Raison M
- Department of Mechanical Engineering, Polytechnique Montreal, Canada.,Technopole in Pediatric Rehabilitation Engineering, Sainte-Justine UHC, Montreal, Canada
| | - Achiche S
- Department of Mechanical Engineering, Polytechnique Montreal, Canada
| | - Fortin C
- Technopole in Pediatric Rehabilitation Engineering, Sainte-Justine UHC, Montreal, Canada.,School of Rehabilitation, Faculty of Medicine, University of Montreal, Canada
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Šarčević Z, Tepavčević A. Association between adolescent idiopathic scoliosis and sacroiliac joint dysfunction in young athletes: A case control study. Medicine (Baltimore) 2019; 98:e15161. [PMID: 30985695 PMCID: PMC6485790 DOI: 10.1097/md.0000000000015161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis, a 3-dimensional deviation in the axis of the spine. Etiology of AIS is unclear and the general belief is that AIS is multifactorial disorder possibly caused by different factors. It would be worthwhile to reveal new factors associated with AIS. The present study aimed to investigate association between sacroiliac joint (SIJ) dysfunction and AIS in young athletes.This case-control study included 196 children athletes (basketball, football, volleyball, handball, ballet, and others), 82 males and 114 females aged 8 to 17, 98 of them with the diagnosis of AIS. The case group consisted of young athletes examined at a regular checkup by a sport physician and diagnosed with AIS. The control group consisted of athletes matched to the case group according to sex, age, sports, number of training years and number of training hours per week, but without AIS.The scoliosis was diagnosed with Adams' forward bend test and the scoliometer measurement. The SIJ dysfunction was determined using the palpation meter (PALM) measuring the sagittal pelvic position in standing position and in standing position with the hip flexion angle of 90°. The data were analyzed using Student t test, Mann-Whitney U test, contingency coefficients, and logistic regression.The average difference in pelvic position in the sagittal plane (in standing position), with and without hip flexion 90° was found to be statistically different in the case and the control groups (t = 13.88, P = .00). There was a strong positive association between variables representing presence of AIS and SIJ dysfunction (determined by contingency coefficient C = 0.62, coefficient Phi = 0.79 and tetrachoric correlation coefficient 0.95).The logistic regression indicated that the average difference in pelvic position in the sagittal plane (in standing position), with and without hip flexion 90° was significantly associated with the probability of scoliosis in young athletes (P = .00, Wald test).There was a strong positive association between SIJ dysfunction and AIS in young athletes.
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Affiliation(s)
- Zoran Šarčević
- Novi Sad Health Care Centre, Sports Medicine Centre
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
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Diebo BG, Shah NV, Pivec R, Naziri Q, Patel A, Post NH, Assi A, Godwin EM, Lafage V, Schwab FJ, Paulino CB. From Static Spinal Alignment to Dynamic Body Balance: Utilizing Motion Analysis in Spinal Deformity Surgery. JBJS Rev 2018; 6:e3. [DOI: 10.2106/jbjs.rvw.17.00189] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Pau M, Leban B, Pilloni G, Porta M, Cubeddu F, Secci C, Piras V, Monticone M. Trunk rotation alters postural sway but not gait in female children and early adolescents: Results from a school-based screening for scoliosis. Gait Posture 2018; 61:301-305. [PMID: 29413801 DOI: 10.1016/j.gaitpost.2018.01.031] [Citation(s) in RCA: 6] [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: 08/05/2017] [Revised: 10/30/2017] [Accepted: 01/26/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to assess the influence of trunk rotation (TR) on postural sway and spatial-temporal parameters of gait in children and early adolescents screened at school for the presence of scoliosis. METHODS Two hundred and fifty-five individuals aged 9-14 (141 boys, 114 girls) underwent trunk rotation (TR) assessment by means of angle of trunk rotation (ATR) measurements performed with Bunnell's scoliometer. Participants with ATR ≥ 5° formed the TR group whose data were compared with those of a control group (CON) composed of individuals with ATR < 5° matched for age and anthropometric features. Postural sway was calculated on the basis of center of pressure (COP) time series acquired using a pressure plate. Spatial-temporal parameters of gait were derived from trunk accelerations collected by a single inertial sensor located in the low-back region. RESULTS Sway area, sway path, COP velocities in medio-lateral (ML) and antero-posterior (AP) directions and COP displacements in ML direction were found significantly higher in girls with TR, while no differences between the TR and CON groups were detected in boys. Both boys and girls with TR exhibited gait patterns similar to those of their CON schoolmates. CONCLUSIONS These findings suggest that even mild levels of TR may influence balance of female children and early adolescents screened for scoliosis, and thus early interventions including selective and task-oriented exercises appear advisable. In contrast, TR does not appear to influence gait, but further investigations are required to clarify whether different ATR cut-offs may reveal alterations of spatial-temporal parameters.
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Affiliation(s)
- Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy.
| | - Bruno Leban
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Giuseppina Pilloni
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Micaela Porta
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy; Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Fabio Cubeddu
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Claudio Secci
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Veronica Piras
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marco Monticone
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Neurorehabilitation Unit, Department of Neuroscience and Rehabilitation, G. Brotzu Hospital, Cagliari, Italy
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Leteneur S, Simoneau-Buessinger É, Barbier F, Rivard CH, Allard P. Effect of natural sagittal trunk lean on standing balance in untreated scoliotic girls. Clin Biomech (Bristol, Avon) 2017; 49:107-112. [PMID: 28918002 DOI: 10.1016/j.clinbiomech.2017.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 09/05/2017] [Accepted: 09/05/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Generally, scoliotic girls have a tendency to lean further back than a comparable group of non-scoliotic girls. To date, no study has addressed how standing balance in untreated scoliotic girls is affected by a natural backwardly or forwardly inclined trunk. METHODS 27 able-bodied young girls and 27 young girls with a right thoracic curve were classified as leaning forward or backward according to the median of their trunk sagittal inclination. Participants stood upright barefoot. Trunk and pelvis orientations were calculated from 8 bony landmarks. Upright standing balance was assessed by 9 parameters calculated from the excursion of the center of pressure and the free moment. FINDINGS In the anterior-posterior direction, backward scoliotic girls had a greater center of pressure range (P=0.036) and speed (P=0.015) by 10.4mm and 2.8mm/s respectively than the forward scoliotic group. Compared to their matching non-scoliotic group, the backward scoliotic girls stood more on their heels by 14.6mm (P=0.017) and display greater center of pressure speed by 2.5mm/s (P=0.028). Medio-lateral center of pressure range (P=0.018) and speed (P=0.008) were statistically higher by 8.7mm and 3.6mm/s for the backward group. Only the free moment RMS was significantly larger (P=0.045) for the backward scoliotic group when compared to the forwardly inclined scoliotic group. INTERPRETATION Only those with a backward lean displayed statistically significant differences from both forward scoliotic girls and non-scoliotic girls. Untreated scoliotic girls with an exaggerated back extension could profit more from postural rehabilitation to improve their standing balance.
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Affiliation(s)
- Sébastien Leteneur
- Univ Lille Nord de France, F-59000 Lille, France; UVHC, LAMIH, F-59313 Valenciennes, France; CNRS, UMR 8201, F-59313 Valenciennes, France.
| | - Émilie Simoneau-Buessinger
- Univ Lille Nord de France, F-59000 Lille, France; UVHC, LAMIH, F-59313 Valenciennes, France; CNRS, UMR 8201, F-59313 Valenciennes, France
| | - Franck Barbier
- Univ Lille Nord de France, F-59000 Lille, France; UVHC, LAMIH, F-59313 Valenciennes, France; CNRS, UMR 8201, F-59313 Valenciennes, France
| | - Charles-Hilaire Rivard
- Faculty of Medicine, University of Montreal, C.P. 6128, Succursale Centre-ville, Montreal, Quebec H3C 3J7, Canada
| | - Paul Allard
- Department of Kinesiology, University of Montreal, C.P. 6128, Succursale Centre-ville, Montreal, Quebec H3C 3J7, Canada; Human Movement Laboratory, Research Center, Sainte-Justine Hospital, 3175 C^ote-Ste-Catherine, Montreal, Quebec H3T 1C5, Canada
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Gait and energy consumption in adolescent idiopathic scoliosis: A literature review. Ann Phys Rehabil Med 2016; 60:107-116. [PMID: 27986427 DOI: 10.1016/j.rehab.2016.10.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 10/25/2016] [Accepted: 10/25/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a progressive growth disease that affects spinal anatomy, mobility, and left-right trunk symmetry. The disease can modify human gait. OBJECTIVE We aimed to review articles describing the measurement of gait parameters and energy consumption in AIS during walking without any intervention. STUDY DESIGN Literature review. METHODS The search strategy was based on the Population Intervention Comparison Outcome method and included all relevant articles published from 1996 to 2015. Articles were searched in MEDLINE via PubMed, Science Direct, Google Scholar, and ISI Web of Knowledge databases. RESULTS We selected 33 studies investigating the effect of scoliosis deformity on gait parameters and energy expenditure during walking. Most of the studies concluded no significant differences in walking speed, cadence and step width in scoliosis patients and normal participants. However, patients showed decreased hip and pelvic motion, excessive energy cost of walking, stepping pattern asymmetry and ground reaction force asymmetry. CONCLUSION We lack consistent evidence of the effect of scoliosis on temporal spatial and kinematic parameters in AIS patients as compared with normal people. However, further research is needed to assess the effect of scoliosis on gait and energy consumption.
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