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Patel M, Liu XC, Tassone C, Escott B, Yang K, Thometz J. Correlation of transverse rotation of the spine using surface topography and 3D reconstructive radiography in children with idiopathic scoliosis. Spine Deform 2024; 12:1001-1008. [PMID: 38403800 DOI: 10.1007/s43390-024-00838-7] [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: 10/05/2023] [Accepted: 02/02/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE The relationship between axial surface rotation (ASR) measured by surface topography (ST) and axial vertebral rotation (AVR) measured by radiography in the transverse plane is not well defined. This study aimed to: (1) quantify ASR and AVR patterns and their magnitudes from T1 to L5; (2) determine the correlation or agreement between the ASR and AVR; and (3) investigate the relationship between axial rotation differences (ASR-AVR) and major Cobb angle. METHODS This is a retrospective study evaluating patients (age 8-18) with IS or spinal asymmetry with both radiographic and ST measurements. Demographics, descriptive analysis, and correlations and agreements between ASR and AVR were evaluated. A piecewise linear regression model was further created to relate rotational differences to Cobb angle. RESULTS Fifty-two subjects met inclusion criteria. Mean age was 14.1 ± 1.7 and 39 (75%) were female. Looking at patterns, AVR had maximal rotation at T8, while ASR had maximal rotation at T11 (r = 0.35, P = .006). Cobb angle was 24.1° ± 13.3° with AVR of - 1° ± 4.6° and scoliotic angle was 20.9° ± 11.5° with ASR of - 2.3° ± 6.6°. (ASR-AVR) vs Cobb angle was found to be very weakly correlated with a curve of less than 38.8° (r = 0.15, P = .001). CONCLUSION Our preliminary findings support that ASR measured by ST has a weak correlation with estimation of AVR by 3D radiographic reconstruction. This correlation may further help us to understand the application of transverse rotation in some clinical scenarios such as specific casting manipulation, padding mechanism in brace, and surgical correction of rib deformity.
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Affiliation(s)
- Milan Patel
- Department of Orthopedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Xue-Cheng Liu
- Department of Orthopedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA.
- Musculoskeletal Functional Assessment Center, Greenfield Clinic, Children's Wisconsin, Medical College of Wisconsin, 3365 S 103rd St, Suite 2206, Greenfield, WI, 53227, USA.
| | - Channing Tassone
- Department of Orthopedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA
- Musculoskeletal Functional Assessment Center, Greenfield Clinic, Children's Wisconsin, Medical College of Wisconsin, 3365 S 103rd St, Suite 2206, Greenfield, WI, 53227, USA
| | - Benjamin Escott
- Department of Orthopedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA
- Musculoskeletal Functional Assessment Center, Greenfield Clinic, Children's Wisconsin, Medical College of Wisconsin, 3365 S 103rd St, Suite 2206, Greenfield, WI, 53227, USA
| | - Kai Yang
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - John Thometz
- Department of Orthopedic Surgery, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA
- Musculoskeletal Functional Assessment Center, Greenfield Clinic, Children's Wisconsin, Medical College of Wisconsin, 3365 S 103rd St, Suite 2206, Greenfield, WI, 53227, USA
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Bode T, Zoroofchi S, Vettorazzi E, Droste JN, Welsch GH, Schwesig R, Marshall RP. Functional analysis of postural spinal and pelvic parameters using static and dynamic spinometry. Heliyon 2024; 10:e29239. [PMID: 38633646 PMCID: PMC11021985 DOI: 10.1016/j.heliyon.2024.e29239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
Background Spinometry is a radiation-free method to three-dimensional spine imaging that provides additional information about the functional gait patterns related to the pelvis and lower extremities. This radiation-free technology uses the surface topography of the trunk to analyze surface asymmetry and identify bony landmarks, thereby aiding the assessment of spinal deformity and supporting long-term treatment regimes. Especially reliable dynamic spinometric data for spine and pelvis are necessary to evaluate the management of non-specific back pain. Research aim This study aims to generate reliable dynamic spinometric data for spine and pelvis parameters that can serve as reference data for future studies and clinical practice. Methods This study assessed 366 subjects (185 females) under static and 360 subjects (181 females) under dynamic (walking on a treadmill at 3 km/h and 5 km/h) conditions. The DIERS Formetric 4Dmotion® system uses stripes of light to detect the surface topography of the spine and pelvis and identifies specific landmarks to analyze the spine during standing and walking. Results Relevant gender effects were calculated for lordotic angle (ηp2 = 0.22) and pelvic inclination (ηp2 = 0.26). Under static conditions, female subjects showed larger values for both parameters (lordotic angle: 41.6 ± 8.60°; pelvic inclination: 25.5 ± 7.49°). Regarding speed effects, three relevant changes were observed (sagittal imbalance: ηp2 = 0.74, kyphotic angle: ηp2 = 0.13, apical deviation: ηp2 = 0.11). The most considerable changes were observed between static condition and 3 km/h, especially for sagittal imbalance and lordotic angle. For these parameters, relevant effect sizes (d > 0.8) were calculated between static and 3 km/h for males and females. Concerning clinical vertebral parameters, only lordotic angle and pelvic inclination were correlated with each other (r = 0.722). Conclusion This study generated a gender-specific reference database of asymptomatic individuals for static and dynamic spinometry. It demonstrated that the DIERS Formetric 4Dmotion® system could capture natural changes in static and dynamic situations and catalogue functional adaptations of spino-pelvic statics at different speeds. The lordotic angle is an indirect marker of pelvic inclination, allowing spinometry to identify individuals at risk even under dynamic conditions.
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Affiliation(s)
- Tobias Bode
- Athleticum, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Schima Zoroofchi
- Athleticum, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Eik Vettorazzi
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Jan-Niklas Droste
- RasenBallsport Leipzig GmbH, Cottaweg 3, 04177, Leipzig, Germany
- BG Klinikum Hamburg-Boberg, Bergedorfer Str. 10, 21033, Hamburg, Germany
| | - Götz H. Welsch
- Athleticum, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - René Schwesig
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, 06120 Halle (Saale), Germany
| | - Robert Percy Marshall
- RasenBallsport Leipzig GmbH, Cottaweg 3, 04177, Leipzig, Germany
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, 06120 Halle (Saale), Germany
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Đorđević S, Stanković M, Jorgić B, Milenković S, Smailović S, Katanić B, Jelaska I, Pezelj L. The Association of Sagittal Spinal Posture among Elementary School Pupils with Sex and Grade. CHILDREN (BASEL, SWITZERLAND) 2024; 11:446. [PMID: 38671663 PMCID: PMC11049048 DOI: 10.3390/children11040446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/27/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024]
Abstract
The objective of this research was to analyze and elucidate the sagittal spinal posture status in older elementary school children, considering their gender and grade differences. The study involved 484 school children (252 males and 232 females) from grades V to VIII, assessed for sagittal spinal posture using the Formetric 4D System. The analysis, employing the Chi-squared test of independence along with the Z-test, did not reveal significant grade-related differences (p < 0.52) in the incidence of normal sagittal alignment or diagnosed outliers. However, within grade levels, no significant difference was observed for male participants (p < 0.80), while a significant difference was identified for females (p < 0.01). Examining gender differences across grades, a disparity was noted only among seventh graders concerning normal spine alignment and outlier existence (p < 0.01), favoring male participants. Regardless of the grade, a significant gender difference emerged in the location of diagnosed outliers: kyphosis (M = 108 vs. F = 72), lordosis (M = 5 vs. F = 14), kypholordosis (M = 18 vs. F = 66), and flatback outlier of the lumbar spine (M = 27 vs. F = 11). These findings suggest potential adjustments to the curriculum and highlight the need to tailor physical education instruction based on this study's outcomes. Consequently, these results imply the importance of a differentiated approach in preventing sagittal plane outliers of the spine in adolescent children.
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Affiliation(s)
- Stefan Đorđević
- Faculty of Sport and Physical Education, University of Niš, 18000 Niš, Serbia
| | - Mima Stanković
- Faculty of Sport and Physical Education, University of Niš, 18000 Niš, Serbia
| | - Bojan Jorgić
- Faculty of Sport and Physical Education, University of Niš, 18000 Niš, Serbia
| | - Saša Milenković
- Faculty of Sport and Physical Education, University of Niš, 18000 Niš, Serbia
| | - Semrija Smailović
- Department of Pedagogical and Psychological Sciences, University of Novi Pazar, 36300 Novi Pazar, Serbia
| | - Borko Katanić
- Montenegrin Sports Academy, 81110 Podgorica, Montenegro
| | - Igor Jelaska
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia;
| | - Luka Pezelj
- Faculty of Maritime Studies, University of Split, 21000 Split, Croatia
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Ali MS, Usama M. Association Between Two Methods of Spinal and Pelvic Analysis Among Children With Cerebral Palsy. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2024; 24:67-72. [PMID: 38427370 PMCID: PMC10910198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 03/02/2024]
Abstract
OBJECTIVES Children with cerebral palsy have weak muscles, which may impair postural adjustments. These postural adjustments are required for gait and dynamic balance during the daily living activities. The aim of this study was to investigate the association between Cobb's angle and Formetric 4D surface topography system in evaluating spinal and pelvic deformity in children with cerebral palsy. METHODS One hundred children with spastic diplegia (6 to 8 years old) diagnosed as cerebral palsy participated in this study and selected from the Outpatient Clinic of Faculty of Physical Therapy. Digital x- ray and formetric analysis were used to measure spinal deformities and pelvic deviation in children with cerebral palsy. RESULTS There were positive correlations between Cobb's angle and formetric parameters, including trunk imbalance, lateral deviation, and pelvic tilt. Also, Formetric parameters were significant predictors of Cobb's angle, including trunk imbalance (for a one-degree increase, Cobb's angle increases by 0.227, lateral deviation (for a one-degree increase, Cobb's angle increases by 0.665), and pelvic tilt (for a one-degree increase, Cobb's angle increases by 0.252). CONCLUSION Formetric 4D surface topography system was effective in evaluating spinal and pelvic deformity in children with cerebral palsy when compared with Digital x-ray.
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Affiliation(s)
- Mostafa S. Ali
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Egypt
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, October 6 University, Egypt
| | - Mahmoud Usama
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Egypt
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Patel M, Liu XC, Yang K, Tassone C, Escott B, Thometz J. 3D Back Contour Metrics in Predicting Idiopathic Scoliosis Progression: Retrospective Cohort Analysis, Case Series Report and Proof of Concept. CHILDREN (BASEL, SWITZERLAND) 2024; 11:159. [PMID: 38397270 PMCID: PMC10886742 DOI: 10.3390/children11020159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/14/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
Adolescent Idiopathic Scoliosis is a 3D spinal deformity commonly characterized by serial radiographs. Patients with AIS may have increased average radiation exposure compared to unaffected patients and thus may be implicated with a modest increase in cancer risk. To minimize lifetime radiation exposure, alternative imaging modalities such as surface topography are being explored. Surface topography (ST) uses a camera to map anatomic landmarks of the spine and contours of the back to create software-generated spine models. ST has previously shown good correlation to radiographic measures. In this study, we sought to use ST in the creation of a risk stratification model. A total of 38 patients met the inclusion criteria for curve progression prediction. Scoliotic curves were classified as progressing, stabilized, or improving, and a predictive model was created using the proportional odds logistic modeling. The results showed that surface topography was able to moderately appraise scoliosis curvatures when compared to radiographs. The predictive model, using demographic and surface topography measurements, was able to account for 86.9% of the variability in the future Cobb angle. Additionally, attempts at classification of curve progression, stabilization, or improvement were accurately predicted 27/38 times, 71%. These results provide a basis for the creation of a clinical tool in the tracking and prediction of scoliosis progression in order to reduce the number of X-rays required.
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Affiliation(s)
- Milan Patel
- Department of Orthopedic Surgery, Children’s Wisconsin, Medical College of Wisconsin, Greenfield, WI 53227, USA
| | - Xue-Cheng Liu
- Department of Orthopedic Surgery, Children’s Wisconsin, Medical College of Wisconsin, Greenfield, WI 53227, USA
| | - Kai Yang
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Channing Tassone
- Department of Orthopedic Surgery, Children’s Wisconsin, Medical College of Wisconsin, Greenfield, WI 53227, USA
| | - Benjamin Escott
- Department of Orthopedic Surgery, Children’s Wisconsin, Medical College of Wisconsin, Greenfield, WI 53227, USA
| | - John Thometz
- Department of Orthopedic Surgery, Children’s Wisconsin, Medical College of Wisconsin, Greenfield, WI 53227, USA
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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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Feustel A, Konradi J, Wolf C, Huthwelker J, Westphal R, Chow D, Hülstrunk C, Drees P, Betz U. Influence of Lateral Sitting Wedges on the Rasterstereographically Measured Scoliosis Angle in Patients Aged 10-18 Years with Adolescent Idiopathic Scoliosis. Bioengineering (Basel) 2023; 10:1086. [PMID: 37760188 PMCID: PMC10525467 DOI: 10.3390/bioengineering10091086] [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: 07/26/2023] [Revised: 08/18/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is a three-dimensional axial deviation of the spine diagnosed in adolescence. Despite a long daily sitting duration, there are no studies on whether scoliosis can be positively influenced by sitting on a seat wedge. For the prospective study, 99 patients with AIS were measured with the DIERS formetric III 4D average, in a standing position, on a level seat and with three differently inclined seat wedges (3°, 6° and 9°). The rasterstereographic parameters 'scoliosis angle' and 'lateral deviation RMS' were analysed. The side (ipsilateral/contralateral) on which the optimal correcting wedge was located in relation to the lumbar/thoraco-lumbar convexity was investigated. It was found that the greatest possible correction of scoliosis occurred with a clustering in wedges with an elevation on the ipsilateral side of the convexity. This clustering was significantly different from a uniform distribution (p < 0.001; chi-square = 35.697 (scoliosis angle); chi-square = 54.727 (lateral deviation RMS)). It should be taken into account that the effect of lateral seat wedges differs for individual types of scoliosis and degrees of severity. The possibility of having a positive effect on scoliosis while sitting holds great potential, which is worth investigating in follow-up studies.
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Affiliation(s)
- Andreas Feustel
- Department of Orthopaedics and Trauma Surgery, University Medical Centre of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
| | - Jürgen Konradi
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
| | - Claudia Wolf
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
| | - Janine Huthwelker
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
| | - Ruben Westphal
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, D-55118 Mainz, Germany
| | - Daniel Chow
- Department of Health & Physical Education of The Education University of Hong Kong, Hong Kong
| | - Christian Hülstrunk
- Asklepios Katharina-Schroth-Klinik Bad Sobernheim, D-55566 Bad Sobernheim, Germany
| | - Philipp Drees
- Department of Orthopaedics and Trauma Surgery, University Medical Centre of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre of the Johannes Gutenberg University Mainz, D-55131 Mainz, Germany
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Tabard-Fougère A, de Bodman C, Dhouib A, Bonnefoy-Mazure A, Armand S, Dayer R. Three-Dimensional Spinal Evaluation Using Rasterstereography in Patients with Adolescent Idiopathic Scoliosis: Is It Closer to Three-Dimensional or Two-Dimensional Radiography? Diagnostics (Basel) 2023; 13:2431. [PMID: 37510176 PMCID: PMC10377872 DOI: 10.3390/diagnostics13142431] [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: 06/14/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Adolescent Idiopathic Scoliosis (AIS) is a three-dimensional (3D) spine deformity. The Cobb angle, evaluated with 2D radiography, is the gold standard to determine curve severity. The primary aim of this study was to evaluate the 3D spinal evaluation with rasterstereography in patients with AIS. The hypothesis was that rasterstereography reached higher accuracy than the gold standard 2D radiography. The second aim was to compare rasterstereography with 3D radiography. The hypothesis was that the rasterstereographic evaluation of patients with severe major scoliosis curves is closer to 3D radiography compared to the gold standard (2D radiography). (2) Methods: This is a prospective comparative study of a consecutive series of 53 patients, with the scoliosis curve evaluated with two 3D methods and the gold standard (2D radiography). (3) Results: The hypothesis that rasterstereography reached higher accuracy than the gold standard 2D radiography was validated for all curves. Even if all curves were highly correlated, both rasterstereography and 2D radiography scoliosis evaluation were underestimated for moderate/severe curves compared to 3D radiography. (4) Conclusions: The rasterstereographic evaluation of major curve scoliosis is not accurate enough to replace 2D radiography for moderate/severe curves. A longitudinal follow-up should be assessed in future studies to define the sensitivity of the detection of a significant change in the scoliotic mild and moderate curve (<40°).
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Affiliation(s)
- Anne Tabard-Fougère
- Division of Pediatric Orthopaedics, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland
| | - Charlotte de Bodman
- Division of Pediatric Orthopaedics, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland
| | - Amira Dhouib
- Department of Radiology, Reseau Hospitalier Neuchatelois, 2000 Neuchatel, Switzerland
| | - Alice Bonnefoy-Mazure
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, 1205 Geneva, Switzerland
| | - Stéphane Armand
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, 1205 Geneva, Switzerland
| | - Romain Dayer
- Division of Pediatric Orthopaedics, Geneva University Hospitals, University of Geneva, 1205 Geneva, Switzerland
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Suresh S, Perera P, Izatt MT, Labrom RD, Askin GN, Little JP. Development and validation of a semi-automated measurement tool for calculating consistent and reliable surface metrics describing cosmesis in Adolescent Idiopathic Scoliosis. Sci Rep 2023; 13:5574. [PMID: 37019938 PMCID: PMC10076386 DOI: 10.1038/s41598-023-32614-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 03/30/2023] [Indexed: 04/07/2023] Open
Abstract
Adolescent Idiopathic Scoliosis (AIS) is a 3D spine deformity that also causes ribcage and torso distortion. While clinical metrics are important for monitoring disorder progression, patients are often most concerned about their cosmesis. The aim of this study was to automate the quantification of AIS cosmesis metrics, which can be measured reliably from patient-specific 3D surface scans (3DSS). An existing database of 3DSS for pre-operative AIS patients treated at the Queensland Children's Hospital was used to create 30 calibrated 3D virtual models. A modular generative design algorithm was developed on the Rhino-Grasshopper software to measure five key AIS cosmesis metrics from these models-shoulder, scapula and hip asymmetry, torso rotation and head-pelvis shift. Repeat cosmetic measurements were calculated from user-selected input on the Grasshopper graphical interface. InterClass-correlation (ICC) was used to determine intra- and inter-user reliability. Torso rotation and head-pelvis shift measurements showed excellent reliability (> 0.9), shoulder asymmetry measurements showed good to excellent reliability (> 0.7) and scapula and hip asymmetry measurements showed good to moderate reliability (> 0.5). The ICC results indicated that experience with AIS was not required to reliably measure shoulder asymmetry, torso rotation and head-pelvis shift, but was necessary for the other metrics. This new semi-automated workflow reliably characterises external torso deformity, reduces the dependence on manual anatomical landmarking, and does not require bulky/expensive equipment.
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Affiliation(s)
- Sinduja Suresh
- Biomechanics and Spine Research Group (BSRG), Centre for Biomedical Technologies (CBT) at the Centre for Children's Health Research (CCHR), School of Mechanical Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia.
| | - Pasan Perera
- Biomechanics and Spine Research Group (BSRG), Centre for Biomedical Technologies (CBT) at the Centre for Children's Health Research (CCHR), School of Mechanical Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia
| | - Maree T Izatt
- Biomechanics and Spine Research Group (BSRG), Centre for Biomedical Technologies (CBT) at the Centre for Children's Health Research (CCHR), School of Mechanical Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia
- Orthopaedics Department, Queensland Children's Hospital (QCH), Brisbane, Australia
| | - Robert D Labrom
- Biomechanics and Spine Research Group (BSRG), Centre for Biomedical Technologies (CBT) at the Centre for Children's Health Research (CCHR), School of Mechanical Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia
- Orthopaedics Department, Queensland Children's Hospital (QCH), Brisbane, Australia
| | - Geoffrey N Askin
- Biomechanics and Spine Research Group (BSRG), Centre for Biomedical Technologies (CBT) at the Centre for Children's Health Research (CCHR), School of Mechanical Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia
- Orthopaedics Department, Queensland Children's Hospital (QCH), Brisbane, Australia
| | - J Paige Little
- Biomechanics and Spine Research Group (BSRG), Centre for Biomedical Technologies (CBT) at the Centre for Children's Health Research (CCHR), School of Mechanical Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia
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Sarnadskiy VN, Batorov DY, Shchuchkina OA. Comparison of scoliosis diagnostic capabilities in screening of schoolchildren by computer optical topography and video rasterstereography using TODP and Formetric topographs. HIRURGIÂ POZVONOČNIKA (SPINE SURGERY) 2023. [DOI: 10.14531/ss2023.1.16-27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Objective. To analyze the results of scoliosis diagnostics during the examination of the same group of schoolchildren by TODP and Formetriс topographs.Material and Methods. A total of 364 schoolchildren (197 girls and 167 boys, mean age 8.92 ± 1.9 years) were examined, divided into 3 age groups: 6–8 years old (n = 135, mean age 7.22 ± 0.7 years), 8–10 years old (n = 134 children, mean age 8.95 ± 0.56 years), 10–12 years old (n = 95 children, mean age 11.35 ± 1.59 years). Schoolchildren were examined in turn by computer optical topography (TODP, released in 2021, WTOPO 5.4-2021 software) and video raster stereography (Formetric 4D released in 2015, DICAM2.6.4 software). Three standard screening poses were used for TODP, and one pose with averaging 12 frames – for Formetric.Results. The obtained statistics on the distribution of topographic analogs of the Cobb angle (the angle of lateral asymmetry for TODP and the angle of scoliosis for Formetric) showed a significant discrepancy in the percentage of detected scoliosis cases: 0–5° – 50,0 % (TODP) and 4.1 % (Formetric); 5–7° – 33.8 % and 9.3 %; 7–9° – 12.4 % and 17.9 %; 9–15° – 3.8 % and 51.6 %; 15–25° – 0,0 % and 16.2 %; 25–50° – 0,0 % and 0.8 %, respectively. Clinically significant cases of scoliosis (9° or more) in the age groups was 3.7 %, 2.2 %, 6.6 % (mean – 3.8 %) for TODP and 71.1 %, 70.1 %, 63.2 % (average – 68.7 %) for Formetric. At the same time, only 14 cases of clinically significant scoliosis (from 9° to 15°), including 9 structural and 5 compensatory scoliosis, were detected by TODP, and 250 scoliosis cases (188 – from 9° to 15°, 59 – from 15° to 25°, 3 – from 25° to 37°) – by Formetric. For 9 structural scoliosis cases (according to TODP), the Formetric diagnosis coincided completely only in 2 cases and partially in 3 (55 %), and in 5 cases of compensatory scoliosis (according to TODP) it coincided completely in 3 cases and partially in 1 (80 %).Conclusion. According to the results of topographic screening of 364 schoolchildren using the TODP topograph, 3.8 % of scoliosis cases of 9° or more was detected, which corresponds to the average screening data in a number of countries around the world. Examination of the same schoolchildren using the Formetric topograph revealed 68.7 % of cases of scoliosis of 9° or more, which allows us to judge about overdiagnosis and conclude that Formetric is poorly suited for topographic screening of scoliosis in schoolchildren.
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Affiliation(s)
- V. N. Sarnadskiy
- LLC “Medical topographic systems “METOS”
31 Krylova str., office 54, Novosibirsk, 630091, Russia
| | - D. Yu. Batorov
- Hippocrates Polyclinic LLC
55b Aviastroitelei prospect, Dimitrovgrad, 433513, Russia
| | - O. A. Shchuchkina
- Polyclinic Hippocrates LLC
55b Aviastroitelei prospect, Dimitrovgrad, 433513, Russia
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11
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An Investigation of the Association between 3D Spinal Alignment and Fibromyalgia. J Clin Med 2022; 12:jcm12010218. [PMID: 36615020 PMCID: PMC9821294 DOI: 10.3390/jcm12010218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/05/2022] [Accepted: 12/25/2022] [Indexed: 12/29/2022] Open
Abstract
Fibromyalgia syndrome (FMS) is a common condition lacking strong diagnostic criteria; these criteria continue to evolve as more and more studies are performed to explore it. This investigation sought to identify whether participants with FMS have more frequent and larger postural/spinal displacements in comparison to a matched control group without the condition of FMS. A total of 67 adults (55 females) out of 380 participants with FMS were recruited. Participants with FMS were sex- and age-matched with 67 asymptomatic participants (controls) without FMS. We used a three-dimensional (3D) postural assessment device (Formetric system) to analyze five posture variables in each participant in both groups: (1) thoracic kyphotic angle, (2) trunk imbalance, (3) trunk inclination, (4) lumbar lordotic angle, and (5) vertebral rotation. In order to determine whether 3D postural measures could predict the likelihood of a participant having FMS, we applied the matched-pairs binary logistic regression analysis. The 3D posture measures identified statistically and clinically significant differences between the FMS and control groups for each of the five posture variables measured (p < 0.001). For three out of five posture measurements assessed, the binary logistic regression identified there was an increased probability of having FMS with an increased: (1) thoracic kyphotic angle proportional odds ratio [Prop OR] = 1.76 (95% CI = 1.03, 3.02); (2) sagittal imbalance Prop OR = 1.54 (95% CI = 0.973, 2.459); and (3) surface rotation Prop OR = 7.9 (95% CI = 1.494, 41.97). We identified no significant probability of having FMS for the following two postural measurements: (1) coronal balance (p = 0.50) and (2) lumbar lordotic angle (p = 0.10). Our study’s findings suggest there is a strong relationship between 3D spinal misalignment and the diagnosis of FMS. In fact, our results support that thoracic kyphotic angle, sagittal imbalance, and surface rotation are predictors of having FMS.
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Reliability and Validity of Scoliosis Measurements Obtained with Surface Topography Techniques: A Systematic Review. J Clin Med 2022; 11:jcm11236998. [PMID: 36498575 PMCID: PMC9737929 DOI: 10.3390/jcm11236998] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Surface topography (ST) is one of the methods in scoliosis assessment. This study aimed to systematically review the reliability and validity of the ST measurements for assessing scoliosis. METHODS A literature search of four databases was performed and is reported following PRISMA guidelines. The methodological quality was evaluated using Brink and Louw appraisal tool and data extraction was performed. The results were analyzed and synthesized qualitatively using the level of evidence method. RESULTS Eighteen studies were included and analyzed. Four were evaluated for reliability, six for validity, and eight for reliability and validity. The methodological quality of fourteen studies was high. Good to excellent intra-investigator reliability was shown on asymmetry, sagittal, horizontal, and most frontal ST measurements (evidence level: strong). Asymmetry and most frontal, sagittal, horizontal ST measurements showed good to excellent inter-investigator reliability (evidence level: moderate). When comparing corresponding ST and radiological measurements, good to strong validity was shown on most frontal, sagittal, and asymmetry measurements (evidence level: strong). Formetric measurements had good intra-investigator reliability and validity (evidence level: strong). CONCLUSIONS Most asymmetry, sagittal, and frontal ST measurements showed satisfactory reliability and validity. Horizontal ST measurements showed good reliability and poor validity. The ST technique may have great potential in assessing scoliosis, especially in reducing radiation exposure and performing cosmetic assessments.
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Moustafa IM, Shousha TM, Walton LM, Raigangar V, Harrison DE. Reduction of Thoracic Hyper-Kyphosis Improves Short and Long Term Outcomes in Patients with Chronic Nonspecific Neck Pain: A Randomized Controlled Trial. J Clin Med 2022; 11:jcm11206028. [PMID: 36294349 PMCID: PMC9604450 DOI: 10.3390/jcm11206028] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 11/22/2022] Open
Abstract
This study investigates thoracic hyper kyphosis (THK) rehabilitation using the Denneroll™ thoracic traction orthosis (DTTO). Eighty participants, with chronic non-specific neck pain (CNSNP) and THK were randomly assigned to the control or intervention group (IG). Both groups received the multimodal program; IG received the DTTO. Outcomes included formetric thoracic kyphotic angle ICT—ITL, neck pain and disability (NDI), head repositioning accuracy (HRA), smooth pursuit neck torsion test (SPNT) and overall stability index (OSI). Measures were assessed at baseline, after 30 treatment sessions over the course of 10 weeks, and 1-year after cessation of treatment. After 10 weeks, the IG improved more in neck pain intensity (p < 0.0001) and NDI (p < 0.001). No differences were found for SPNT (p = 0.48) and left-sided HRA (p = 0.3). IG improved greater for OSI (p = 0.047) and right sided HRA (p = 0.02). Only the IG improved in THK (p < 0.001). At 1-year follow-up, a regression back to baseline values for the control group was found for pain and disability such that all outcomes favored improvement in the IG receiving the DTTO; all outcomes (p < 0.001). The addition of the DTTO to a multimodal program positively affected CNSNP outcomes at both the short and 1-year follow-up.
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Affiliation(s)
- Ibrahim Moustafa Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Giza 12511, Egypt
| | - Tamer Mohamed Shousha
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Giza 12511, Egypt
| | - Lori M. Walton
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| | - Veena Raigangar
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| | - Deed E. Harrison
- Private Practice and CBP Non-Profit, Inc., Eagle, ID 83616, USA
- Correspondence:
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14
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Reply to de Reuver et al. Comment on "Grivas et al. Morphology, Development and Deformation of the Spine in Mild and Moderate Scoliosis: Are Changes in the Spine Primary or Secondary? J. Clin. Med. 2021, 10, 5901". J Clin Med 2022; 11:jcm11072049. [PMID: 35407658 PMCID: PMC8999794 DOI: 10.3390/jcm11072049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 12/04/2022] Open
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15
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The effects of two different 8-week stretching protocols on postural stability in amateur sportsmen. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-021-00842-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Purpose
The purpose of this study was to compare the long-term effects of a static versus proprioceptive neuromuscular facilitation (PNF) stretching protocols by means of spinometry and baropodometry. We hypothesized that PNF may be more effective than static stretching in supporting the static and dynamic balance.
Methods
Thirty-six sport science students were divided into three groups: the first group attended a warm-up protocol on the treadmill only (warm-up group) while the other two carried out the same warm-up protocol followed by a static stretching (static group) or by a Contract Relax Antagonist Contract stretching (CRAC group). Stretching programs were performed three times per week on lower limb muscles and the postural stability of each participant was evaluated at entry (pre) and after 8 weeks of training (post).
Results
The ellipse area after a warm-up-only protocol did not change; after the static stretching protocol, it was significantly increased (from 111.3 ± 35.8 to 135.0 ± 32.3, p < 0.05), while after the CRAC protocol, it significantly decreased (from 119.1 ± 23.0 to 88.2 ± 19.8, p < 0.01). CRAC group had a significant reduction in average forces (− 3.9% from pre to post, p < 0.05) and in load response (− 0.6% from pre to post, p < 0.05). Pelvic inclination was reduced from 2.22 to 1.33 mm (p < 0.01) and pelvic torsion decreased by 0.94 ± 0.22° (p < 0.05) after the CRAC protocol.
Conclusions
Eight-week CRAC protocol was an excellent training for static and dynamic balance improvement and it was more effective than static stretching.
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Abstract
PURPOSE This study introduces a novel surface-topographic scanning system capable of automatically generating a suite of objective measurements to characterize torso shape. RESEARCH QUESTION what is the reliability of the proposed system for measurement of trunk alignment parameters in patients with adolescent idiopathic scoliosis (AIS) and controls? METHODS Forty-six adolescents (26 with AIS and 20 controls) were recruited for a prospective reliability study. A series of angular, volumetric, and area measures were computed from topographic scans in each of three clinically relevant poses using a fully automated processing pipeline. Intraclass correlation coefficients (ICC(2,1)) were computed within (intra-) and between (inter-) raters. Measurements were also performed on a torso phantom. RESULTS Topographic measurements computed on a phantom were highly accurate (mean RMS error 1.7%) compared with CT. For human subjects, intra- and inter-rater reliability were both high (average ICC > 0.90) with intrinsic (pose-independent) measurements having near-perfect reliability (average ICC > 0.98). CONCLUSION The proposed system is a suitable tool for topographic analysis of AIS; topographic measurements offer an objective description of torso shape that may complement other imaging modalities. Further research is needed to compare topographic findings with gold standard imaging of spinal alignment, e.g., standing radiography. CONCLUSION clinical parameters can be reliably measured in a fully automated system, paving the way for objective analysis of symmetry, body shape pre/post-surgery, and tracking of pathology without ionizing radiation.
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Karpiel I, Ziębiński A, Kluszczyński M, Feige D. A Survey of Methods and Technologies Used for Diagnosis of Scoliosis. SENSORS (BASEL, SWITZERLAND) 2021; 21:8410. [PMID: 34960509 PMCID: PMC8707023 DOI: 10.3390/s21248410] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/04/2021] [Accepted: 12/09/2021] [Indexed: 02/07/2023]
Abstract
The purpose of this article is to present diagnostic methods used in the diagnosis of scoliosis in the form of a brief review. This article aims to point out the advantages of select methods. This article focuses on general issues without elaborating on problems strictly related to physiotherapy and treatment methods, which may be the subject of further discussions. By outlining and categorizing each method, we summarize relevant publications that may not only help introduce other researchers to the field but also be a valuable source for studying existing methods, developing new ones or choosing evaluation strategies.
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Affiliation(s)
- Ilona Karpiel
- Łukasiewicz Research Network—Institute of Medical Technology and Equipment, 118 Roosevelt, 41-800 Zabrze, Poland;
| | - Adam Ziębiński
- Department of Distributed Systems and Informatic Devices, Silesian University of Technology, 16 Akademicka, 44-100 Gliwice, Poland;
| | - Marek Kluszczyński
- Department of Health Sciences, Jan Dlugosz University, 4/8 Waszyngtona, 42-200 Częstochowa, Poland;
| | - Daniel Feige
- Łukasiewicz Research Network—Institute of Medical Technology and Equipment, 118 Roosevelt, 41-800 Zabrze, Poland;
- Department of Distributed Systems and Informatic Devices, Silesian University of Technology, 16 Akademicka, 44-100 Gliwice, Poland;
- PhD School, Silesian University of Technology, 2A Akademicka, 44-100 Gliwice, Poland
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18
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Liu X, Liu H, Yang X, Liu Z, Liu X, Yu M. Can formetric 4D measurements predict the development of adjacent segment degeneration after single-segment PLIF?: Relative rotation angle as a sensitive predictor. J Orthop Sci 2021; 26:941-947. [PMID: 33148477 DOI: 10.1016/j.jos.2020.09.011] [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: 04/19/2020] [Revised: 08/24/2020] [Accepted: 09/08/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Adjacent segment degeneration (ASD) is a major issue after posterior lumbar interbody fusion (PLIF). The postoperative dynamic change of adjacent segments remains unknown. Hence, this study using the formetric 4D system (DIERS, International GmbH of Schlangenbad, Germany) to determine the impact of PLIF on ASD, and to compare the effectiveness with traditional radiography for the predication of ASD. METHODS Eighty-five consecutive patients who underwent PLIF of a single-segment were included. The formetric 4D system was used to calculate the relative rotation angle between the fusion segment and the upper and lower adjacent vertebrae before and at 6, 12 and 24 months after surgery. The range of motion (ROM) and disc height (DH) of adjacent segments were measured using radiography before surgery and 24 months postoperatively. At the final follow-up, the visual analogue scale (VAS) and Oswestry disability index were used to evaluate the surgical outcome. The patients were divided into two groups according to the occurrence of radiographic ASD: the ASD group with progression of degeneration and the N-ASD group without progression of degeneration. RESULTS The index fusion segments included L2-3 to L5-S1. Preoperatively, the relative rotation angles formed by the fusion segment with the upper and lower adjacent vertebrae were 5.1° ± 2.2° and 3.3° ± 2.0°, respectively, and both angles increased significantly at all time points after surgery (p < 0.05). The angles changed most significantly during L2-3 fusion. Radiographic ASD developed in 13 of 85 patients (15.3%) at 24 months. And the relative rotation angle with the upper adjacent vertebra was larger in the ASD group than in the N-ASD group (p < 0.05). CONCLUSION The relative rotation angle with adjacent vertebra increased significantly after lumbar fusion surgery. It may be a more sensitive predictor than the flexion-extension ROM and DH for the development of radiographic ASD.
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Affiliation(s)
- Xiao Liu
- Department of Orthopedics, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Haonan Liu
- Department of Orthopedics, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 South Lishi Road, Xicheng District, Beijing, 100045, China
| | - Xiaosong Yang
- Department of Orthopedic Surgery, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China
| | - Zhongjun Liu
- Department of Orthopedics, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Xiaoguang Liu
- Department of Orthopedics, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
| | - Miao Yu
- Department of Orthopedics, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
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El Kafy EMA, El-Shamy SM. Efficacy of TheraTogs orthotic undergarment on modulation of spinal geometry in children with diplegic cerebral palsy. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2021. [DOI: 10.1186/s43161-021-00047-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The use of TheraTogs orthotic undergarments has been suggested to improve the ability to stabilize the posture, to correct or prevent deformities, to improve functionality, and to enable the user a more appropriate functional pattern. The aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on modulation of spinal geometry in children with diplegic cerebral palsy. Forty children with diplegic cerebral palsy, with ages ranging from 6 to 9 years, were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Spinal geometry was measured at baseline and after 3 months of intervention using the Formetric system.
Results
Children in both groups showed significant improvements in the spinal geometry (P < 0.05), with significantly greater improvements in the experimental group than the control group. The post-treatment mean values of lateral deviation (mm), pelvic tilt (mm), trunk imbalance (mm), and surface rotation (mm) were 5.45, 6.35, 8.8, and 3.65 and 8, 8.9, 11.2, and 5.9 for the experimental and control group, respectively.
Conclusions
TheraTogs orthotic undergarment may be a useful tool for improving spinal geometry in children with diplegic cerebral palsy.
Trial registration
This study was registered in the ClinicalTrial.gov PRS (NCT04271618).
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Madiraju A, Mulcahey PJ, Knott PT, Haas AR, Cuddihy LA, Antonacci MD, Betz RR. Assessing clinical trunk change with surface topography: anterior scoliosis correction as a model to evaluate curve progression. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:3533-3539. [PMID: 34609617 DOI: 10.1007/s00586-021-06998-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 06/24/2021] [Accepted: 09/14/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Previous work has suggested that surface topography can be used for repeated measurements of deformity during curve monitoring following an initial radiograph. Changes in deformity during natural curve progression may be subtle. An important preemptive question to answer is whether topography can follow a large change in spine deformity, as in scoliosis correction. We assess the ability of surface topography to track the evolution of spine deformity during anterior scoliosis correction relative to traditional radiographs. Anterior scoliosis correction was chosen for this analysis because it changes the shape of the trunk without leaving a surgical scar and muscle atrophy along the posterior spine. METHODS Following IRB approval, 18 patients aged 14.6 ± 2.0 years at surgery were enrolled in a retrospective review of coronal radiographs and topographic scans acquired before and after scoliosis correction. Radiographic and topographic measures for the coronal curve angle before and after surgery were compared. RESULTS Surface topography estimates correlate with radiographic measures of the pre- (r = 0.7890, CI = [0.4989 0.9201], p < 0.00001), postsurgical (r = 0.7485, CI = [0.4329 0.9006], p = 0.0004), and the change in the coronal curve angle (r = 0.6744, CI = [0.3028 0.8680], p = 0.0021) due to surgery. CONCLUSIONS We provide evidence open for further extension that topography can follow changes in the coronal curve angle comparably to radiographs. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Alekhya Madiraju
- The Institute for Spine and Scoliosis, 3100 Princeton Pike Bldg. 1-D, Lawrenceville, NJ, 08648, USA
| | - Patrick J Mulcahey
- The Institute for Spine and Scoliosis, 3100 Princeton Pike Bldg. 1-D, Lawrenceville, NJ, 08648, USA
| | - Patrick T Knott
- Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL, 60064, USA
| | - Allison R Haas
- The Institute for Spine and Scoliosis, 3100 Princeton Pike Bldg. 1-D, Lawrenceville, NJ, 08648, USA
| | - Laury A Cuddihy
- The Institute for Spine and Scoliosis, 3100 Princeton Pike Bldg. 1-D, Lawrenceville, NJ, 08648, USA
| | - M Darryl Antonacci
- The Institute for Spine and Scoliosis, 3100 Princeton Pike Bldg. 1-D, Lawrenceville, NJ, 08648, USA
| | - Randal R Betz
- The Institute for Spine and Scoliosis, 3100 Princeton Pike Bldg. 1-D, Lawrenceville, NJ, 08648, USA.
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Pasha S, Rajapaske CR, Reddy R, Diebo B, Knott P, Jones BC, Kumar D, Zhu W, Lou E, Shapira N, Noel P, Ho-Fung V, Jaramillo D. Quantitative imaging of the spine in adolescent idiopathic scoliosis: shifting the paradigm from diagnostic to comprehensive prognostic evaluation. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2021; 31:1273-1285. [PMID: 33517495 DOI: 10.1007/s00590-021-02883-8] [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: 10/14/2020] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE We aimed to provide a perspective review of the available quantitative imaging modalities of the spine for prognostic evaluation of the adolescent idiopathic scoliosis (AIS). METHODS A technical description of the current imaging technologies for quantitative assessment of the pediatric spine with scoliosis was provided, and the pros and cons of each method were discussed. Imaging modalities that quantify the overall 3D alignment of the spine as well as the structural specification of the spinal bone, intervertebral disc, endplates, and ligaments as it pertains to development and progression of the idiopathic spinal deformities in adolescents were discussed. RESULTS Low-dose and microdose stereoradiography, ultrasound, and rasterstereography provide quantitative imaging of the 3D spinal alignment with low or no radiation in standing posture which allows repetitive imaging for early detection of the curve development. Quantitative magnetic resonance imaging, including ultrashort dual-echo time and T1-rho can provide quantitative assessment of the spinal tissues relevant to development of idiopathic spinal deformity in pediatric population. New computed tomography scans that uses dual-energy can provides high-resolution measure of the current-state of the bone quality and morphology as well as the osteogenic properties of the bone by quantitative evaluation of the bone marrow. CONCLUSION The presented imaging modalities can provide a wide spectrum of quantifiable information relevant to development and progression of the spinal deformity. Clinical application of these technologies can change the paradigm in clinical assessment of the pediatric scoliosis by improving our understanding of the pathogenesis of the idiopathic scoliosis.
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Affiliation(s)
- Saba Pasha
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, USA.
| | - Chamith R Rajapaske
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Ravinder Reddy
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Bassel Diebo
- State University of New York Downstate Medical Center, New York, USA
| | - Patrick Knott
- Rosalind Franklin University of Medicine and Science, Chicago, USA
| | - Brandon C Jones
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Dushyant Kumar
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Winnie Zhu
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, USA
| | - Edmond Lou
- Department of Electrical Computer Engineering, University of Alberta, Edmonton, Canada
| | - Nadav Shapira
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Peter Noel
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Victor Ho-Fung
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, USA
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Jeon KK, Kim DI. Low Body Mass Index Levels and Idiopathic Scoliosis in Korean Children: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2021; 8:570. [PMID: 34356550 PMCID: PMC8303972 DOI: 10.3390/children8070570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The prevalence of idiopathic scoliosis is rapidly increasing in Korean children, but research on the disorder is limited compared to that in other countries. Accordingly, in the present study, we aimed to investigate the relationship between idiopathic scoliosis and body mass index (BMI) levels in Korean children. METHODS This cross-sectional study enrolled elementary school students and middle school first graders in the Capital Area in Korea. The participants underwent body composition measurements and screening for idiopathic scoliosis. Idiopathic scoliosis was defined as a Cobb angle of ≥10°. The students were classified into three groups-the severely underweight (SUW: BMI < 16 kg/m2) group, the underweight group (UW: 16 ≤ BMI < 18.5 kg/m2), and the normal weight group (NW: 18.5 ≤ BMI < 25 kg/m2) to compare the risk of idiopathic scoliosis across BMI levels. RESULTS The final cohort comprised 1375 participants. The odds ratio (OR) of idiopathic scoliosis was 0.69 (95% confidence interval (CI): 0.50-0.94) and 0.66 (95% CI: 0.49-0.89) for the UW and the NW groups, respectively, with the SUW group as the reference. This shows that the risk decreased significantly by 31% and 34% in the UW and the NW groups, respectively. After controlling for age and sex, the corresponding ORs were 0.72 (95% CI: 0.52-0.98) and 0.70 (95% CI: 0.51-0.96), and the risk significantly decreased by 28% and 30% in the UW and the NW groups, respectively. CONCLUSIONS Low body weight is closely associated with spinal deformity and idiopathic scoliosis.
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Affiliation(s)
- Kyoung-kyu Jeon
- Division of Sports Science, Incheon National University, Incheon 22012, Korea;
- Sport Science Institute, Incheon National University, Incheon 22012, Korea
- Health Promotion Center, Incheon National University, Incheon 22012, Korea
- Functional Rehabilitation Biomechanics Laboratory, Incheon National University, Incheon 22012, Korea
| | - Dong-il Kim
- Sport Science Institute, Incheon National University, Incheon 22012, Korea
- Health Promotion Center, Incheon National University, Incheon 22012, Korea
- Division of Health and Kinesiology, Incheon National University, Incheon 22012, Korea
- Exercise Medicine & Disability & Rehabilitation Laboratory, Incheon National University, Incheon 22012, Korea
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D’Amico M, Kinel E, D’Amico G, Roncoletta P. A Self-Contained 3D Biomechanical Analysis Lab for Complete Automatic Spine and Full Skeleton Assessment of Posture, Gait and Run. SENSORS 2021; 21:s21113930. [PMID: 34200358 PMCID: PMC8201118 DOI: 10.3390/s21113930] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022]
Abstract
Quantitative functional assessment of Posture and Motion Analysis of the entire skeleton and spine is highly desirable. Nonetheless, in most studies focused on posture and movement biomechanics, the spine is only grossly depicted because of its required level of complexity. Approaches integrating pressure measurement devices with stereophotogrammetric systems have been presented in the literature, but spine biomechanics studies have rarely been linked to baropodometry. A new multi-sensor system called GOALS-E.G.G. (Global Opto-electronic Approach for Locomotion and Spine-Expert Gait Guru), integrating a fully genlock-synched baropodometric treadmill with a stereophotogrammetric device, is introduced to overcome the above-described limitations. The GOALS-EGG extends the features of a complete 3D parametric biomechanical skeleton model, developed in an original way for static 3D posture analysis, to kinematic and kinetic analysis of movement, gait and run. By integrating baropodometric data, the model allows the estimation of lower limb net-joint forces, torques and muscle power. Net forces and torques are also assessed at intervertebral levels. All the elaborations are completely automatised up to the mean behaviour extraction for both posture and cyclic-repetitive tasks, allowing the clinician/researcher to perform, per each patient, multiple postural/movement tests and compare them in a unified statistically reliable framework.
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Affiliation(s)
- Moreno D’Amico
- SMART Lab (Skeleton Movement Analysis and Advanced Rehabilitation Technologies)—Bioengineering & Biomedicine Company, 65126 Pescara, Italy; (G.D.); (P.R.)
- Department of Neuroscience, Imaging and Clinical Sciences University G. D’Annunzio, 66100 Chieti, Italy
- Correspondence:
| | - Edyta Kinel
- Department of Rehabilitation, University of Medical Sciences, 61-545 Poznan, Poland;
| | - Gabriele D’Amico
- SMART Lab (Skeleton Movement Analysis and Advanced Rehabilitation Technologies)—Bioengineering & Biomedicine Company, 65126 Pescara, Italy; (G.D.); (P.R.)
| | - Piero Roncoletta
- SMART Lab (Skeleton Movement Analysis and Advanced Rehabilitation Technologies)—Bioengineering & Biomedicine Company, 65126 Pescara, Italy; (G.D.); (P.R.)
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Kinel E, D'Amico M, Roncoletta P. 3D Quantitative Evaluation of Posture and Spine Proprioceptive Perception Through Instinctive Self-Correction Maneuver in Adolescent Idiopathic Scoliosis. Front Bioeng Biotechnol 2021; 9:663394. [PMID: 34141701 PMCID: PMC8204188 DOI: 10.3389/fbioe.2021.663394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/14/2021] [Indexed: 11/24/2022] Open
Abstract
Background Conservative treatment in the adolescent idiopathic scoliosis (AIS) population is based on individual proprioceptive and motor control training. Such training includes physiotherapeutic scoliosis-specific exercises (PSSEs) stimulating the individual capacity to perceive and control his/her posture, particularly the shape of the spine. However, limited knowledge about basic proprioception capability in AIS patients is reported in the literature. Questions (1) How do AIS patients, who did not receive any previous specific postural education treatment, perceive their posture and 3D spine shape? Are they able to modify their posture and 3D spine shape correctly through an instinctive self-correction (ISCO) maneuver? (2) Are posture and ISCO maneuver ability gender dependent in AIS patients? (3) Do AIS patients present different posture and spine shape characteristics as well as different ISCO ability compared with the healthy young adult population? Methods Cross-sectional observational study. 132 (75 females, 57 males) AIS patients’ posture and 3D spine shape have been measured comparing indifferent orthostasis (IO) (neutral erect posture) to ISCO using a non-ionizing 3D optoelectronic stereophotogrammetric approach. Thirteen quantitative biomechanical parameters described the AIS patients body posture. The statistical analysis was performed using a multivariate approach to compare genders in IO, ISCO, and AIS patients vs. healthy young adults–previously published data (57 females, 64 males). Results Males (87.7%) and females (93.3%) of AIS patients were unable to modify posture and 3D spine shape globally. AIS patients gender differences were found in IO, ISCO, and the comparison vs. healthy young adults. When changes occurred, subjects could not focus and control their posture globally, but only in a few aspects at a time. Conclusion Self-correction maneuver producing an improvement in body posture and spine shape is not instinctive and must be trained. In such characteristics, AIS patients are not so dissimilar to healthy young adults. Sagittal plane control is the highest, but ISCO in AIS patients led to worsening in this plane. Control at the lumbar level is neglected in both genders. Such outcomes support the necessity of customized PSSEs to treat AIS patients. The 3D stereo-photogrammetric approach is effective in quantitatively describing the subject’s posture, motor control, and proprioception.
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Affiliation(s)
- Edyta Kinel
- Chair of Rehabilitation and Physiotherapy, Department of Rehabilitation, University of Medical Sciences, Poznań, Poland
| | - Moreno D'Amico
- SMART LAB (Skeleton Movement Analysis and Advanced Rehabilitation Technologies), Bioengineering & Biomedicine Company Srl, San Giovanni Teatino, Italy.,Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Piero Roncoletta
- SMART LAB (Skeleton Movement Analysis and Advanced Rehabilitation Technologies), Bioengineering & Biomedicine Company Srl, San Giovanni Teatino, Italy
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Yıldırım Y, Tombak K, Karaşin S, Yüksel İ, Nur AH, Ozsoy U. Assessment of the reliability of hand-held surface scanner in the evaluation of adolescent idiopathic scoliosis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:1872-1880. [PMID: 33625577 DOI: 10.1007/s00586-021-06769-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 01/02/2021] [Accepted: 02/08/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Spinal deformities due to adolescent idiopathic scoliosis (AIS) result in impairment in the back surface topography. Sophisticated interventions are needed that address different aspects of deformity. The purpose of our study is to test the reliability of hand-held 3D scanners on the assessment of AIS. METHODS Forty-two AIS patients were included in our study. The back surfaces of the patients were scanned with the hand-held 3D scanner, while the patients were in the standing position with the arms hanging at the sides (P1), with the arms extended (P2), and forward bending position (P3). The acquired original image was superimposed with the mirror image. Root mean square (RMS) of the point-to-point distance was calculated, and the differences between the surfaces were determined. Correlation between RMS, Cobb, POTSI, scoliometer, radiographic rotations, TRACE results was calculated. RESULTS A significant correlation coefficency (r) was found between the RMS and Cobb values in the thoracic (P1 = 0.80, P2 = 0.76, P3 = 0.71) and lumbal region (P1 = 0.56, P2 = 0.65, P3 = 0.63); between RMS and Raimondi in the thoracic (r, P1 = 0.80, P2 = 0.81, P3 = 0.78) and lumbar regions (P1 = 0.54, P2 = 0.64, P3 = 0.59); between RMS and scoliometer measurements in the thoracic (r, P1 = 0.58, P2 = 0.50, P3 = 0.41) and lumbar regions (P1 = 0.35, P2 = 0.41, P3 = 0.59); in thoracolumbar region between RMS and POTSI (P1 = 0.50, P2 = 0.25, P3= 0.36), between RMS and TRACE (P1 = 0.68, P2 = 0.5, P3 = 0.52), CONCLUSION: The hand-held scanners may contribute to gaining new insight into diagnosis and follow-up of AIS by its mobility that enables the acquisition of data in desired body position and place such as bedside or our patient clinics. LEVEL OF EVIDENCE IV Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
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Affiliation(s)
- Yılmaz Yıldırım
- Department of Anatomy, Faculty of Medicine, Akdeniz University, Dumlupinar Bulvari, 07058, Antalya, Turkey
| | - Kadriye Tombak
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, Cyprus
| | - Sezen Karaşin
- Department of Anatomy, Faculty of Medicine, Akdeniz University, Dumlupinar Bulvari, 07058, Antalya, Turkey
| | - İnci Yüksel
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, Cyprus
| | - Ahmet Hakan Nur
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Umut Ozsoy
- Department of Anatomy, Faculty of Medicine, Akdeniz University, Dumlupinar Bulvari, 07058, Antalya, Turkey.
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Moustafa IM, Shousha TM, Harrison DE. An investigation of 3D spinal alignment in cervicogenic headache. Musculoskelet Sci Pract 2021; 51:102284. [PMID: 33212363 DOI: 10.1016/j.msksp.2020.102284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/11/2020] [Accepted: 10/29/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is a growing interest in the impact of body posture influences on outcome measures of cervicogenic headache (CGH). OBJECTIVE To evaluate differences in the 3D spinal alignment in cases suffering from chronic CGH compared to a group of strictly matched control participants without CGH. DESIGN A single-blinded, comparative cohort design. METHODS 100 participants suffering from frequent headaches for at least 3 months who fulfilled the CHISG criteria for CGH were match by age and sex to 100 asymptomatic control group participants. A 4D Formetric device was used to assess participants' posture variables of: 1) thoracic kyphosis max (ICT-ITL in degrees); 2) trunk lateral imbalance (VP-DM in mm); 3) Trunk anterior inclination (VP-DM in mm); 4) lumbar lordotic angle (ITL-ILS max in degrees); 5) Vertebral rotation (rms) in degrees. A matched-pairs binary logistic regression was used to determine whether measurements of posture demonstrated an association with the likelihood of the presence of CGH. RESULTS There were statistically significant differences between the CGH and control group for all posture variables indicating larger posture displacements in the CGH group: ICT-ITL (p < .001), Lateral VP-DM (p < .001), Sagittal VP-DM (p < .001), ITL-ILS (p < .001), RMS (p < .001). Logistic regression revealed that as posture displacement increased, a statistically significant increased likelihood of having CGH occurred: (ICT-ITL (max) (p < .001); Trunk imbalance VP-DM (p < .004); Trunk inclination VP-DM (p < .001); and vertebral rotation (RMS) (p = .007). No such relationship was found for Lumbar Lordosis ITL-ILS max. CONCLUSIONS Participants with CGH exhibited increased magnitudes of thoracolumbar posture displacements which corresponded to an increased odds of suffering from CGH compared to matched control participants.
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Affiliation(s)
- Ibrahim M Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, United Arab Emirates; Faculty of Physical Therapy, Cairo University, Egypt.
| | - Tamer M Shousha
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, United Arab Emirates; Faculty of Physical Therapy, Cairo University, Egypt
| | - Deed E Harrison
- Private Practice and CBP Non-Profit, Inc. (A Spine Research Foundation), Eagle, ID, USA
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A Randomized Controlled Trial Investigating the Effects of Equine Simulator Riding on Low Back Pain, Morphological Changes, and Trunk Musculature in Elderly Women. ACTA ACUST UNITED AC 2020; 56:medicina56110610. [PMID: 33202928 PMCID: PMC7696898 DOI: 10.3390/medicina56110610] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 01/20/2023]
Abstract
Background and objectives: Studies on the effects of an equine riding simulator (ERS) program on back pain, spinal alignment, and isokinetic moments in subjects with chronic low back pain (CLBP) remain limited. The purpose of this study was to analyze changes in elderly women with CLBP who participate in an ERS program. Materials and Methods: The 80 participants were all women aged 61–84 years who were randomly assigned to either the control group (CON) or ERS group (ERSG). ERS exercise was performed for a duration of 12 weeks (three times each week). The degree of pain was measured using the Oswestry Disability Index and the visual analog scale. Body composition and spinal alignment were measured using bioelectrical impedance and raster stereography. The isokinetic moments of trunk extensor and flexor were measured before and after the training period. Results: The ERSG showed a significant decrease in back pain compared to the CON. There was a significant decrease in levels of fat in the ERSG, although no differences were shown in terms of muscle mass. However, there was an increased basal metabolic rate (BMR) in the ERSG. Spinal alignment in the ERSG significantly improved. The peak torques of the trunk extensor in the ERSG were also significantly increased. Conclusion: It can be inferred that the ERS exercise can decrease fat and improve the trunk extensor strength through increased BMR, leading to better spinal alignment and reducing back pain in elderly women with CLBP.
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Liu X, Yang XS, Wang L, Yu M, Liu XG, Liu ZJ. Usefulness of a combined approach of DIERS Formetric 4D® and QUINTIC gait analysis system to evaluate the clinical effects of different spinal diseases on spinal-pelvic-lower limb motor function. J Orthop Sci 2020; 25:576-581. [PMID: 31668912 DOI: 10.1016/j.jos.2019.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/31/2019] [Accepted: 09/24/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND To investigate the alterations in body movement and their compensatory characteristics under different spinal diseases through an objective and quantitative analysis of the spinal-pelvic-lower limb motor function. METHODS A total of 120 subjects were recruited from October 2016 to April 2017. The patients were classified into 2 groups in which 65 patients with cervical spondylotic myelopathy (CSM) and 25 patients with idiopathic scoliosis (IS). The former group was evaluated with JOA score while those in the IS group underwent Lenke classification. A control group was set up with 30 healthy subjects. All the subjects were instructed to walk at a constant speed for one minute on a treadmill, and their spinal-pelvic-lower limb motions were monitored simultaneously with a DIERS Formetric 4D® grating system and a QUINTIC gait analysis system. RESULTS The rotation angle of thoracic and lumbar vertebrae in IS group were larger than those in the control group (P < 0.05), and the knee joint angle A in the CSM group and IS group were larger than the control group (P < 0.05). In the CSM group, the knee joint angular velocity and angular acceleration were both greater than the control group (P < 0.05). And there was a negative linear correlation between the JOA score for the lower extremity of CSM patients and their knee joint angular acceleration. CONCLUSION IS patients tend to demonstrate increased swing amplitude of the trunk. Those with CSM will also have larger knee joint angular velocity and angular acceleration.
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Affiliation(s)
- Xiao Liu
- Orthopaedic Department, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Xiao Song Yang
- Orthopaedic Department, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Lei Wang
- Orthopaedic Department, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Miao Yu
- Orthopaedic Department, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China.
| | - Xiao Guang Liu
- Orthopaedic Department, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Zhong Jun Liu
- Orthopaedic Department, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China
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Applebaum A, Ference R, Cho W. Evaluating the role of surface topography in the surveillance of scoliosis. Spine Deform 2020; 8:397-404. [PMID: 31965557 DOI: 10.1007/s43390-019-00001-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 10/19/2019] [Indexed: 11/28/2022]
Abstract
STUDY DESIGN Literature review. OBJECTIVE To review the history, modern uses, limitations, and future direction of surface topography (ST) in surveillance of scoliosis. Spinal deformities, including scoliosis, can be characterized using measurements such as the Cobb angle, lateral curvature, and vertebral rotation. The gold standard for diagnosis and surveillance of such deformities utilizes radiographic images. To minimize repeated radiation exposure, many systems have been developed utilizing ST. ST measures local deviations of a surface from a flat plane. Applying this concept to spinal deformities, ST can non-radiographically study the 3-dimensional shape of the back. One ST system, rasterstereography, projects parallel white light lines onto a patient's back and analyzes line distortion with a camera. While radiography has long been considered the primary diagnostic tool for scoliosis, rasterstereography may possess alternative or complementary benefits in monitoring scoliosis and other diseases. METHODS A comprehensive literature review was performed on the history, development, and validity of ST. The advantages and limitations of this technique were compared to those of radiography. RESULTS While the initial goal of ST, designing a system to accurately reproduce the Cobb angle, was not successful, research efforts over the last 40 years have attempted to improve this correlation. ST technologies, including rasterstereography and the Formetric ST System, currently play important roles in scoliosis surveillance, research, and minimizing radiation exposure in longitudinal care of patients. Such technologies are also useful as an adjunct to X-rays for monitoring disease progression, especially in Parkinson's disease. CONCLUSION Despite its limitations, ST has proven useful across multiple fields of medicine. It is a safe and cost-effective tool for long-term surveillance of scoliosis and early detection of progressive disease. With technological improvements, the Formetric System will become a critical alternative in dynamic spinal motion and gait analysis. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
- Ariella Applebaum
- Department of Orthopedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Ryan Ference
- Department of Orthopedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Woojin Cho
- Department of Orthopedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
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Krott NL, Wild M, Betsch M. Meta-analysis of the validity and reliability of rasterstereographic measurements of spinal posture. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:2392-2401. [PMID: 32277336 DOI: 10.1007/s00586-020-06402-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 03/25/2020] [Accepted: 03/28/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE We provide a meta-analysis for clinicians and researchers regarding reliability and validity of rasterstereographic measurement of the spinal posture. METHOD A comprehensive PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) literature search identified 19 eligible studies evaluating reliability and validity of static rasterstereographic measurements in healthy subjects and patients with different spinal pathologies. RESULTS Our meta-analysis suggests that rasterstereography is a reliable and valid instrument to assess spinal posture parameters, especially thoracic kyphosis, lumbar lordosis, and scoliosis, reliability overall effect sizes rs > .91, ps < .001, validity overall effect sizes rs > 70, ps < .001, when compared to traditional radiological imaging techniques. Validity is higher in scoliosis patients compared with healthy controls. Limitations are a lack of reported statistics of the included studies and small sample sizes. CONCLUSION The first meta-analysis on reliability and validity of rasterstereography shows satisfactory results. Rasterstereography thus presents a reliable and valid alternative to classic radiological imaging technique to assess and evaluate spinal posture in patients with spinal pathologies. Further studies are needed, focusing on the measurement properties of both static and dynamic rasterstereographic measurements.
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Affiliation(s)
- Nikolas Leon Krott
- Department of Orthopaedics, University Hospital RWTH Aachen, Aachen, Germany.
| | - Michael Wild
- Department of Orthopaedics Trauma and Hand Surgery, Klinikum Darmstadt, Darmstadt, Germany
| | - Marcel Betsch
- Department of Orthopaedics, University Hospital RWTH Aachen, Aachen, Germany
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Emerging Techniques in Diagnostic Imaging for Idiopathic Scoliosis in Children and Adolescents: A Review of the Literature. World Neurosurg 2020; 136:128-135. [DOI: 10.1016/j.wneu.2020.01.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 11/18/2022]
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Lonner BS, Castillo A, Kassin G, Ren Y. Surface topography assessment of body shape after surgical correction in adolescent idiopathic scoliosis. Spine Deform 2020; 8:213-220. [PMID: 32030642 DOI: 10.1007/s43390-020-00041-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 05/21/2019] [Indexed: 10/25/2022]
Abstract
HYPOTHESIS Body surface topography (ST) improvements are associated with surgical correction in adolescent idiopathic scoliosis (AIS) and correlate with radiographic imaging. DESIGN Prospective observational study. INTRODUCTION Patients undergoing correction of AIS are most affected by body image. Radiographs have been the standard assessment tool but do not assess body shape features. ST, a validated, radiation-free assessment tool, directly represents the patient's deformity. We set out to assess ST improvements associated with surgical correction in AIS. METHODS Twenty-three consecutive operative AIS patients were enrolled and had radiographs and posterior ST obtained pre- and postoperatively (PO). ST changes were compared using paired t test, and correlations of ST with radiograph measurements were evaluated by linear regression. RESULTS Mean age at surgery was 15.0 ± 2 years, 82.6% female with mean follow-up of 1.0 year. Major Cobb angle improved from 56.91° ± 15.57° to 13.70° ± 4.89°. ST scoliosis angle corrected from 41.43° ± 11.52° to 11.78° ± 7.84° (p < .0001). Trunk length increased from 401.22 ± 32.43 to 422.30 ± 25.77 mm (Δ21.08 mm; p = .0004). Pelvic obliquity (waist asymmetry) trended toward improvement (6.0 ± 4.3 vs. 5.3 ± 7.1 mm; p = .06). Surface rotation was corrected from 17.35 ± 6.73 to 11.8 ± 4.12 mm (p < .0001), highly correlated with clinical trunk rotation (T p = .002 and TL p = .02). ST highly correlated with radiographic parameters. Sagittal balance correlated with improved function (p = .02). CONCLUSION ST, a radiation-free body shape assessment tool, improved with surgical correction of AIS and was highly correlated with radiographic outcomes.
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Affiliation(s)
- Baron S Lonner
- Orthopaedic Surgery, Mount Sinai Hospital, 1468 Madison Ave, New York, NY, 10029, USA.
| | - Andrea Castillo
- Orthopaedic Surgery, Mount Sinai Hospital, 1468 Madison Ave, New York, NY, 10029, USA
| | - Gabrielle Kassin
- Orthopaedic Surgery, Mount Sinai Hospital, 1468 Madison Ave, New York, NY, 10029, USA
| | - Yuan Ren
- Orthopaedic Surgery, Mount Sinai Hospital, 1468 Madison Ave, New York, NY, 10029, USA
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Reliability of the DIERS Formetric 4D Spine Shape Parameters in Adults without Postural Deformities. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1796247. [PMID: 32104678 PMCID: PMC7040381 DOI: 10.1155/2020/1796247] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/06/2019] [Accepted: 12/14/2019] [Indexed: 11/18/2022]
Abstract
The DIERS formetric 4D provides a safe method to monitor and track the progression of postural deformities over time. However, further evaluation of reliability is necessary. Reference values are also needed to indicate postural change. The current study examined the reliability of spine shape parameters produced by the formetric 4D in adults without postural abnormalities and established reference values to determine when real change occurs. Thirty participants were scanned during 1 week. Intraclass correlation coefficients (ICCs) were calculated for 40 spine shape parameters for scans with participants stationary between scans, scans with repositioning between scans, and between days. Within-day and between-day standard error of measurement (SEM), absolute relative SEM, and smallest detectable change (SDC) were reported. ICC for stationary scans was excellent for 29 parameters, good for 10 parameters, and fair for 1 parameter. With repositioning, ICC was excellent for 27 parameters, good for 12 parameters, and fair for 1 parameter. Between days, ICC was excellent for 26 parameters, good for 10 parameters, and fair for 4 parameters. Within-day SEM% was greater than 10% for 6 parameters. Within-day SDC ranged from 1.80 to 25.03 units for a single scan and from 0.97 to 17.93 units for 6 scans. Between-day SEM% was greater than 10% for 9 parameters. Between-day SDC ranged from 1.44 to 28.24 units for a single scan and from 1.05 to 22.2 units for 6 scans. Thirty-six of the 40 spine shape parameters from the DIERS formetric 4D reliably distinguished between participants over time. Reference values were established that can be used to track patient postural change over time. Future research should investigate the clinical relevance of these 40 spine shape parameters and determine when a clinically important change in posture occurs.
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Wu HD, Liu W, Wong MS. Reliability and validity of lateral curvature assessments using clinical ultrasound for the patients with scoliosis: a systematic review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:717-725. [DOI: 10.1007/s00586-019-06280-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/18/2019] [Accepted: 12/29/2019] [Indexed: 01/18/2023]
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Maragkoudakis EG, Gelalis I, Grivas T, Burwell GR, Mazioti C, Tsilimidos G. Using the Scoliometer and a Surface Topography Apparatus to Check if Back Trunk Asymmetry Changes in Children and Adolescents in the Forward Flexion and Standing Erect Positions. Cureus 2019; 11:e6334. [PMID: 31938623 PMCID: PMC6948675 DOI: 10.7759/cureus.6334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The purpose of this study is to evaluate the effects of the forward bending (FB) test versus the standing erect (SE) position on back trunk asymmetry (TA). The Scoliometer in the FB position and the 4D Formetric (4DF; Diers International, Schlangenbad, Germany) readings in the SE position were assessed. Method The angle of trunk inclination (ATI) was measured at the midthoracic, thoracolumbar, and lumbar levels using the Scoliometer in the FB position and the 4DF in the SE position. A total of 134 subjects attending the scoliosis clinic (86 girls and 48 boys), age ranging from seven to 18 years, were assessed. The children and adolescents were divided into three groups according to the severity of TA, symmetric group 1 (0-2 degrees), asymmetry group 2 (2 to 6 degrees), and group 3 having asymmetry of seven or more degrees. Children with leg length discrepancy were excluded from the study. The IBM SPSS v.20 package (IBM Corp., Armonk, NY) was used for analysis. Results At the midthoracic level comparing the Scoliometer to 4DF readings in males in group 1, the Wilcoxon signed ranks test was p=0.451 while for the Spearman’s Rho, it was -0.138; in group 2, p=0.184 and Rho=0.204; and in group 3, p=0.109 and Rho=0.500. For females in group 1, p=0.000 while Rho=0.003; in group 2, p=0.008 and Rho=0.000, and in group 3, p=0.003 while Rho=0.642. At the thoracolumbar level in males for group 1, p=0.004 and Rho=-0.517; in group 2, p=0.006 and Rho=0.000; and in group 3, p=0.043 while Spearman’s Rho=0.053. For females in group 1, p=0.000 and Rho=-0.095; in group 2, p=0.000 and Rho=-0.171; in group 3, p=0.001 while Rho= -0.081. At the lumbar level for males in group 1 p=0.000 while Rho=0.149; in group 2, p=0.003 and Rho=0.373; while in group 3, p=0.109 and Rho= (-). For females in group 1, p=0.000 while Rho=-0.072; in group 2, p=0.001 and Rho=0.168; and in group 3, p=0.068 while Rho=0.500. Conclusion The results of this study show that the back TA in children and adolescents is not similar in the FB and SE positions. This phenomenon probably is attributed to the complicated trunkal (spinal, thoracic, and pelvic) anatomy, and the results of this study may be used as a useful foundation for further understanding of torso dynamics.
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Affiliation(s)
| | - Ioannis Gelalis
- Orthopaedics, University Hospital of Ioannina, Ioannina, GRC
| | - Theodoros Grivas
- Orthopaedics and Traumatology, Tzaneio General Hospital of Piraeus, Piraeus, GRC
| | - Geofrey R Burwell
- Orthopaedics, Centre for Spinal Studies and Surgery, Nottingham University Hospitals Trust, Nottingham, GBR
| | - Christina Mazioti
- Scoliosis Assessment, "Tzaneio" General Hospital of Piraeus, Piraeus, GRC
| | - Gerasimos Tsilimidos
- Family Medicine, Scoliosis Assessment, "Tzaneio" General Hospital of Piraeus, Piraeus, GRC
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Michoński J, Witkowski M, Glinkowska B, Sitnik R, Glinkowski W. Decreased Vertical Trunk Inclination Angle and Pelvic Inclination as the Result of Mid-High-Heeled Footwear on Static Posture Parameters in Asymptomatic Young Adult Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224556. [PMID: 31752144 PMCID: PMC6888429 DOI: 10.3390/ijerph16224556] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/27/2019] [Accepted: 11/13/2019] [Indexed: 12/20/2022]
Abstract
The influence of high-heel footwear on the lumbar lordosis angle, anterior pelvic tilt, and sacral tilt are inconsistently described in the literature. This study aimed to investigate the impact of medium-height heeled footwear on the static posture parameters of homogeneous young adult standing women. Heel geometry, data acquisition process, as well as data analysis and parameter extraction stage, were controlled. Seventy-six healthy young adult women with experience in wearing high-heeled shoes were enrolled. Data of fifty-three subjects were used for analysis due to exclusion criteria (scoliotic posture or missing measurement data). A custom structured light surface topography measurement system was used for posture parameters assessment. Three barefoot measurements were taken as a reference and tested for the reliability of the posture parameters. Two 30-degree wedges were used to imitate high-heel shoes to achieve a repeatable foot position. Our study confirmed the significant (p < 0.001) reduced vertical balance angle and pelvis inclination angle with large and medium-to-large effects, respectively, due to high-heel shoes. No significant differences were found in the kyphosis or lordosis angles. High-heeled shoes of medium height in young asymptomatic women can lead to a straightening effect associated with a reduced vertical balance angle and decreased pelvic inclination.
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Affiliation(s)
- Jakub Michoński
- Institute of Micromechanics and Photonics, Faculty of Mechatronics, Warsaw University of Technology, 02525 Warsaw, Poland; (J.M.); (M.W.); (R.S.)
| | - Marcin Witkowski
- Institute of Micromechanics and Photonics, Faculty of Mechatronics, Warsaw University of Technology, 02525 Warsaw, Poland; (J.M.); (M.W.); (R.S.)
| | - Bożena Glinkowska
- Department of Sports and Physical Education, Medical University of Warsaw, 00581 Warsaw, Poland;
| | - Robert Sitnik
- Institute of Micromechanics and Photonics, Faculty of Mechatronics, Warsaw University of Technology, 02525 Warsaw, Poland; (J.M.); (M.W.); (R.S.)
| | - Wojciech Glinkowski
- Centre of Excellence “TeleOrto” for Telediagnostics and Treatment of Disorders and Injuries of the Locomotor System, Medical University of Warsaw, 00581 Warsaw, Poland
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 00581 Warsaw, Poland
- Polish Telemedicine and eHealth Society, 03728 Warsaw, Poland
- Correspondence: ; Tel.: +48-601-230-577
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Luković V, Ćuković S, Milošević D, Devedžić G. An ontology-based module of the information system ScolioMedIS for 3D digital diagnosis of adolescent scoliosis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2019; 178:247-263. [PMID: 31416553 DOI: 10.1016/j.cmpb.2019.06.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/28/2019] [Accepted: 06/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Conventional information systems are built on top of a relational database. The main weakness of these systems is impossibility to define stable data schema ahead when the knowledge of the system is evolving and dynamic. The widely accepted alternatives to relational databases are ontologies that can be used for designing information systems. Many research papers describe various methods for improving reliability and precision in generating the type of the Lenke classification based on the image processing techniques or a computer program, but all of them require radiograph images. The main objective of this paper is to demonstrate the development of an ontology-based module of the information system ScolioMedIS for adolescent idiopathic scoliosis (AIS) diagnosis and monitoring, which uses optical 3D methods to determine the Lenke classification of AIS and to avoid harmful effects of traditional radiation diagnosis. METHODS For creating an ontology-based module of the ScolioMedIS we used the following steps: specification, conceptualization, formalization and implementation. In the specification and conceptualization phase we performed data collection and analysis to define domain, concepts and relationships for ontology design. In the formalization and implementation stage we developed the OBR-Scolio ontology and the ontology-based module of the ScolioMedIS. The module employs the Protégé-OWL API, as a collection of Java interfaces for the OBR-Scolio ontology, which enables the creating, deleting, and editing of the basic elements of the OBR-Scolio ontology, as well as the querying of the ontology. RESULTS The ontology-based module of ScolioMedIS is tested on the datasets of 20 female and 15 male patients with AIS between the ages of 11 and 18, to categorize spinal curvatures and to automatically generate statistical indicators about the frequency of the basic spinal curvatures, degree of progression or regression of deformity and statistical indicators about curvature characteristics according to the Lenke classification system and Lenke scoliosis types. Results are then compared with analysis of the Lenke classification of 315 observed patients, performed using traditional radiation techniques. CONCLUSIONS This part of the system allows continuous monitoring of the progression/regression of spinal curvatures for each registered patient, which may provide a better management of scoliosis (diagnosis and treatment).
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Affiliation(s)
- Vanja Luković
- Faculty of Technical Sciences, University of Kragujevac, Svetog Save 65, 32000 Čačak, Serbia.
| | - Saša Ćuković
- Faculty of Engineering, University of Kragujevac, Sestre Janjić 6, 34000 Kragujevac, Serbia.
| | - Danijela Milošević
- Faculty of Technical Sciences, University of Kragujevac, Svetog Save 65, 32000 Čačak, Serbia.
| | - Goran Devedžić
- Faculty of Engineering, University of Kragujevac, Sestre Janjić 6, 34000 Kragujevac, Serbia.
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Navarro IJRL, Rosa BND, Candotti CT. Anatomical reference marks, evaluation parameters and reproducibility of surface topography for evaluating the adolescent idiopathic scoliosis: a systematic review with meta-analysis. Gait Posture 2019; 69:112-120. [PMID: 30708093 DOI: 10.1016/j.gaitpost.2019.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 12/30/2018] [Accepted: 01/01/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Surface topography is a radiation-free examination that provides relevant information for the evaluation of patients with Adolescent Idiopathic Scoliosis (AIS). However, its usage is not standardized, which restricts the applicability of this instrument. RESEARCH QUESTIONS (a) To identify the anatomical reference markers used on surface topography; (b) to identify the parameters used on surface topography; and (c) to pool correlation and reproducibility results. METHODS Systematic searches were conducted following MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines. The methodological quality was assessed according to Brink & Louw appraisal tool. RESULTS Twenty-three studies were included for the qualitative synthesis. The most commonly used anatomical reference markers were: the prominent vertebra (C7 or T1), the posterior superior iliac spines (PSISs) and the sacrum (S1). The parameters for the evaluation of the AIS by surface topography are: spinal inclination angle (analogous to Cobb), gibbosity, thoracic kyphosis angle, lumbar lordosis angle, pelvic obliquity, spine length, apex of the curve, C7-S1 distance (frontal plane), and C7-S1 displacement (sagittal plane). Data from eleven studies were metanalyzed and evidenced the correlation of the surface topography with X-ray exams and the reproducibility of the surface topography in the sagittal and frontal planes. SIGNIFICANCE The findings of this study recommend the use of a protocol for the application of the equipment. The analyzed studies predict the use of only four markers for anatomical reference. The evaluation of the AIS can be carried out observing nine parameters. Surface topography correlates with radiography when the spinal inclination angle (Cobb angle), thoracic kyphosis angle and lumbar lordosis angle are compared. Also, surface topography presents inter and intra-rater reproducibility in the sagittal plane and intra-rater reproducibility in the frontal plane.
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Affiliation(s)
- Isis Juliene Rodrigues Leite Navarro
- Physical Education, Physiotherapy and Dance School of Universidade Federal do Rio Grande do Sul (UFRGS), ESEFID/LAPEX/BIOMEC, Rua Felizardo, 750, Porto Alegre, RS, CEP 90690-200, Brazil.
| | - Bruna Nichele da Rosa
- Physical Education, Physiotherapy and Dance School of Universidade Federal do Rio Grande do Sul (UFRGS), ESEFID/LAPEX/BIOMEC, Rua Felizardo, 750, Porto Alegre, RS, CEP 90690-200, Brazil.
| | - Cláudia Tarragô Candotti
- Physical Education, Physiotherapy and Dance School of Universidade Federal do Rio Grande do Sul (UFRGS), ESEFID/LAPEX/BIOMEC, Rua Felizardo, 750, Porto Alegre, RS, CEP 90690-200, Brazil.
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Dakin G, Turner RJ, Cherak SJ. Principal component analysis of the relationship between pelvic inclination and lumbar lordosis. SCOLIOSIS AND SPINAL DISORDERS 2019; 14:1. [PMID: 30783632 PMCID: PMC6375125 DOI: 10.1186/s13013-019-0175-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 01/29/2019] [Indexed: 12/01/2022]
Abstract
Background The purpose of this study was to describe the relationship between pelvic inclination (PI) and lumbar lordosis (LL). Pelvic inclination and pelvic tilt are two different names for the same metric. The geometrical parameters of the spine and pelvis were measured using surface topography scanning, and the data was explored for any physical relationships using principal component analysis. Once widely assumed to be a direct correlation, research in the 1980s first cast doubt upon the PI to LL relationship. And yet, other studies have suggested a relationship does exist. Decades later, the rehabilitation professionals often still rely on this supposed correlation when making decisions about rehabilitation treatment interventions. This theoretical relationship requires further clarification, which is explored herein. Methods Surface topography imaging is a technology that has proven to be a radiation-free way to produce accurate, reliable skeletal alignment measures. Patient data from one physical rehabilitation clinic was collected at the time of initial assessment. Patients presented with a wide range of musculoskeletal complaints. Surface topography scans were performed on 107 patients at the commencement and completion of their therapy. Principal component analysis was performed on the collected data to determine how these spine and pelvic alignment parameters changed between the two points in time and what trends and/or relationships exist between the parameters. Our analysis evaluated eight spinal and pelvic measurements as input and focused on LL and PI as the two principal components at time points of beginning and completion of treatment. Results Pelvic inclination and lumbar lordosis changed during treatment but were not correlated. Conclusion Our data demonstrates that pelvic inclination and lumbar lordosis do not have a predictable relationship as previously assumed.
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Affiliation(s)
- Geoff Dakin
- Dakin Rehab Inc., #603-550 11 Ave SW, Calgary, Alberta T2R 1M7 Canada
| | - Raymond J Turner
- 2Department of Biological Sciences, University of Calgary, Calgary, Alberta T2N 1N4 Canada
| | - Stephana J Cherak
- 3Alberta Children's Hospital Research Institute for Child and Maternal Health, Heritage Medical Research Building, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1 Canada
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KIM K, MULLINEAUX DR, JEON K. A Comparative Study of Spinal Deformity and Plantar Pressure according to the Static Standing Posture of Female Adolescents with or without Idiopathic Scoliosis. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:345-346. [PMID: 31205890 PMCID: PMC6556179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Kewwan KIM
- Division of Exercise and Health Science, College of Arts and Physical Education, Incheon National University, Incheon, Korea
| | - David R. MULLINEAUX
- School of Sport and Exercise Science, College of Social Sciences, University of Lincoln, Lincoln, United Kingdom
| | - Kyoungkyu JEON
- Division of Exercise and Health Science, College of Arts and Physical Education, Incheon National University, Incheon, Korea, Sport Science Institute, Incheon National University, Incheon, Republic of Korea,Corresponding Author:
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Is rasterstereography a valid noninvasive method for the screening of juvenile and adolescent idiopathic scoliosis? EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:526-535. [DOI: 10.1007/s00586-018-05876-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/28/2018] [Accepted: 12/29/2018] [Indexed: 01/24/2023]
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Tabard-Fougère A, Bonnefoy-Mazure A, Dhouib A, Valaikaite R, Armand S, Dayer R. Radiation-free measurement tools to evaluate sagittal parameters in AIS patients: a reliability and validity study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:536-543. [DOI: 10.1007/s00586-018-05875-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 12/17/2018] [Accepted: 12/27/2018] [Indexed: 11/28/2022]
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Heitz PH, Aubin-Fournier JF, Parent É, Fortin C. Test-retest reliability of posture measurements in adolescents with idiopathic scoliosis. Spine J 2018; 18:2247-2258. [PMID: 29746961 DOI: 10.1016/j.spinee.2018.05.006] [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: 10/29/2017] [Revised: 04/16/2018] [Accepted: 05/01/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Posture changes are a major consequence of idiopathic scoliosis (IS). Posture changes can lead to psychosocial and physical impairments in adolescents with IS. Therefore, it is important to assess posture, but the test-retest reliability of posture measurements still remains unknown in this population. PURPOSE The primary objective of the present study was to determine the test-retest reliability of 25 head and trunk posture indices using the Clinical Photographic Postural Assessment Tool (CPPAT) in adolescents with IS. The secondary objective was to determine the standard error of measurement and the minimal detectable change. STUDY DESIGN/SETTING This is a prospective test-retest reliability study carried out at two tertiary university hospital centers. PATIENTS SAMPLE Forty-one adolescents with IS, aged 10-16 years old with curves 10°-45° and treated by medical intervention, were recruited. METHODS Two posture assessments were done using the CPPAT 5-10 days apart following a standardized procedure. Photographs were analyzed with the CPPAT software by digitizing reference landmarks placed on the participant by a physiotherapist evaluator. Generalizability theory was used to obtain a coefficient of dependability, standard error of measurement, and the minimal detectable change at 90% confidence interval. RESULTS Fourteen of 25 posture indices had a good reliability (ϕ≥0.78), 10 had moderate reliability (ϕ=0.55-0.74), and 1 had poor reliability (ϕ=0.45). The most reliable posture indices were waist angle asymmetry (ϕ=0.93), right waist angle (ϕ=0.91), and frontal trunk list (ϕ=0.92). Right sagittal trunk list was the least reliable posture index (ϕ=0.45). The MDC90 values ranged from 2.6 to 10.3° for angular measurements and from 8.4 to 35.1 mm for linear measurements. CONCLUSIONS The present study demonstrates that most posture indices, especially the trunk posture indices, are reproducible in time among adolescents with IS and provides reference values. Clinicians and researchers can use these reference values to assess change in posture over time attributable to treatment effectiveness.
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Affiliation(s)
- Pierre-Henri Heitz
- École de réadaptation, Faculté de médecine, Université de Montréal, 6128, succursale Centre-ville, Montréal, Québec, Canada H3C 3J7
| | - Jean-François Aubin-Fournier
- Centre de réadaptation Marie-Enfant du CHU Sainte-Justine, 5200, rue Bélanger Est, Montréal, Québec, Canada H1T 1C9
| | - Éric Parent
- Department of Physical Therapy, University of Alberta, 8205 114St, Edmonton, Alberta, Canada T6G 2G4
| | - Carole Fortin
- École de réadaptation, Faculté de médecine, Université de Montréal, 6128, succursale Centre-ville, Montréal, Québec, Canada H3C 3J7; Centre de réadaptation Marie-Enfant du CHU Sainte-Justine, 5200, rue Bélanger Est, Montréal, Québec, Canada H1T 1C9; Centre de recherche du CHU Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, Montréal, Québec, Canada H3T 1C5.
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Reply to the letter to the editor of L. Russo et al. concerning "Relationship between sagittal spinal curves geometry and isokinetic trunk muscle strength in adults" by W. Elsayed, A. Farrag, Q. Muaidi, N. Almulhim (2018) Eur Spine J 27:2014-2022. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 28:193-194. [PMID: 30430250 DOI: 10.1007/s00586-018-5829-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 11/04/2018] [Indexed: 10/27/2022]
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KIM K, MULLINEAUX D, JEON K. Exercise Rehabilitative Approach to Functional Improvement in Adult Idiopathic Scoliosis: A Functional Movement Screen-based Program. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:1041-1043. [PMID: 30182006 PMCID: PMC6119563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kewwan KIM
- Division of Sport Science, College of Arts and Physical Education, Incheon National University, Incheon, Republic of Korea
| | - David MULLINEAUX
- School of Sport and Exercise Science, University of Lincoln, Lincoln, United Kingdom
| | - Kyoungkyu JEON
- Division of Sport Science, College of Arts and Physical Education, Incheon National University, Incheon, Republic of Korea, Sport Science Institute, Incheon National University, Incheon, Republic of Korea,Corresponding Author:
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Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, Lebel A, Marti C, Maruyama T, O’Brien J, Price N, Parent E, Rigo M, Romano M, Stikeleather L, Wynne J, Zaina F. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. SCOLIOSIS AND SPINAL DISORDERS 2018; 13:3. [PMID: 29435499 PMCID: PMC5795289 DOI: 10.1186/s13013-017-0145-8] [Citation(s) in RCA: 412] [Impact Index Per Article: 68.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/06/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) produced its first guidelines in 2005 and renewed them in 2011. Recently published high-quality clinical trials on the effect of conservative treatment approaches (braces and exercises) for idiopathic scoliosis prompted us to update the last guidelines' version. The objective was to align the guidelines with the new scientific evidence to assure faster knowledge transfer into clinical practice of conservative treatment for idiopathic scoliosis (CTIS). METHODS Physicians, researchers and allied health practitioners working in the area of CTIS were involved in the development of the 2016 guidelines. Multiple literature reviews reviewing the evidence on CTIS (assessment, bracing, physiotherapy, physiotherapeutic scoliosis-specific exercises (PSSE) and other CTIS) were conducted. Documents, recommendations and practical approach flow charts were developed using a Delphi procedure. The process was completed with the Consensus Session held during the first combined SOSORT/IRSSD Meeting held in Banff, Canada, in May 2016. RESULTS The contents of the new 2016 guidelines include the following: background on idiopathic scoliosis, description of CTIS approaches for various populations with flow-charts for clinical practice, as well as literature reviews and recommendations on assessment, bracing, PSSE and other CTIS. The present guidelines include a total of 68 recommendations divided into following topics: bracing (n = 25), PSSE to prevent scoliosis progression during growth (n = 12), PSSE during brace treatment and surgical therapy (n = 6), other conservative treatments (n = 2), respiratory function and exercises (n = 3), general sport activities (n = 6); and assessment (n = 14). According to the agreed strength and level of evidence rating scale, there were 2 recommendations on bracing and 1 recommendation on PSSE that reached level of recommendation "I" and level of evidence "II". Three recommendations reached strength of recommendation A based on the level of evidence I (2 for bracing and one for assessment); 39 recommendations reached strength of recommendation B (20 for bracing, 13 for PSSE, and 6 for assessment).The number of paper for each level of evidence for each treatment is shown in Table 8. CONCLUSION The 2016 SOSORT guidelines were developed based on the current evidence on CTIS. Over the last 5 years, high-quality evidence has started to emerge, particularly in the areas of efficacy of bracing (one large multicentre trial) and PSSE (three single-centre randomized controlled trials). Several grade A recommendations were presented. Despite the growing high-quality evidence, the heterogeneity of the study protocols limits generalizability of the recommendations. There is a need for standardization of research methods of conservative treatment effectiveness, as recognized by SOSORT and the Scoliosis Research Society (SRS) non-operative management Committee.
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Affiliation(s)
- Stefano Negrini
- Clinical and Experimental Sciences Department, University of Brescia Viale Europa 11, Brescia, Italy
- IRCCS Fondazione Don Gnocchi, Milan, Italy
| | - Sabrina Donzelli
- ISICO (Italian Scientific Spine Institute), Via R. Bellarmino 13/1, 20141 Milan, Italy
| | - Angelo Gabriele Aulisa
- U.O.C. of Orthopedics and Traumatology, Children’s Hospital Bambino Gesù, Institute of Scientific Research, 00165 Rome, Italy
| | - Dariusz Czaprowski
- Center of Body Posture, Olsztyn, Poland
- Department of Physiotherapy, Józef Rusiecki University College, Olsztyn, Poland
| | - Sanja Schreiber
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Alberta Health Services, Department of Surgery, Edmonton, Canada
| | | | - Helmut Diers
- Department of Orthopedics and Trauma Surgery, University Medical Center, Mainz, Germany
| | - Theodoros B. Grivas
- Department of Orthopaedics and Traumatology, “Tzaneio” General Hospital of Piraeus, Piraeus, Greece
| | - Patrick Knott
- Rosalind Franklin University of Medicine and Science, North Chicago, IL USA
| | - Tomasz Kotwicki
- Department of Spine Disorders and Pediatric Orthopedics, University of Medical Sciences, Poznan, Poland
| | - Andrea Lebel
- Scoliosis Physiotherapy & Posture Centre, 231 McLeod Street, Ottawa, Ontario K2P0Z8 Canada
| | - Cindy Marti
- Schroth-Barcelona Institute, LLC, Spinal Dynamics of Wisconsin, SC., Barcelona, Spain
| | - Toru Maruyama
- Saitama Prefectural Rehabilitation Center, Saitama, Japan
| | - Joe O’Brien
- National Scoliosis Foundation, Stoughton, MA USA
| | - Nigel Price
- Section of Spine Surgery, Children’s Mercy Hospitals and Clinics, UMKC Orthopedics, Kansas City, MO USA
| | - Eric Parent
- Department of Physical Therapy, 2-50 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Manuel Rigo
- Salvá SLP (E. Salvá Institute), Vía Augusta 185, 08021 Barcelona, Spain
| | - Michele Romano
- ISICO (Italian Scientific Spine Institute), Via R. Bellarmino 13/1, 20141 Milan, Italy
| | - Luke Stikeleather
- National Scoliosis Center, 3023 Hamaker Court, Suite LL-50, Fairfax, VA 22124 USA
| | - James Wynne
- Boston Orthotics & Prosthetics, Boston, MA USA
| | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), Via R. Bellarmino 13/1, 20141 Milan, Italy
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Schroeder J, Hollander K. Effects of high-heeled footwear on static and dynamic pelvis position and lumbar lordosis in experienced younger and middle-aged women. Gait Posture 2018; 59:53-57. [PMID: 28987767 DOI: 10.1016/j.gaitpost.2017.09.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 08/25/2017] [Accepted: 09/26/2017] [Indexed: 02/02/2023]
Abstract
There is still conflicting evidence about the effect of high-heeled footwear on posture, especially if methodological confounders are taken into account. The purpose of this study was to investigate the effect of high-heeled footwear on lumbopelvic parameters in experienced younger and middle-aged women while standing and walking. Thirty-seven experienced younger (n=19:18-25 years) and middle-aged (n=18:26-56 years) women were included in this randomized crossover study. Using a non-invasive back shape reconstruction device (rasterstereography), static (pelvic tilt and lumbar lordosis angle) and dynamic (pelvic rotation, median lumbar lordosis angle and range of motion) parameters representing pelvis position and lumbar curvature were measured. In order to analyse standing and walking on a treadmill (0.83m/s), the effects of high-heels (7-11cm) were compared to standard control shoes. There were no effects on the lumbar lordosis angle or range of motion under static or dynamic conditions (p>0.05, d≤0.06). But there was a small effect for a reduced pelvic tilt (p=0.003, d=0.24) and a moderate effect for an increased transversal pelvic rotation (p=0.001, d=0.63) due to high heel shoed standing or walking, respectively. There were no significant age-group or interaction effects (p>0.05). Altered pelvic parameters may be interpreted as compensatory adaptations to high-heeled footwear rather than lumbar lordosis adaptations in experienced wearers. The impact of these findings on back complaints should be revisited carefully, because muscular overuse as well as postural load relieving may contribute to chronic consequences. Further research is necessary to examine clinically relevant outcomes corresponding to postural alterations.
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Affiliation(s)
- Jan Schroeder
- Department of Sports and Exercise Medicine, Institute of Human Movement Science, University of Hamburg, Germany.
| | - Karsten Hollander
- Department of Sports and Exercise Medicine, Institute of Human Movement Science, University of Hamburg, Germany
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Ng SY, Bettany-Saltikov J. Imaging in the Diagnosis and Monitoring of Children with Idiopathic Scoliosis. Open Orthop J 2017; 11:1500-1520. [PMID: 29399226 PMCID: PMC5759132 DOI: 10.2174/1874325001711011500] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/10/2017] [Accepted: 09/11/2017] [Indexed: 11/22/2022] Open
Abstract
The paper reviews the current imaging methods in the diagnosis and monitoring of patients with adolescent idiopathic scoliosis. Radiography is generally used in the initial diagnosis of the condition. Postero-anterior erect full spine radiograph is generally prescribed, and is supplemented by lateral full spine radiograph when indicated. To reduce the radiation hazard, only the area of interest should be exposed, and follow-up radiographs should be taken with as few projections as possible. When available, EOS® stereoradiography should be used. The radiation of the microdose protocol is 45 times less than that of the conventional radiography. Surface topography offers another approach to monitoring changes of curvatures in AIS patients. Recently, 3D ultrasound has been found to be able to measure the Cobb angle accurately. Yet, it is still in the early developmental stages. The inherent intrinsic and external limitations of the imaging system need to be resolved before it can be widely used clinically. For AIS patients with atypical presentation, computed tomography (CT) and/or magnetic resonance imaging (MRI) may be required to assess for any underlying pathology. As CT is associated with a high radiation dose, it is playing a diminishing role in the management of scoliosis, and is replaced by MRI, which is also used for pre-operative planning of scoliosis. The different imaging methods have their limitations. The EOS® stereoradiography is expensive and is not commonly available. The surface topography does not enable measurement of Cobb angle, particularly when the patient is in-brace. The 3D ultrasound scanning has inherent intrinsic technical limitation and cannot be used in all subjects. Radiography, however, enables diagnosis and monitoring of the adolescent idiopathic scoliosis (AIS). It is thus the gold standard in the evaluation and management of scoliosis curves.
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Affiliation(s)
- Shu-Yan Ng
- Wanchai Chiropractic Clinic, 11/fl China Hong Kong Tower, 8 Hennessy Road, Wanchai, Hong Kong
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Sedrez JA, Candotti CT, Rosa MIZD, Medeiros FDS, Marques MT, Loss JF. Assessment of Vert-3D repeatability and reproducibility for evaluating the scoliosis of children with different nutritional profiles. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.004.ao06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The Vert-3D is a radiation-free system which offers a three-dimensional view of the back’s surface, providing a quantitative assessment of spinal curvatures. Objective: To verify the repeatability, inter-rater reproducibility, and correlation between Cobb angles and the results of the Vert-3D system version 1 in the evaluation of the front curvatures of the spine in children with different nutritional profiles. Methods: The sample was composed of 115 children who underwent posterior-anterior panoramic digital radiography of the spine and five evaluations with the Vert-3D system by three trained raters. Results: Version 1 of the Vert-3D system showed: (1) significant and moderate correlations of repeatability for arrows on the left (ICC between .54 to .83) and significant and moderate correlations for arrows on the right (ICC between .55 to .60) for only normal BMI; (2) significant correlations of inter-rater reproducibility for left arrows (ICC between .47 to .65), weak to moderate correlations for right arrows (ICC between .29 to .60), and no significance for obese samples; and (3) significant correlations ranging between .31 and .60 on the left side and non-significant correlations to the right side between Cobb angles and scoliosis arrows. Conclusion: High correlation levels solely on the left side decrease the possibility of system-use for the assessment of scoliosis.
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Degenhardt B, Starks Z, Bhatia S, Franklin GA. Appraisal of the DIERS method for calculating postural measurements: an observational study. SCOLIOSIS AND SPINAL DISORDERS 2017; 12:28. [PMID: 28975159 PMCID: PMC5613330 DOI: 10.1186/s13013-017-0134-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 05/01/2017] [Indexed: 11/15/2022]
Abstract
Background Surface topography is increasingly used with postural analysis. One system, DIERS formetric 4D, measures 40 defined spine shape parameters from a 6-s scan. Through system algorithms, a set of spine shape parameter values from 1 of 12 recorded images obtained during a scan becomes the DIERS-reported value (DRV) for postural assessment. The purpose of the current study was to compare DRV with a standard average value (SAV) calculated from all 12 images to determine which method is more appropriate for assessing postural change. Methods One mannequin and 30 human participants were scanned over 5 days. Values from each image and the DRV for 40 defined spine shape parameters were exported, and mean DRV, mean SAV, mean DRV, and within-scan variance were calculated. Absolute difference and percent change between mean DRV and mean SAV were calculated for the mannequin and humans. Inter-method reliability was calculated for humans. Within-scan variance for each parameter was tested for significant variability. Results For all spine shape parameters on the mannequin, absolute difference (< 0.6 mm, 0.1°, or 0.1%) and percent change (< 2.90%) between mean DRV and mean SAV for each parameter were small. Nine parameters on human participants had a large percent change (> 7%). Absolute difference between mean DRV and mean SAV for those nine parameters was small (≤ 0.87 mm or 0.61°). Absolute difference for all other parameters ranged from 0.02 to 6.98 mm for distance measurements, from 0.01 to 1.21° for angle measurements, and from 0.15 to 0.22% for percentage measurements. Inter-method reliability between DRV and SAV was excellent (0.94–1.00). For the mannequin, within-scan variance was small (< 1.62) for all parameters. For humans, within-scan variance ranged from 0.05 to 36.04 and was different from zero for all parameters (all P < 0.001). Conclusions The minimal variability observed in the mannequin suggested the DIERS formetric 4D instrument had high within-scan reliability. The DRV and SAV provided comparable spine shape parameter values. Because within-scan variability is not reported with the DRV, the clinical usefulness of current DRV values is limited. Establishing an estimate of variance with the SAV will allow clinicians to better identify a clinically meaningful change.
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Affiliation(s)
- Brian Degenhardt
- A.T. Still University, 800 W. Jefferson St, Kirksville, 63501 Missouri USA
| | - Zane Starks
- A.T. Still University, 800 W. Jefferson St, Kirksville, 63501 Missouri USA
| | - Shalini Bhatia
- A.T. Still University, 800 W. Jefferson St, Kirksville, 63501 Missouri USA
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