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Bastianel L, Beraldo LM, Pilling BM, Candotti CT. Development, validity and reliability of patient perception of scoliosis-specific physiotherapy (physio-is) questionnaire. Disabil Rehabil 2024; 46:6187-6194. [PMID: 38411124 DOI: 10.1080/09638288.2024.2322040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE To develop a questionnaire for adolescent idiopathic scoliosis (AIS) patients undergoing physiotherapeutic scoliosis-specific exercises (PSSE) and to evaluate its content validity, structural validity, and reliability. METHODOLOGY Seven PSSE treatment experts checked the content validity of the Patient's Perception of Scoliosis-Specific Physiotherapy Questionnaire (Physio-IS). For each Physio-IS item, the content validity indexes must be ≥ 90%. Regarding structural validity and reliability 52 adolescents (ages 10-17) with AIS completed the questionnaire. Structural validity was assessed through exploratory factor analysis. Reliability was verified through internal consistency. RESULTS Physio-IS content was validated in three evaluation rounds, obtaining 100% expert agreement. About structural validity we identified four domains (cumulative explained variance = 68.2%): (1) specific knowledge (seven questions on understanding their scoliosis condition); (2) social repercussion (five questions about social relationship implications); (3) pain (two questions about scoliosis-associated pain); and (4) associated concern (apprehension/expectations regarding the future). The Physio-IS demonstrated very good internal consistency (Cronbach's alpha = 0.76-0.92). CONCLUSION The Physio-IS is a valid and reliable tool for assessing AIS patients undergoing PSSE and helping physiotherapists identify aspects requiring more attention, thus facilitating intervention strategies, as knowing the patient's perception of their condition or treatment is fundamental to AIS treatment success.
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Affiliation(s)
- Laura Bastianel
- Human Movement Sciences in the School of Physical Education, Physical Therapy and Dance of the Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Lucas Menghin Beraldo
- Human Movement Sciences in the School of Physical Education, Physical Therapy and Dance of the Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Betiane Moreira Pilling
- Human Movement Sciences in the School of Physical Education, Physical Therapy and Dance of the Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cláudia Tarragô Candotti
- Human Movement Sciences in the School of Physical Education, Physical Therapy and Dance of the Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Labrom FR, Izatt MT, Askin GN, Labrom RD, Claus AP, Little JP. Segmental deformity markers offer novel indicators of deformity progression risk in deformity-matched adolescent idiopathic scoliosis patients. Spine Deform 2024; 12:1647-1655. [PMID: 39044108 PMCID: PMC11499335 DOI: 10.1007/s43390-024-00927-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 07/01/2024] [Indexed: 07/25/2024]
Abstract
PURPOSE Identification of adolescent idiopathic scoliosis (AIS) patients with mild curvatures who pose significant risk of progressing to severe levels of curvatures is of paramount importance for clinical care. This study aimed to compare segmental deformity changes in AIS sub-cohorts that are dichotomised by progression status. METHODS Thirty-six female participants with Lenke 1 AIS curves were investigated with sequential MRIs during growth. Scans were reformatted to measure orthogonal segmental parameters, including sagittal/coronal wedging angles and axial rotation angles. Participants were dichotomised by progression. Two-tailed, independent sample t-tests were used to compare sub-cohort multi-segmental and segmental deformity parameters. Measurements were compared at each scan number and variable rates of change were determined using actual time between measures. RESULTS AIS progression status sub-cohorts were comparable at scan 1 for multi-segmental deformity parameters (e.g. major thoracic curve angle, rib hump, kyphosis) (P > 0.05). However, apical measures of coronal IVD wedging, axial IVD rotation and axial vertebral rotation were segmental parameters at scan 1 which were larger for participants whose AIS would later go on to clinically progress (all P < 0.05). Measures of segmental hypokyphosis were comparable between groups. As development was tracked at each subsequent scan, coronal and axial plane differences between groups increased in both magnitude and number of differences. CONCLUSION Initial disparity and then subsequent increasing magnitude of change of axial rotation may indicate a higher propensity to clinically progress in the future. This knowledge hopes to provide useful management information for AIS care providers and prognostic education for patients alike. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Fraser R Labrom
- Biomechanics & Spine Research Group, Level 5, Centre for Children's Health Research, Queensland University of Technology and Mater Health Services, 62 Graham St, South Brisbane, 4101, Australia.
- Queensland Children's Hospital and Mater Health Services, Brisbane, Australia.
| | - Maree T Izatt
- Biomechanics & Spine Research Group, Level 5, Centre for Children's Health Research, Queensland University of Technology and Mater Health Services, 62 Graham St, South Brisbane, 4101, Australia
- Queensland Children's Hospital and Mater Health Services, Brisbane, Australia
| | - Geoffrey N Askin
- Biomechanics & Spine Research Group, Level 5, Centre for Children's Health Research, Queensland University of Technology and Mater Health Services, 62 Graham St, South Brisbane, 4101, Australia
- Queensland Children's Hospital and Mater Health Services, Brisbane, Australia
| | - Robert D Labrom
- Biomechanics & Spine Research Group, Level 5, Centre for Children's Health Research, Queensland University of Technology and Mater Health Services, 62 Graham St, South Brisbane, 4101, Australia
- Queensland Children's Hospital and Mater Health Services, Brisbane, Australia
| | - Andrew P Claus
- Tess Cramond Pain and Research Centre, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- School of Health & Rehabilitation Sciences, University of Queensland, St Lucia, QLD, Australia
| | - J Paige Little
- Biomechanics & Spine Research Group, Level 5, Centre for Children's Health Research, Queensland University of Technology and Mater Health Services, 62 Graham St, South Brisbane, 4101, Australia
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Duray C, Ilharreborde B, Khalifé M, Julien-Marsollier F, Simon AL, Ferrero E. Benefit-risks analysis of thoracoplasty in adolescent idiopathic scoliosis treated by sublaminar bands. Orthop Traumatol Surg Res 2024; 110:103484. [PMID: 36435372 DOI: 10.1016/j.otsr.2022.103484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Cosmetic concerns are one of the main complaints of patients with adolescent idiopathic scoliosis (AIS). Several studies have shown a significant improvement in self-image scores after thoracoplasty. However, the effects of thoracoplasty on pulmonary function and clinical outcomes remain debated. The objective was to analyze the benefits and risks of thoracoplasty during AIS surgery using a hybrid construct with sublaminar bands. MATERIAL AND METHODS In this monocentric prospective cohort study, 68 patients with thoracic AIS were consecutively included between 2016 and 2017. All patients had low-dose 3D radiographs. Surgical correction was performed via the posterior approach, using the posteromedial translation technique with a hybrid construct (thoracic sublaminar band and lumbar pedicle screws). A thoracoplasty was proposed in cases of severe rib hump (more than 3cm). Pulmonary function was assessed by pulmonary function tests (PFT) with forced vital capacity, forced expiratory volume in 1 second and total lung capacity). Radiographic parameters and PFT were compared between patients who had or had not had a thoracoplasty preoperatively and 2 years postoperatively. The SRS-22 score was collected at follow-up. RESULTS The average age was 15±3 years. Nineteen patients (27%) had a thoracoplasty. The demographic, radiographic and respiratory data of the 2 groups were comparable preoperatively. The correction was similar between the groups on sagittal and coronal views. At 2 years, the PFTs were comparable to those performed preoperatively and no difference was found between the groups. None of the 12 patients who had a pleural effusion had it drained. The total SRS-22 score and the cosmetic subscore were higher in the thoracoplasty group (p<0.03). DISCUSSION The association of a thoracoplasty with AIS surgery improves the self-image of patients without altering the PFTs at 2 years postoperatively. Given the low morbidity of thoracoplasty, it seems reasonable to offer it to patients with severe rib hump and high cosmetic demands. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Cédric Duray
- Service de chirurgie orthopédique et du rachis, HEGP, université de Paris, Paris, France.
| | - Brice Ilharreborde
- Service de chirurgie orthopédique infantile, université de Paris, hôpital Robert-Debré, Paris, France
| | - Marc Khalifé
- Service de chirurgie orthopédique et du rachis, HEGP, université de Paris, Paris, France
| | | | - Anne-Laure Simon
- Service de chirurgie orthopédique infantile, université de Paris, hôpital Robert-Debré, Paris, France
| | - Emmanuelle Ferrero
- Service de chirurgie orthopédique et du rachis, HEGP, université de Paris, Paris, France
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Zhang Y, Chai T, Weng H, Liu Y. Association between trunk rotation and pelvic rotation in adolescents with idiopathic scoliosis. J Back Musculoskelet Rehabil 2024; 37:337-346. [PMID: 37980642 DOI: 10.3233/bmr-230070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND Previous studies have suggested an association between pelvic rotation (PR) and scoliotic deformity in severe adolescent idiopathic scoliosis (AIS), but none have investigated this relationship in mild to moderate AIS. OBJECTIVE To investigate the relationship between PR and trunk rotation in mild to moderate AIS. METHODS This was a case-control study. The cases were 32 AIS patients with PR in the opposite direction to the thoracic curve, and the controls were 32 AIS patients with PR in the same direction as the thoracic curve. All patients were assessed with the Adams forwards bend test. Type II trunk rotation was selected as exposure. Logistic regression was used to estimate the association between PR direction and types of trunk rotation while accounting for confounders. Multiple linear regression was used to analyse the relationships between PR magnitude and the angle of trunk rotation (ATR). RESULTS Logistic regression showed an unadjusted OR of 9.13 (95% CI 2.92-28.50, P< 0.001), and adjustment for sex and Cobb angle only slightly changed the OR (adjusted OR, 8.23; 95% CI, 2.51-27.01; P= 0.001). The concave/convex ratio was associated with ATR measurements in both cases (β=-0.379; P= 0.030) and controls (β=-0.468, P= 0.008). CONCLUSION An association was found between PR and trunk rotation, which may help achieve more effective physiotherapy in mild to moderate AIS.
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Almahmoud OH, Baniodeh B, Musleh R, Asmar S, Zyada M, Qattousah H. Assessment of idiopathic scoliosis among adolescents and associated factors in Palestine. J Pediatr Nurs 2024; 74:85-91. [PMID: 38029690 DOI: 10.1016/j.pedn.2023.11.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE This study aimed to investigate adolescent idiopathic scoliosis (AIS) and its related risk factors, including body mass index (BMI), physical activity (PA), gender, time of the first menstrual cycle, transportation, backpack weight and the way of carrying a backpack. DESIGN AND METHOD a cross-sectional quantitative design was utilized. A convenient sample of adolescent students in grades seven through ten was included in the study. A self-reported questionnaire with three sections: demographic data; physical data including height, weight and PA; and Adam's forward bend test to determine each student's spine's Cobb angle by measuring the angle of trunk rotation using a scoliometer. The data were analyzed using SPSS version 25, with confidence intervals of 95%. RESULTS A total of 820 schoolchildren participated in the study; 53.7% were female and 46.3% were male. Only 22% of these students engaged in vigorous exercise, compared to 36.7% who engaged in low PA; additionally, 10% of the adolescents had a low BMI. After the analysis, it was found that 5.4% of participants had AIS. Low PA (p = 0.001), being underweight (p = 0.038), and time of first menstrual period (p = 0.033) were significantly associated with AIS, while gender, backpack weight, and way of carrying were not statistically related to AIS. Binary logistic regression identified low PA as an independent predictor of AIS (OR = 7.22, 95%CI [1.64, 31.79]). CONCLUSIONS The frequency of AIS in Palestine was significant, which highlighted the importance of this issue at a national and global level. There was an association between AIS and BMI, PA, and the time of the first menstrual cycle, which signifies the importance of early detection of the problem to limit its burden later in life. PRACTICE IMPLICATIONS Teachers, teenagers, and their parents should be provided with programs that educate and clarify AIS, and a specific protocol should be established for scoliosis screening in schools.
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Affiliation(s)
- Omar H Almahmoud
- Nursing Department, Pharmacy, Nursing and Health Professions College, Birzeit University, Birzeit, Palestine.
| | - Baraa Baniodeh
- Nursing Department, Pharmacy, Nursing and Health Professions College, Birzeit University, Birzeit, Palestine
| | - Reem Musleh
- Nursing Department, Pharmacy, Nursing and Health Professions College, Birzeit University, Birzeit, Palestine
| | - Sanabel Asmar
- Nursing Department, Pharmacy, Nursing and Health Professions College, Birzeit University, Birzeit, Palestine
| | - Mohammed Zyada
- Nursing Department, Pharmacy, Nursing and Health Professions College, Birzeit University, Birzeit, Palestine
| | - Hadeel Qattousah
- Nursing Department, Pharmacy, Nursing and Health Professions College, Birzeit University, Birzeit, Palestine
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Pacheco MP, Carvalho PJ, Cavalheiro L, Sousa FM. Prevalence of Postural Changes and Musculoskeletal Disorders in Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7191. [PMID: 38131742 PMCID: PMC10743088 DOI: 10.3390/ijerph20247191] [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: 10/23/2023] [Revised: 11/24/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Postural changes are considered a public health problem, especially those that affect the spine, as they may predispose to degenerative conditions of the spine in adulthood. Musculoskeletal disorders are the main cause of chronic pain, illness, reduced educational performance, productivity, and quality of life, and are responsible for increased absenteeism, which could compromise the future career of students. The purpose of this study was to identify the prevalence of postural changes and the occurrence of musculoskeletal disorders in different anatomical regions in the 12 months prior and 7 days prior to the application of the questionnaire and the number of affected anatomical regions. METHODS This is an observational, descriptive, cross-sectional study. It included 508 students selected by a stratified random sample. Our outcomes were the Portuguese version of the Standardized Nordic Musculoskeletal Questionnaire, the Adam's test, a scoliometer, and the visual analog pain scale associated with the Nordic Musculoskeletal Questionnaire. RESULTS In total, 79.3% of the students tested positive with the Adam's test. The neck, shoulder, lumbar region, and knee stood out in all of the temporal references, the 12 months prior (44.3%; 35.2%, 50.2%, 34.1%) and the 7 days prior (16.5%, 16.9%; 28.9%, 17.5%), and even in the restriction of activity due to painful symptoms in the 12 months prior (4.3%, 5.3%, 10.6%, 8.5%). CONCLUSIONS Out of 497 students, 403 were identified with postural changes. The high prevalence rate of identified musculoskeletal symptoms in the anatomical regions of the neck, lumbar region, and shoulder raises the need for intervention in students. Gender appears to generate differences between men and women. Pain from multiple body sites is frequent among young adults.
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Affiliation(s)
- Maria Paula Pacheco
- Polytechnic Institute of Coimbra, Coimbra Health School, 3046-854 Coimbra, Portugal;
| | | | - Luís Cavalheiro
- Polytechnic Institute of Coimbra, Coimbra Health School, 3046-854 Coimbra, Portugal;
| | - Filipa Manuel Sousa
- Biomechanics Laboratory, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal;
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Zheng Q, Xie L, Xu J, Xia N, Ma CZH. A feasibility study of applying two-dimensional photogrammetry for screening and monitoring of patients with adolescent idiopathic scoliosis in clinical practice. Sci Rep 2023; 13:14273. [PMID: 37652928 PMCID: PMC10471746 DOI: 10.1038/s41598-023-41267-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023] Open
Abstract
Standing posteroanterior radiographs have been the golden standard to quantify the severity of scoliosis deformity. However, it exposes ionizing radiation to scoliosis patients, and cannot be used for routine screening and monitoring. This study aimed to develop a protocol of measuring postural indexes by using the noninvasive and radiation-free two-dimensional (2D) photogrammetry method and identify its clinical value in scoliosis screening and monitoring. The five postural indexes were measured from the posterior view of 110 participants. One-way ANOVA with post hoc Tukey HSD/Games-Howell analysis was used to compare the differences between the participants in the scoliosis group and the non-scoliosis group. Pearson coefficients of correlation were analyzed to identify the relationships between Cobb angles and each of the five quantitative postural indexes. Based on 2D photogrammetry, the postural indexes of C7 deviation (p = 0.02), shoulder alignment (p < 0.001), scapula alignment (p < 0.001), waist angle discrepancy (p < 0.001), and PSIS alignment (p < 0.001) could significantly differentiate scoliosis and non-scoliosis patients during screening. The waist angle discrepancy (r = 0.4, p = 0.01; r = 0.8, p = 0.03; r = 0.7, p = 0.01) and shoulder alignment (r = 0.6, p = 0.03) had moderate to strong positive correlations with the Cobb angles, which supported their clinical values in monitoring scoliotic curvature changes of adolescent idiopathic scoliosis (AIS) patients.
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Affiliation(s)
- Qian Zheng
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Wuhan, 430030, China
| | - Lingfeng Xie
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Wuhan, 430030, China.
| | - Jiang Xu
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Wuhan, 430030, China
| | - Nan Xia
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Wuhan, 430030, China
| | - Christina Zong-Hao Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, 999077, Hong Kong SAR, China
- Research Institute for Smart Aging, The Hong Kong Polytechnic University, Hung Hom, 999077, Hong Kong SAR, China
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Yoon SY, Lee SY. Effects of 3D Postural Correction and Abdominal Muscle Contraction on the Symmetry of the Transverse Abdominis and Spinal Alignment in Patients with Idiopathic Scoliosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5016. [PMID: 36981926 PMCID: PMC10048999 DOI: 10.3390/ijerph20065016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to investigate the effectiveness of 3D postural correction (3DPC) using corrective cushions (CCs) and abdominal muscle contraction (AMC) on the thickness symmetry of the transversus abdominis (TrA) and spinal alignment in patients with idiopathic scoliosis (IS). In the first experiment, ultrasound measurements were taken of the TrA thickness on both the convex and concave sides of the lumbar curve in the supine position during AMC and non-AMC without 3DPC, and during AMC and non-AMC with 3DPC using CCs, in 11 IS patients. In the second experiment, 37 IS patients participated in a four-week 3DPC exercise program that aimed to maintain TrA thickness symmetry based on the results of the first experiment. The study found that TrA thickness symmetry significantly increased after 3DPC using CCs and combined with AMC (p < 0.05). Additionally, the Cobb angles and trunk rotation angles showed significant decreases, and trunk expansion showed a significant increase (p < 0.05). These results indicate that the simultaneous application of 3DPC and AMC is the most effective way to achieve TrA thickness symmetry in IS patients. Therefore, 3DPC and AMC should be considered as crucial elements in exercise interventions for IS patients.
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Affiliation(s)
- Sung-Young Yoon
- Department of Physical Therapy, Busan Health University, Busan 49318, Republic of Korea;
- Department of Physical Therapy, Graduated School of Kyungsung University, Busan 48434, Republic of Korea
| | - Sang-Yeol Lee
- Department of Physical Therapy, Kyungsung University, Busan 48434, Republic of Korea
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Albuquerque PMNM, Da Silva EPC, Melo TMDS, Montenegro EJN, de Oliveira DA, Guerino MR, De Siqueira GR. Inter-rater Accuracy and Reliability of a Palpation Protocol of the C7 Spinous Process Comprising a Combination of 3 Traditional Palpation Techniques. J Manipulative Physiol Ther 2022; 45:227-234. [PMID: 35879125 DOI: 10.1016/j.jmpt.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 06/08/2022] [Accepted: 06/08/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the accuracy and intrarater reliability of a palpatory protocol based on a combination of 3 palpatory methods to identify both the C7 spinous process (C7 SP) and the factors that affect the errors and inaccuracy of palpation. METHODS Twenty-five women between the ages of 18 and 60 years were submitted to a palpation protocol of the C7 SP, and a radiopaque marker was fixed on the skin at the possible location of the vertebrae. A radiograph and a photograph of the cervical spine were obtained in the same posture by a first rater. A second rater performed the same palpation protocol and took a second photograph. The accuracy and measurement error of the palpation protocol of C7 SP were assessed through radiographic images. The inter-rater reliability was estimated by the interclass correlation coefficient and assessed using photographs of each rater. The Pearson's correlation coefficients (r), the Fisher exact test, and the χ2 test were used to identify the factors associated with the error and inaccuracy of palpation. RESULTS Accuracy of the C7 palpation was 76% with excellent reliability (interclass correlation coefficient = 0.99). There was a moderate correlation between weight and the measurement of palpation error (r = -0.6; P = .003). One hundred percent of inaccuracy palpation was related to the increased soft-tissue thickness (P = .005) in the cervical region. CONCLUSION The palpation protocol described in this study was accurate and presented excellent reliability in identifying the C7 SP. Increased weight and dorsocervical fat pad were associated to error and palpation inaccuracy, respectively.
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Affiliation(s)
| | | | - Thania M de S Melo
- Department of Physiotherapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Eduardo J N Montenegro
- Department of Physiotherapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Daniella A de Oliveira
- Department of Physiotherapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Marcelo R Guerino
- Department of Physiotherapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Gisela R De Siqueira
- Department of Physiotherapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
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Dufvenberg M, Diarbakerli E, Charalampidis A, Öberg B, Tropp H, Aspberg Ahl A, Möller H, Gerdhem P, Abbott A. Six-Month Results on Treatment Adherence, Physical Activity, Spinal Appearance, Spinal Deformity, and Quality of Life in an Ongoing Randomised Trial on Conservative Treatment for Adolescent Idiopathic Scoliosis (CONTRAIS). J Clin Med 2021; 10:4967. [PMID: 34768487 PMCID: PMC8585057 DOI: 10.3390/jcm10214967] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/18/2021] [Accepted: 10/23/2021] [Indexed: 11/23/2022] Open
Abstract
Adolescents with idiopathic scoliosis (AIS) often receive conservative treatments aiming to prevent progression of the spinal deformity during puberty. This study aimed to explore patient adherence and secondary outcomes during the first 6 months in an ongoing randomised controlled trial of three treatment interventions. Interventions consisted of physical activity combined with either hypercorrective Boston brace night shift (NB), scoliosis-specific exercise (SSE), or physical activity alone (PA). Measures at baseline and 6 months included angle of trunk rotation (ATR), Cobb angle, International Physical Activity Questionnaire short form (IPAQ-SF), pictorial Spinal Appearance Questionnaire (pSAQ), Scoliosis Research Society (SRS-22r), EuroQol 5-Dimensions Youth (EQ-5D-Y) and Visual Analogue Scale (EQ-VAS). Patient adherence, motivation, and capability in performing the intervention were reported at 6 months. The study included 135 patients (111 females) with AIS and >1-year estimated remaining growth, mean age 12.7 (1.4) years, and mean Cobb angle 31 (±5.3). At 6 months, the proportion of patients in the groups reporting high to very high adherence ranged between 72 and 95%, while motivation ranged between 65 and 92%, with the highest proportion seen in the NB group (p = 0.014, p= 0.002). IPAQ-SF displayed significant between group main effects regarding moderate activity (F = 5.7; p = 0.004; ηp2 = 0.10), with a medium-sized increase favouring the SSE group compared to NB. Walking showed significant between group main effects, as did metabolic equivalent (MET-min/week), with medium (F = 6.8, p = 0.002; ηp2 = 0.11, and large (F = 8.3, p = < 0.001, ηp2 = 0.14) increases, respectively, for the SSE and PA groups compared to NB. From baseline to 6 months, ATR showed significant between group medium-sized main effects (F = 1.2, p = 0.019, ηp2 = 0.007) favouring the NB group compared to PA, but not reaching a clinically relevant level. In conclusion, patients reported high adherence and motivation to treatment, especially in the NB group. Patients in the SSE and PA groups increased their physical activity levels without other clinically relevant differences between groups in other clinical measures or patient-reported outcomes. The results suggest that the prescribed treatments are viable first-step options during the first 6 months.
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Affiliation(s)
- Marlene Dufvenberg
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, SE 581 83 Linköping, Sweden; (B.Ö.); (A.A.)
| | - Elias Diarbakerli
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, SE 141 86 Stockholm, Sweden; (E.D.); (A.C.); (H.M.); (P.G.)
- Department of Reconstructive Orthopaedics, Karolinska University Hospital Huddinge, SE 141 86 Stockholm, Sweden
| | - Anastasios Charalampidis
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, SE 141 86 Stockholm, Sweden; (E.D.); (A.C.); (H.M.); (P.G.)
- Department of Reconstructive Orthopaedics, Karolinska University Hospital Huddinge, SE 141 86 Stockholm, Sweden
| | - Birgitta Öberg
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, SE 581 83 Linköping, Sweden; (B.Ö.); (A.A.)
| | - Hans Tropp
- Department of Biomedical and Clinical Sciences, Linköping University, SE 581 83 Linköping, Sweden;
- Center for Medical Image Science and Visualization, Linköping University, SE 581 83 Linköping, Sweden
- Department of Orthopaedics, Linköping University Hospital, SE 581 83 Linköping, Sweden
| | - Anna Aspberg Ahl
- Department of Orthopaedics, Ryhov County Hospital, SE 551 85 Jönköping, Sweden;
| | - Hans Möller
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, SE 141 86 Stockholm, Sweden; (E.D.); (A.C.); (H.M.); (P.G.)
- Stockholm Center for Spine Surgery, SE 171 64 Stockholm, Sweden
| | - Paul Gerdhem
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, SE 141 86 Stockholm, Sweden; (E.D.); (A.C.); (H.M.); (P.G.)
- Department of Reconstructive Orthopaedics, Karolinska University Hospital Huddinge, SE 141 86 Stockholm, Sweden
| | - Allan Abbott
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, SE 581 83 Linköping, Sweden; (B.Ö.); (A.A.)
- Department of Orthopaedics, Linköping University Hospital, SE 581 83 Linköping, Sweden
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11
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Factors affecting the prevalence of idiopathic scoliosis among children aged 8-15 years in Prishtina, Kosovo. Sci Rep 2021; 11:16786. [PMID: 34408255 PMCID: PMC8373958 DOI: 10.1038/s41598-021-96398-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 06/24/2021] [Indexed: 11/08/2022] Open
Abstract
Prospective study, Level of evidence II. The aim of the study was to assess the prevalence of scoliosis among children aged 8–15 years old and to identify the impact of schoolbag weight in developing adolescent idiopathic scoliosis (AIS). AIS is a common disease whose prevalence varies between countries and gender, with an increased rate among females compared to males. Screening children in primary school settings for idiopathic scoliosis (IS) is an important public health issue and is crucial for early detection, prevention of further deformity, and healthy child growth. Our sample was composed of 1619 pupils from the municipality of Prishtina, surveyed from March to April 2019. Measurements were made with a scoliometer on the basis of the Adams test process. Three measurements were taken for each of the participants. Additionally, all the pupils were subjected to bare-foot height and weight measurements with and without school bags. The mean ± standard deviation age of pupils was 11.67 ± 2.00 years old and 49% were females. The prevalence of the angle of trunk rotation (ATR) ≥ 5 ° was 26.1%, females had 1.49 higher odds (95%CI 1.19–1.86) to develop an ATR of ≥ 5° compared to males. The highest rate of ATR of ≥ 5° was seen among the ninth-grade students (31.3%). 56.5% of 4th grade students carry a schoolbag weighing over 12.5% of body weight. Relatively high prevalence of idiopathic scoliosis was found in primary schools in Prishtina. The highest prevalence was found in students attending the ninth grade, while females gender dominated.
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Idiopathic scoliosis and associated factors among school children: a school-based screening in Ethiopia. ACTA ACUST UNITED AC 2021; 79:107. [PMID: 34144710 PMCID: PMC8212494 DOI: 10.1186/s13690-021-00633-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/07/2021] [Indexed: 11/10/2022]
Abstract
Background Early detection of scoliosis is a preface to prevent progression. In resource-constrained countries like Ethiopia, there is a need for a cost-effective reliable solution for screening. The surprising fact is that there is neither idiopathic scoliosis screening nor reporting of data from Ethiopia. This study aimed to identify the magnitude, associated factors of scoliosis among school children by using non-invasive and less expensive scoliometer Smartphone app and Adams forward bending test. Methods A school-based cross-sectional survey was carried out from March to June 2019 at seven primary schools. Children were screened by using physical examination (Adams forward bend test) and scoligauge iPhone app. Univariate and multivariable binary logistic regression model analysis was used to identify factors associated with idiopathic scoliosis. Results A total of 1905 children aged between 5 and 16 years were screened, 3.3 % (95 % CI 2.5–4.1) of them were found positive using the scoligauge HD and among them only 1.8 % were identified positive for Adam’s forward bend test. The associated factors of idiopathic scoliosis identified by multivariate analysis were; spinal pain (AOR 4.1, 95 % CI 2.42, 6.89), student sitting on stool: (AOR, 7.03; 95 % CI, 1.52, 32.5), sitting on the bench with a backrest (AOR 4.12; 95 %CI, 1.12, 15.14) and sitting on the bench without backrest: (AOR 4.56; 95 % CI 1.20, 17.34). Conclusions The magnitude of idiopathic scoliosis was relatively low in study setup. More attention is needed towards sitting furniture designs and for children reporting spinal pain.There is a reasonable level of recommendation to advocate that large school-based scoliosis screening was able to detect scoliosis among school children. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00633-0.
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Li C, Zhang B, Liu L, Li Y, Xu Y, Wang L, Yun C, Zhao Y. Design, reliability, and validity of a portable electronic device based on ergonomics for early screening of adolescent scoliosis. J Orthop Translat 2021; 28:83-89. [PMID: 33786321 PMCID: PMC7972962 DOI: 10.1016/j.jot.2020.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/24/2020] [Accepted: 10/20/2020] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND/OBJECTIVE The reported incidence of scoliosis among adolescents in China differs according to screening method owing to the lack of uniformity and limitations of certain techniques. We aimed to design, develop, and validate a non-invasive, accurate, portable, fast, and automated tool that would enable the measurement and storage of data during scoliosis screening. METHODS We designed a new portable electronic scoliosis screening device (PESSD)-for the identification of adolescent scoliosis based on ergonomics theory. The device measured the axial deflection angle of the trunk of the human body using a built-in angle sensor. Data obtained using the PESSD, a traditional scoliometer manual ruler, and X-ray measurement of the Cobb angle were compared. RESULTS The PESSD exhibited more sensitive detection of small-angle scoliosis and improved repeatability compared with the scoliometer. The data obtained using the PESSD showed good correlation with Cobb angle data measured from X-ray images. All patients who were indicated to be positive for scoliosis using the PESSD were found to have clinically identifiable scoliosis from X-ray examination. CONCLUSIONS The PESSD may be able to achieve early detection of scoliosis in adolescents. It is non-invasive, highly precise, portable, easy to use, and offers automated data storage and traceability. This study is a pilot or preliminary validation study. With further, more in depth studies, the PESSD has excellent potential for transformation into an effective tool for use in large-scale screening programs for adolescent scoliosis in schools and communities. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE This article is about designing a new portable electronic scoliosis screening device based on ergonomics theory. Because there are currently no uniform screening methods and standards, the results in this article could facilitate the adoption of a uniform screening tool into large-scale screening programs for adolescent scoliosis in schools and communities, preliminary examination in hospitals, and self-testing at home after parent training.
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Affiliation(s)
- Chunxu Li
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Bojun Zhang
- Department of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, Shanxi, 710049, China
| | - Liang Liu
- National Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Center, Beijing, 100094, China
| | - You Li
- National Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Center, Beijing, 100094, China
| | - Yong Xu
- Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, 100043, China
| | - Li Wang
- National Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Center, Beijing, 100094, China
| | - Cai Yun
- Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing, 100043, China
| | - Yu Zhao
- Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
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González-Ruiz JM, Pérez-Núñez MI, García-Alfaro MD, Bastir M. Geometric morphometrics of adolescent idiopathic scoliosis: a prospective observational 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 2020; 30:612-619. [DOI: 10.1007/s00586-020-06583-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/04/2020] [Accepted: 08/25/2020] [Indexed: 01/13/2023]
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Adamczewska K, Wiernicka M, Kamińska E, Małecka J, Dąbrowska A, Malchrowicz-Mośko E. Annual Observation of Changes in the Angle of Trunk Rotation. Trunk Asymmetry Predictors. A Study from a Scoliosis Screening in School Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061899. [PMID: 32183373 PMCID: PMC7143366 DOI: 10.3390/ijerph17061899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/05/2020] [Accepted: 03/13/2020] [Indexed: 01/09/2023]
Abstract
Adolescent forms of idiopathic scoliosis are commonly encountered deformities of the thoracic and lumbar spine. They affect a significant number of adolescents, yet their cause is still unknown. The presented research is a cross-sectional analysis of 3933 volunteers (2131 girls and 1802 boys). The participants were primary school students aged 9 to 13 years old. This study determined a relationship between predictors such as: body mass, body height and body mass index (BMI) (independent variables) and angle of trunk rotation (ATR) value (dependent variable). Moreover, a stepwise multiple regression with backward selection was conducted to determine to what extent the dependent variable is explained by body mass, body height and BMI. In the group of 11,12,13-year-old girls, the analyzed results of multiple stepwise regression were statistically significant. Among the all studied predictors, it has been shown that body mass in the 11-year-old girls and body height in 12- and 13-year-old girls are major correlates of a 1-year ATR increase in proximal and main thoracic spine levels.
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Affiliation(s)
- Katarzyna Adamczewska
- Faculty of Health Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland; (M.W.); (E.K.); (J.M.)
- Correspondence: ; Tel.: +48-(61)-835-5140, +48-(61)-835-5147
| | - Marzena Wiernicka
- Faculty of Health Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland; (M.W.); (E.K.); (J.M.)
| | - Ewa Kamińska
- Faculty of Health Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland; (M.W.); (E.K.); (J.M.)
| | - Joanna Małecka
- Faculty of Health Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland; (M.W.); (E.K.); (J.M.)
| | - Agata Dąbrowska
- Faculty of Sport Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland; (A.D.); (E.M.-M.)
| | - Ewa Malchrowicz-Mośko
- Faculty of Sport Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland; (A.D.); (E.M.-M.)
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16
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Inter-and intra-observer reliability of scoliogauge app to assess the axial trunk rotation of scoliosis: Prospective reliability analysis study. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kamelska-Sadowska AM, Protasiewicz-Fałdowska H, Zakrzewska L, Zaborowska-Sapeta K, Nowakowski JJ, Kowalski IM. The Effect of an Innovative Biofeedback SKOL-AS® Treatment on the Body Posture and Trunk Rotation in Children with Idiopathic Scoliosis—Preliminary Study. Medicina (B Aires) 2019; 55:medicina55060254. [PMID: 31181685 PMCID: PMC6630342 DOI: 10.3390/medicina55060254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/01/2019] [Accepted: 06/03/2019] [Indexed: 12/02/2022] Open
Abstract
Background and Objectives: The deformity in idiopathic scoliosis (IS) is three dimensional and effective correction involves all three planes. Recently, the biofeedback method has been implemented in the treatment of scoliosis. The aim of this study was to evaluate the effectiveness of an innovative biofeedback SKOL-AS® postural training among children with scoliosis. Materials and Methods: The target population for this study was 28 patients (25 girls and 3 boys) aged between 5 and 16 years old diagnosed and treated with progressing low-grade scoliosis. The postural diagnosis consisted of anthropometric measurements, posterior–anterior X-ray imaging, SpinalMeter® postural assessment and the angle of trunk rotation (ATR) assessment. The SKOL-AS® treatment comprised of 24 sessions conducted in lying and sitting positions, two times a week. Results: It has been shown that the postural training resulted in the decrease in the ATR value (pre- vs. post-exercise in younger: 5.55 vs. 3.0 and older patients: 5.2 vs. 3.0). The increase in height of the subjects seemed to confirm a positive effect of SKOL-AS® elongation treatment. In the posterior view, a statistically significant decrease in shoulder asymmetry in the sitting position in younger children has been observed. In the anterior view, the changes in the head position (based on mouth and eye symmetry) have been observed. The statistically significant increase in acromion–heel, acromion–iliac crest and posterior superior iliac spine (PSIS)–heel length values has been shown in younger children on the left side of the body. After treatment, older subjects had higher acromion–iliac crest and PSIS–heel values on the left side of the body. On the right side only PSIS–heel length was higher. In a sitting position, only a small increase in acromion–iliac crest length value has been observed. Conclusions: The SKOL-AS® biofeedback method could teach good postural habits and teach patients the auto-correction of the spine.
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Affiliation(s)
- Anna M Kamelska-Sadowska
- Clinic of Rehabilitation, Provincial Specialist Children's Hospital in Olsztyn, 18A Żołnierska Street, 10-561 Olsztyn, Poland.
| | - Halina Protasiewicz-Fałdowska
- Department of Rehabilitation, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 18A Żołnierska Street, 10-561 Olsztyn, Poland.
- HUMANUS Centre of Rehabilitation, 15B Kanta, 10-691 Olsztyn, Poland.
| | - Lidia Zakrzewska
- HUMANUS Centre of Rehabilitation, 15B Kanta, 10-691 Olsztyn, Poland.
| | - Katarzyna Zaborowska-Sapeta
- Department of Rehabilitation, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 18A Żołnierska Street, 10-561 Olsztyn, Poland.
| | - Jacek J Nowakowski
- Department of Ecology and Environmental Protection, University of Warmia and Mazury in Olsztyn, 3 Lodzki Square, 10-727 Olsztyn, Poland.
| | - Ireneusz M Kowalski
- Clinic of Rehabilitation, Provincial Specialist Children's Hospital in Olsztyn, 18A Żołnierska Street, 10-561 Olsztyn, Poland.
- Department of Rehabilitation, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 18A Żołnierska Street, 10-561 Olsztyn, Poland.
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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: 1.5] [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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Stępień A, Jędrzejowska M, Guzek K, Rekowski W, Stępowska J. Reliability of four tests to assess body posture and the range of selected movements in individuals with spinal muscular atrophy. BMC Musculoskelet Disord 2019; 20:54. [PMID: 30732590 PMCID: PMC6367749 DOI: 10.1186/s12891-018-2389-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 12/19/2018] [Indexed: 01/26/2023] Open
Abstract
Background The majority of individuals with spinal muscular atrophy (SMA) experience progressive skeletal deformities which may affect the quality of life and mobility. To date, no studies have evaluated the reliability of tests assessing body posture and joint mobility in SMA patients. The purpose of this study was to assess the reliability of Cervical Rotation test (CR), Supine Angle of Trunk Rotation test (SATR), Hip Extension test (HE) and Pelvic Obliquity test (PO) developed to evaluate the musculoskeletal system in SMA individuals. Methods Thirty individuals (12 girls and 18 boys) aged 4–15 with SMA type II (n = 24) and III (n = 6) confirmed by genetic examinations were qualified for the study. The participants were examined twice by three physiotherapists on the same day. The examination included four tests, i.e. CR, SATR, HE and PO tests aimed at assessing ranges of rotation in the cervical spine, chest deformities, ranges of hip extension and pelvis position while sitting. Statistical calculations were made with the use of statistical software IBM SPSS Statistics version 20. Reliability was assessed using the Intraclass Correlation Coefficient (ICC). Results Intraobserver reliability was excellent for CR (ICC range 0.839–0.911), SATR (ICC range 0.918–0.939 - the upper part of the sternum; ICC range 0.951–0.975 - the lower part of the sternum), HE (ICC range 0.988–0,991) and PO (ICC range 0.896–0.935) tests. The interobserver ICC reached the excellent values in CR (ICC range 0.912–0.920), SATR (ICC = 0.888 - the upper part of the sternum, ICC = 0.951 - the lower part of the sternum), HE (ICC range 0.922–0.923) and PO (ICC = 0.928) tests. Conclusions CR, SATR, HE and PO tests are reliable and may be used for examining individuals with SMA. The application of these tests provides a possibility to detect early changes in the musculoskeletal system in children and adolescents and to assess the effectiveness of the implemented pharmacotherapy and rehabilitation.
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Affiliation(s)
- Agnieszka Stępień
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education, Marymoncka 34, 00-968, Warsaw, Poland.
| | - Maria Jędrzejowska
- Mossakowski Medical Research Centre, Polish Academy of Sciences, Neuromuscular Unit, Pawińskiego 5, 02-106, Warsaw, Poland
| | - Katarzyna Guzek
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education, Marymoncka 34, 00-968, Warsaw, Poland
| | - Witold Rekowski
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education, Marymoncka 34, 00-968, Warsaw, Poland
| | - Jolanta Stępowska
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education, Marymoncka 34, 00-968, Warsaw, Poland
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20
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Zaborowska-Sapeta K, Giżewski T, Binkiewicz-Glińska A, Kamelska-Sadowska AM, Kowalski IM. The Duration of the correction loss after removing cheneau brace in patients with adolescent idiopathic scoliosis. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2019; 53:61-67. [PMID: 30459102 PMCID: PMC6424669 DOI: 10.1016/j.aott.2018.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/01/2018] [Accepted: 10/08/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the loss of truncal rotation over 54 hours after removing Chêneau brace. METHODS The studied groups consisted of 39 girls aged 10-18 years old, diagnosed with adolescent idiopathic scoliosis (AIS) and treated with Chêneau brace (CAST) and 20 AIS girls aged 10-18 years old, not treated with bracing. Posterior-anterior radiographs were obtained from the clinical assessment of all subjects and were subsequently used to determine Cobb angles. The measurements of the angle of trunk rotation (ATR) were taken with the Scoliometer® and back-contour device during Adams forward bending test by the two evaluators. The changes in ATRs during 54 hours of observation were performed after the brace had been taken off (0, 2, 24, 30, 48 and 54 hours after debracing). This was described using VATR variable, defined as the change in the absolute Scoliometer® readings in the time intervals against the time interval Δt between the measurements. During back-contour assessment the differential factor (kra) has been used for the digital analysis. The changes in kra over 54 hours of observation were expressed as Vkra factor, defined as the difference in the absolute value of the amplitude differential factor (kra) in the time intervals against the time interval Δt between the measurements. RESULTS The highest changes were observed in the thoracic as well as in lumbar spine in patients with Cobb angle ≥30°, axial rotation of the apical vertebrae within 5-15°, Risser sign 0-2. The biggest change in the trunk rotation after Chêneau brace had been taken off was noted within the first two hours of observation. CONCLUSION The patients should be advised to take the brace off for a minimum of two hours before the scheduled x-ray, to allow full relaxation of the trunk in order to obtain reliable radiological images of the deformation. LEVEL OF EVIDENCE Level III Therapeutic study.
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Affiliation(s)
| | - Tomasz Giżewski
- Department of Material Science and Metallurgy, University of Cambridge, Cambridge, United Kingdom
| | | | - Anna M Kamelska-Sadowska
- Clinic of Rehabilitation, Provincial Specialist Children's Hospital in Olsztyn, Olsztyn, Poland.
| | - Ireneusz M Kowalski
- Department of Rehabilitation, University of Warmia and Mazury, Olsztyn, Poland; Clinic of Rehabilitation, Provincial Specialist Children's Hospital in Olsztyn, Olsztyn, Poland
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Cofré RM, Calderón MDS, González PM, Saavedra NM, Cabello ME. Confiabilidad en la medición de la presión inspiratoria máxima y de la capacidad inspiratoria de un fisioterapeuta en entrenamiento. FISIOTERAPIA E PESQUISA 2018. [DOI: 10.1590/1809-2950/18007825042018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMEN Este estudio pretende explorar el impacto de la experiencia clínica en la fiabilidad y consistencia de la medición de la presión inspiratoria máxima (PIM) y la capacidad inspiratoria (CI) durante el período de la entrenamiento clínico. Los 37 participantes fueron evaluados por un fisioterapeuta especializado (FE) y un fisioterapeuta novato (FN), por medio de un pletismógrafo corporal. Se utilizó el coeficiente de correlación intraclase (ICC, en inglés) para analizar la fiabilidad de las pruebas PIM y CI, mientas que para explorar las diferencias individuales se utilizaron los gráficos de Bland-Altman (gB/A). El análisis ICC en tres estudios clínicos demostró excelente fiabilidad interevaluadores (ICC 1°: 0,914; ICC 2°: 0,915; ICC 3°: 0,925) para la prueba PIM y (ICC 1 °: 0,955; ICC 2°: 0,965; ICC 3°: 0,970) para la prueba CI. Sin embargo, la correlación según gB/A entre los evaluadores reveló una tendencia sistemática con resultados absolutos más elevados para FE de 9,2 cmH2O en PIM y 0,06 L en CI, respectivamente. Los resultados demostraron que el FN tuvo habilidades técnicas y de discernimiento fiables en la prueba PIM y CI, pero los pacientes suelen mejorar el rendimiento con un evaluador experimentado. La experiencia del evaluador influye en los resultados obtenidos de la medición de PIM en los pacientes, la formación de un FN requiere la incorporación de más habilidades para que se reconozca su verdadero esfuerzo.
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Affiliation(s)
| | | | | | | | - Máximo Escobar Cabello
- Universidad Católica del Maule, Chile; Universidad Católica del Maule, Chile; Universidad del Bío-Bío, Chile
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Accuracy of 3D surface scanners for clinical torso and spinal deformity assessment. Med Eng Phys 2018; 63:63-71. [PMID: 30467027 DOI: 10.1016/j.medengphy.2018.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/19/2018] [Accepted: 11/05/2018] [Indexed: 02/03/2023]
Abstract
Externally visible deformities are cosmetic features of great concern for Adolescent Idiopathic Scoliosis (AIS) patients. Current assessment techniques for AIS do not fully encompass the external deformity. A non-invasive method capable of capturing superficial anatomy, such as 3D scanning, would enable better qualitative and quantitative evaluation of cosmesis. This study aimed to quantify the accuracy of commonly available scanners, in assessing posterior asymmetry in AIS. The technique of 3D surface deviation analysis was proposed as a suitable method for comparing the models created by each scanner. Eight plaster cast moulds manufactured to create braces for AIS patients were used as test samples. Four 3D scanners were selected: Solutionix RexScan CS+; Artec Eva; Microsoft Kinect V1; iPhone with 123D Catch App. These scanners were selected from those available as representative of a range of scanning technologies. Each cast was scanned and 3D models created. A simulated rib hump measurement was obtained and the surface-to-surface deviations between the Solutionix scan and all other scans were determined. The Solutionix scanner is a metrology scanner of very high quality and so it was selected as the reference. Surface-to-surface deviations were calculated in the positive and negative directions separately to specifically identify size and volume inaccuracies created by the scans. Surface deviations showed excellent agreement between the Solutionix and the Eva with deviations of +0.17 ± 0.17 mm (Eva regions larger) and -0.20 ± 0.32 mm (Eva regions smaller) (mean±SD). The Kinect showed lower agreement (+1.58 ± 1.50 mm and -0.58 ± 0.58 mm). The iPhone scans were not able to be scaled to the correct size, so were excluded. Rib hump measurements with all scanners were within clinical measurement variability (±4.9 deg) of the known values. These commercially available 3D scanners are capable of imaging torso shape in 3D and deriving clinically relevant external deformity measures. The non-invasive 3D topographic information provided can be used to improve assessment of torso shape in spinal deformity patients.
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Tyrakowski M, Czaprowski D, Szczodry M, Siemionow K. Cobb angle measurements on digital radiographs using Bunnell scoliometer: Validation of the method. J Back Musculoskelet Rehabil 2018; 30:667-673. [PMID: 27858675 DOI: 10.3233/bmr-150338] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND Electronic rulers on computer screen are used to measure the Cobb angle (CA) instead of traditional methods with rulers, protractors and pens. The variety of software used to assess radiographs might make the CA measurements cumbersome in everyday clinical practice. OBJECTIVE The aim of the study was to verify the method of CA measurements on digital radiographs using Bunnell scoliometer (BS). METHODS Eighty patients with idiopathic scoliosis were enrolled into the study. CA of each curve was measured by use of Centricity software and BS. CA on 30 randomly chosen patients were measured 3 times by one researcher using only scoliometer. Three researchers measured CA on the same 30 radiographs using BS. RESULTS The mean CA of 224 curves measured by Centricity and BS were 29° ± 12.2° and 28° ± 11.7°, respectively. The ICC for agreement for 2 methods was 0.96 with SEM of 1.7°. Excellent intra- and interobserver reliability of CA measurements with scoliometer was noted: ICC of 0.96 with SEM of 1.4° and ICC of 0.93 with SEM of 1.9°, respectively. CONCLUSIONS The study revealed excellent reliability of CA measurements on digital radiographs using the BS. The proposed method of using the Bunnell scoliometer for CA measurements may be clinically useful.
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Affiliation(s)
- Marcin Tyrakowski
- Department of Orthopedics, Pediatric Orthopedics and Traumatology, The Centre of Postgraduate Medical Education in Warsaw, Otwock, Poland
| | - Dariusz Czaprowski
- Department of Physiotherapy, Józef Rusiecki University College, Olsztyn, Poland
| | - Michal Szczodry
- Department of Orthopedic Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Kris Siemionow
- Department of Orthopedic Surgery, University of Illinois at Chicago, Chicago, IL, USA
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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: 533] [Impact Index Per Article: 76.1] [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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Whyte Ferguson L. Adolescent idiopathic scoliosis: The Tethered Spine III: Is fascial spiral the key? J Bodyw Mov Ther 2017; 21:948-971. [DOI: 10.1016/j.jbmt.2017.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 01/20/2017] [Accepted: 01/25/2017] [Indexed: 11/16/2022]
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Stępień A, Fabian K, Graff K, Podgurniak M, Wit A. An immediate effect of PNF specific mobilization on the angle of trunk rotation and the Trunk-Pelvis-Hip Angle range of motion in adolescent girls with double idiopathic scoliosis-a pilot study. SCOLIOSIS AND SPINAL DISORDERS 2017; 12:29. [PMID: 28905003 PMCID: PMC5586026 DOI: 10.1186/s13013-017-0132-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 04/18/2017] [Indexed: 11/20/2022]
Abstract
Background Impairment of spine rotation is a key concept in several theories explaining the pathogenesis and progression of scoliosis. In previous studies, a more limited range of motion in scoliotic girls compared to their non-scoliotic peers was noted. The Trunk-Pelvis-Hip Angle measurement is a test used to assess the range of motion in the trunk-pelvis-hip complex in the transverse plane. The aim of this study was to assess an immediate effect of Proprioceptive Neuromuscular Facilitation specific mobilization (mPNF) on the angle of trunk rotation and Trunk-Pelvis-Hip Angle range of motion in adolescent girls with double scoliosis. Methods The study was conducted on 83 girls aged 10 to 17 years (mean 13.7 ± 1.9) with double idiopathic scoliosis consisting of a right-sided thoracic curve (mean 25.1° ± 13.9°) and a left-sided thoracolumbar or lumbar curve (mean 20.8° ± 11.4°). The angle of trunk rotation and Trunk-Pelvis-Hip Angle were measured at baseline and after PNF mobilization. Bilateral lower limb patterns of Proprioceptive Neuromuscular Facilitation were used in combination with the “contract–relax” technique and stimulation of asymmetrical breathing. In the statistical analysis, the SAS rel. 13.2 software was used. Preliminary statistical analysis was performed using descriptive statistics. According to Shapiro-Wilk criterion of normality, the Wilcoxon test was used to compare paired samples. Next, the data was analyzed using multivariate GLM models. Results In adolescent girls with double scoliosis, significant differences between the left and right side of the body concerning the Trunk-Pelvis-Hip Angle ranges were noted. A single, unilateral PNF mobilization significantly decreased the angle of trunk rotation in the thoracic (p < 0.001) and lumbar spine (p < 0.001). Unilateral PNF mobilization also increased the Trunk-Pelvis-Hip Angle ranges on the left (p < 0.001) and right (p < 0.001) side significantly. Conclusions Unilateral PNF mobilization led to a decrease in the angle of trunk rotation, improvement in the range of motion, and the symmetry of mobility in the transverse plane in the trunk-pelvis-hip complex in adolescent girls with double idiopathic scoliosis. The effects should be treated only as immediate. Further studies are required to determine long-term effects of PNF mobilization on the spinal alignment. Trial registration ISRCTN11750900.
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Affiliation(s)
- A Stępień
- Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland
| | - K Fabian
- Regional Children's Hospital, Jastrzębie Zdrój, Poland
| | - K Graff
- Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland
| | - M Podgurniak
- Department of Physiological Sciences, University of Life Science, Warsaw, Poland
| | - A Wit
- Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland
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Paolucci T, Piccinini G, Iosa M, Piermattei C, De Angelis S, Zangrando F, Saraceni VM. The importance of trunk perception during brace treatment in moderate juvenile idiopathic scoliosis: What is the impact on self-image? J Back Musculoskelet Rehabil 2017; 30:203-210. [PMID: 27392847 DOI: 10.3233/bmr-160733] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The perception of body image and the deformity of the trunk in patients with adolescent idiopathic scoliosis (AIS) are a silver lining that has yet to be discussed in the relevant literature during brace rehabilitation treatment. OBJECTIVE To determine whether and how the use of the brace changes perception of the trunk in patients with AIS by the drawing test. METHODS We observed 32 subjects with AIS from our Rehabilitation outpatient clinic and divided them into the brace treatment (BG-16 subjects) and the non-brace treatment (CG-16 subjects). Trunk perception and quality of life were evaluated using the Trunk Appearance Perception Scale and Scoliosis Research Society-22 questionnaire, and the perception of one's back was measured by the drawing test. RESULTS Pain was lower in BG versus CG (p= 0.095). Satisfaction with the treatment was higher in BG than in CG (p= 0.002). Self-image did not differ significantly between the groups in terms of TAPS. Drawings of the most severe cases of scoliosis were made by the group without the brace. CONCLUSIONS The use of the brace corrects the function of the trunk and has a positive influence on its perception.
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Affiliation(s)
- Teresa Paolucci
- Complex Unit of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Rome, Italy
| | - Giulia Piccinini
- Complex Unit of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Rome, Italy
| | - Marco Iosa
- Clinical Laboratory of Experimental Neurorehabilitation, Santa Lucia Foundation, Rome, Italy
| | - Cristina Piermattei
- Complex Unit of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Rome, Italy
| | - Simona De Angelis
- Complex Unit of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Rome, Italy
| | - Federico Zangrando
- Complex Unit of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Rome, Italy
| | - Vincenzo Maria Saraceni
- Complex Unit of Physical Medicine and Rehabilitation, Azienda Policlinico Umberto I, Rome, Italy
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Linek P, Saulicz E, Wolny T, Myśliwiec A. Assessment of the abdominal muscles at rest and during abdominal drawing-in manoeuvre in adolescent physically active girls: A case-control study. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:118-124. [PMID: 30356579 PMCID: PMC6188935 DOI: 10.1016/j.jshs.2015.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 05/30/2015] [Accepted: 07/05/2015] [Indexed: 06/06/2023]
Abstract
BACKGROUND An impact of regular physical activity (RPA) on the abdominal muscles may be significant when comparing various symptomatic groups. However, there is lack comprehensive information in this field. The objective of this study was to assess the lateral abdominal wall at rest and during abdominal drawing-in manoeuvre in adolescent physically active girls in different body positions. METHODS One hundred and forty-four female students, 13-17 years of age, participated in the study. Participants were divided into 2 groups based on a physical activity (PA) statement. Measurements of the thickness of the abdominal muscles at rest and during abdominal drawing-in manoeuvre were made in the supine and standing positions by ultrasound imaging. RESULTS Compared to the control group, activities of the obliquus internus and transversus abdominis muscles were higher in the regular PA group by 8.9% (95%CI: 3.1-14.7) and 36% (95%CI: 19.1-47.5), respectively. In the RPA group, the transversus abdominis preferential activation ratio was greater by 0.03 (95%CI: 0.01-0.04), and the contraction ratio was greater by a mean value of 0.35 (95%CI: 0.18-0.46). CONCLUSION RPA does not have any effect on the resting thickness of the abdominal muscles in the supine and standing positions. Girls performing RPA have a greater ability to perform an independent activation and greater contractions of the transversus abdominis.
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Prowse A, Aslaksen B, Kierkegaard M, Furness J, Gerdhem P, Abbott A. Reliability and concurrent validity of postural asymmetry measurement in adolescent idiopathic scoliosis. World J Orthop 2017; 8:68-76. [PMID: 28144582 PMCID: PMC5241548 DOI: 10.5312/wjo.v8.i1.68] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/17/2016] [Accepted: 10/18/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the reliability and concurrent validity of the Baseline® Body Level/Scoliosis meter for adolescent idiopathic scoliosis postural assessment in three anatomical planes.
METHODS This is an observational reliability and concurrent validity study of adolescent referrals to the Orthopaedic department for scoliosis screening at Karolinska University Hospital, Stockholm, Sweden between March-May 2012. A total of 31 adolescents with idiopathic scoliosis (13.6 ± 0.6 years old) of mild-moderate curvatures (25°± 12°) were consecutively recruited. Measurement of cervical, thoracic and lumbar curvatures, pelvic and shoulder tilt, and axial thoracic rotation (ATR) were performed by two trained physiotherapists in one day. The intraclass correlation coefficient (ICC) was used to determine the inter-examiner reliability (ICC2,1) and the intra-rater reliability (ICC3,3) of the Baseline® Body Level/Scoliosis meter. Spearman’s correlation analyses were used to estimate concurrent validity between the Baseline® Body Level/Scoliosis meter and Gold Standard Cobb angles from radiographs and the Orthopaedic Systems Inc. Scoliometer.
RESULTS There was excellent reliability between examiners for thoracic kyphosis (ICC2,1 = 0.94), ATR (ICC2,1 = 0.92) and lumbar lordosis (ICC2,1 = 0.79). There was adequate reliability between examiners for cervical lordosis (ICC2,1 = 0.51), however poor reliability for pelvic and shoulder tilt. Both devices were reproducible in the measurement of ATR when repeated by one examiner (ICC3,3 0.98-1.00). The device had a good correlation with the Scoliometer (rho = 0.78). When compared with Cobb angle from radiographs, there was a moderate correlation for ATR (rho = 0.627).
CONCLUSION The Baseline® Body Level/Scoliosis meter provides reliable transverse and sagittal cervical, thoracic and lumbar measurements and valid transverse plan measurements of mild-moderate scoliosis deformity.
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Park J, Lee SG, Bae J, Lee JC. The correlation between calcaneal valgus angle and asymmetrical thoracic-lumbar rotation angles in patients with adolescent scoliosis. J Phys Ther Sci 2015; 27:3895-9. [PMID: 26834376 PMCID: PMC4713815 DOI: 10.1589/jpts.27.3895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 09/25/2015] [Indexed: 11/29/2022] Open
Abstract
[Purpose] This study aimed to provide a predictable evaluation method for the progression
of scoliosis in adolescents based on quick and reliable measurements using the naked eye,
such as the calcaneal valgus angle of the foot, which can be performed at public
facilities such as schools. [Subjects and Methods] Idiopathic scoliosis patients with a
Cobb’s angle of 10° or more (96 females, 22 males) were included in this study. To
identify relationships between factors, Pearson’s product-moment correlation coefficient
was computed. The degree of scoliosis was set as a dependent variable to predict thoracic
and lumbar scoliosis using ankle angle and physique factors. Height, weight, and left and
right calcaneal valgus angles were set as independent variables; thereafter, multiple
regression analysis was performed. This study extracted variables at a significance level
(α) of 0.05 by applying a stepwise method, and calculated a regression equation. [Results]
Negative correlation (R=−0.266) was shown between lumbar lordosis and asymmetrical lumbar
rotation angles. A correlation (R=0.281) was also demonstrated between left calcaneal
valgus angles and asymmetrical thoracic rotation angles. [Conclusion] Prediction of
scoliosis progress was revealed to be possible through ocular inspection of the calcaneus
and Adams forward bending test and the use of a scoliometer.
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Affiliation(s)
- Jaeyong Park
- Institute of Sports Health Science, Sunmoon University, Repubic of Korea
| | - Sang Gil Lee
- Schroth Corrective Exercise Center, Repubic of Korea
| | - Jongjin Bae
- Jeollanamdo Sports Council, Repubic of Korea
| | - Jung Chul Lee
- Department of Exercise Prescription, Dongshin University, Repubic of Korea
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Persson-Bunke M, Czuba T, Hägglund G, Rodby-Bousquet E. Psychometric evaluation of spinal assessment methods to screen for scoliosis in children and adolescents with cerebral palsy. BMC Musculoskelet Disord 2015; 16:351. [PMID: 26578150 PMCID: PMC4650493 DOI: 10.1186/s12891-015-0801-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 11/03/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In cerebral palsy (CP) there is an increased risk of scoliosis. It is important to identify a progressive scoliosis early-on because the results of surgery depend on the magnitude of the curve. The Swedish follow-up program for cerebral palsy (CPUP) includes clinical examinations of the spine. The reliability and validity of the assessment method have not been studied. In this study we evaluate the interrater reliability of the clinical spinal examination used in CPUP and scoliometer measurement in children with CP and we evaluate their validity compared to radiographic examination. METHODS Twenty-eight children (6-16 years) with CP in Gross Motor Function Classification System levels II-V were included. Clinical spinal examinations and scoliometer measurements in sitting position were performed by three independent examiners. The results were compared to the Cobb angle as determined by radiographic measurement. Interrater reliability was calculated using weighted kappa. Concurrent validity was analyzed using the Cobb angle as gold standard. Sensitivity, specificity, area under receiver operating characteristic curves (AUC) and likelihood ratios (LR) were calculated. Cut-off values for scoliosis were set to ≥ 20° Cobb angle and ≥ 7° scoliometer angle. RESULTS There was an excellent interrater reliability for both clinical examination (weighted kappa = 0.96) and scoliometer measurement (weighted kappa = 0.86). The clinical examination showed a sensitivity of 75 % (95 % CI: 19.4-99.4 %), specificity of 95.8 % (95 % CI: 78.9-99.9 %) and an AUC of 0.85 (95 % CI: 0.61-1.00). The positive LR was 18 and the negative LR was 0.3. The scoliometer measurement showed a sensitivity of 50 % (95 % CI: 6.8-93.2 %), specificity of 91.7 % (95 % CI: 73.0-99.0 %) and AUC of 0.71 (95 % CI: 0.42-0.99). The positive LR was 6 and the negative LR was 0.5. CONCLUSION The psychometric evaluation of the clinical examination showed an excellent interrater reliability and a high concurrent validity compared to the Cobb angle. The findings should be interpreted cautiously until research with larger samples may further quantify the psychometric properties. Clinical spinal examinations seem appropriate as a screening tool to identify scoliosis in children with CP.
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Affiliation(s)
- Måns Persson-Bunke
- Department of Clinical Sciences, Lund, Orthopaedics, Lund University, S-221 85, Lund, Sweden. .,Department of Orthopaedic, Skane University Hospital, SE 221 85, Lund, Sweden.
| | - Tomasz Czuba
- National Competence Center for Quality Registers, Lund University, University Hospital, S-221 85, Lund, Sweden.
| | - Gunnar Hägglund
- Department of Clinical Sciences, Lund, Orthopaedics, Lund University, S-221 85, Lund, Sweden.
| | - Elisabet Rodby-Bousquet
- Department of Clinical Sciences, Lund, Orthopaedics, Lund University, S-221 85, Lund, Sweden. .,Centre for Clinical Research, Uppsala University, County Hospital, S-721 89, Västerås, Sweden.
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Haber CK, Sacco M. Scoliosis: lower limb asymmetries during the gait cycle. Arch Physiother 2015; 5:4. [PMID: 29340173 PMCID: PMC5721726 DOI: 10.1186/s40945-015-0001-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 02/18/2015] [Indexed: 11/10/2022] Open
Abstract
Background Several studies indicate that the gait pattern of subjects suffering from scoliosis differs from the norm. However, there is conflicting evidence regarding the source of this discrepancy. Objective To evaluate lower limb asymmetries in selected gait variables. Study design A case–control study on lower limb asymmetries during gait which can be related to scoliosis. Methods 31 subjects with scoliosis (Study Group - SG) and an equal comparative control sample (Control Group – CG) of subjects underwent objective gait analysis with the Vicon® motion caption system whilst walking at a comfortable speed along the gait laboratory walkway. Analysis was performed at three levels: (1) Asymmetry in the SG against asymmetry in the CG, (2) Difference in magnitude of asymmetry between the SG and CG, and (3) Global mean values in the SG vs. CG. The Paired Student T-Test was used for intra-group analysis whilst the Independent Student T-Test was used for inter-group analysis of the selected parameters, which include temporal parameters (stride length, stride time, step length, individual step speed, speed of gait, cadence, swing-to-stance ratio), ground reaction force (peak GRF values during Loading and Propulsion phases, vertical component only) and electromyography (peak EMG values and their time of onset, as a percentage of the gait cycle) of two lower limb muscles (Gastronemius and Vastus Medialis). Results No intra-group variation was found to be significant. However, the speed of gait was found to be significantly slower (p = 0.03) in scoliotic subjects when compared to the norm, as a result of the shorter stride length (p = 0.002 and longer stride time (p = 0.001) in the SG. Furthermore, there was statistical significance in the time of onset of EMG peaks for the Lateral Gastrocnemius (p = 0.02) with regards to inter-group difference in magnitude of lower limb asymmetry and global mean values. Conclusions Scoliosis is a tri-planar deformity which has some impact on the gait pattern. This research study concludes that scoliotic subjects have a slower speed of gait due to a shorter stride length and a longer stride time, together with variations in the timing of muscle activation.
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Affiliation(s)
| | - Mark Sacco
- Department of Physiotherapy, Faculty of Health Sciences, Mater Dei Hospital, Room 10, Block A, Level 1, Msida, Malta
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Reliability and validity of inexpensive and easily administered anthropometric clinical evaluation methods of postural asymmetry measurement in adolescent idiopathic 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 2015; 25:450-66. [PMID: 25917824 DOI: 10.1007/s00586-015-3961-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 04/13/2015] [Accepted: 04/13/2015] [Indexed: 12/24/2022]
Abstract
PURPOSE As accurate and reproducible measurements of spinal curvature are crucial in the examination of patients with adolescent idiopathic scoliosis (AIS), this systematic review aims to report on the reliability and validity of a range of inexpensive and easily administered anthropometric methods of postural asymmetry measurement in an AIS population, to inform practice in a clinical setting. METHODS A systematic search of health research databases located studies assessing reliability and validity of inexpensive and easily administered anthropometric measures. RESULTS Fourteen studies satisfied eligibility criteria. The methodological quality of included studies ranged from low to high. Validity studies were of moderate to high quality. In total, nine clinically applicable, inexpensive and easily administered anthropometric methods were identified, for assessing AIS curvature. All methods demonstrated high to very high inter-observer and intra-observer reliability. Reported criterion validity of the scoliometer and 2D photographs, when compared to Cobb angle assessed from radiographs, ranged from low to very high. iPhone measurements correlated well with scoliometer measurements. 2D photography results had a moderate to high correlation with 3D topography results. CONCLUSIONS Overall, strong levels of evidence exist for iPhone and scoliometer measurements, with a high to very high reliability and moderate to very high validity. Moderate levels of evidence exist for scoliometer with mathematical formula and clinical examination with moderate and low validity, respectively. Limited evidence exists for aesthetic tools TRACE and AI and 2D photography. These results indicate there are accurate and reproducible anthropometric measures that are inexpensive and applicable in therapy settings to assess postural asymmetry; however, these only exist for measurement in the transverse plane, despite 3D characteristics of AIS. Further research is required into an inexpensive and easily administered method that can assess postural asymmetry in all anatomical planes.
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Baroni MP, Sanchis GJB, de Assis SJC, dos Santos RG, Pereira SA, Sousa KG, Lopes JM. Factors associated with scoliosis in schoolchildren: a cross-sectional population-based study. J Epidemiol 2015; 25:212-20. [PMID: 25716134 PMCID: PMC4340998 DOI: 10.2188/jea.je20140061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The present study aimed to investigate the prevalence of scoliosis and to analyze the factors associated with scoliosis in schoolchildren aged between 7 and 17 years. METHODS This is a cross-sectional and quantitative study with stratified random selection of public school students in the city of Santa Cruz, Brazil. The presence of scoliosis was examined, as well as the flexibility of the posterior muscle chain, socioeconomic characteristics, anthropometry, lifestyle habits, sexual maturation, and ergonomics of school furniture. In order to identify factors associated with scoliosis, the variables were divided in biological, socioeconomic, lifestyle, and ergonomic factors, and crude and adjusted prevalence ratios (PRs) were estimated by means of Poisson regression analysis. RESULTS Two hundred and twelve pupils participated in this study (mean age 11.61 years, 58% female). The prevalence of scoliosis was 58.1% (n = 123) and associated with female sex (PR 2.54; 95% CI, 1.33-4.86) and age between 13 and 15 years (PR 5.35; 95% CI, 2.17-13.21). Sleeping in a hammock was inversely associated with scoliosis (PR 0.44; 95% CI, 0.23-0.81). CONCLUSIONS Scoliosis seems to be positively associated with female sex and age between 13 and 15 years, whereas the habit of sleeping in a hammock is negatively associated with the onset of scoliosis.
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Abstract
STUDY DESIGN This was a prospective blinded validity and reliability analysis. OBJECTIVE The aim of this study was validation and reliability evaluation of the Scoligauge iPhone app. BACKGROUND The scoliometer is used to clinically measure the rib hump in scoliosis as a means to evaluate the axial trunk rotation. The increasing availability of smartphone with built-in accelerometer led to the development of a vast number of applications to measure angles. Of these, the Scoligauge mimics a scoliometer. The aim of this study was to compare the validity of the Scoligauge iPhone application without an associated adapter with the traditional scoliometer and to test the reliability of the application in a clinical setting. METHODS Two observers measured the rib hump deformity on 34 consecutive patients with idiopathic scoliosis with an average Cobb angle of 24.2 ± 13.5 degrees (range, 4 to 65 degrees). Measurements were made with an iPhone without the adapter and with a scoliometer. The validity as well as the interobserver and intraobserver reliability were calculated using the intraclass coefficient (ICC) and the Bland-Altman test. RESULTS The mean difference between the scoliometer and the Scoligauge application was 0.4 degrees [95% confidence interval (CI) of ± 3.1 degrees] with an ICC of 0.947 (P < 0.001). The intraobserver and interobserver ICC were 0.961 (P < 0.001) and 0.901 (P < 0.001), respectively. The mean intraobserver difference was 0.0 degrees (95% CI of ± 2.7 degrees) and the mean interobserver difference was 0.1 degrees (95% CI of ± 4.4 degrees). CONCLUSIONS The intraobserver and interobserver reliability of the Scoligauge iPhone app, as well as its validity compared with the scoliometer, are excellent. The mean differences between measurements are small and clinically not significant. Thus, the Scoligauge application is valid for clinical evaluation even without special adapter. LEVEL OF EVIDENCE Level I (Diagnostic Study).
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Qiao J, Xu L, Zhu Z, Zhu F, Liu Z, Qian B, Qiu Y. Inter- and intraobserver reliability assessment of the axial trunk rotation: manual versus smartphone-aided measurement tools. BMC Musculoskelet Disord 2014; 15:343. [PMID: 25305758 PMCID: PMC4198676 DOI: 10.1186/1471-2474-15-343] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 10/03/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Scoliogauge, has been developed for the measurement of ATR on iPhone smartphones. This study was to evaluate the reliability for the smartphone-aided ATR measurement method and to compare its reliability with that of the manual method. METHODS Sixty-four AIS patients with single thoracic or lumbar curve participated in this study. Of these patients, thirty-two patients had main thoracic scoliosis while other thirty-two had main thoracolumbar/lumbar scoliosis. Two spine surgeons performed the measurements with Scoliometer and Scoliogauge. The Scoliogauge measurements were conducted on an iPhone 4 smartphone. The intraclass correlation coefficient (ICC) 2-way mixed model on absolute agreement was used to analyze the reliability categorized according to regions: thoracic or lumbar, and Cobb angles: <20 degrees and >40 degrees. ICC < 0.40 is considered as poor, 0.40-0.59 as fair, 0.60-0.74 as good, and 0.75-1.00 as excellent. RESULTS The overall intraobserver variability was 0.954 and the overall interobserver variability was 0.943 for the scoliometer set, whereas the intraobserver variability was 0.965 and interobserver variability was 0.964 for the scoliogauge set. Both the intraobserver and interobserver ICCs reached the excellent value in the 2 sets for both observers. The mean Cobb angle of thoracic curves in patients with main thoracic scoliosis was similar to that of lumbar curves in those with main thoracolumbar/lumbar scoliosis (35.7 degrees vs. 36.1 degrees). The intraobserver and interobserver reliability was similar between two groups (thoracic vs. lumbar) in the 2 sets. There were 21 patients having Cobb angles < 20 degrees, while 20 patients >40 degrees. The intraobserver and interobserver reliability was better in severe curve(>40 degrees) group. CONCLUSION Smartphone-aided measurement for ATR showed excellent reliability, and the reliability of measurement with either scoliometer or scoliogauge could be influenced by Cobb angle that reliability was better for curves with larger Cobb angles.
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Affiliation(s)
- Jun Qiao
- Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, China
| | - Leilei Xu
- Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, China
| | - Zezhang Zhu
- Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, China
| | - Feng Zhu
- Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, China
| | - Zhen Liu
- Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, China
| | - Bangping Qian
- Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, China
| | - Yong Qiu
- Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, 321 Zhongshan Road, Nanjing, China
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Haber LL, Hughes JD, Womack ED, Roberson RM, Wright PB. Screw Versus Hybrid Constructs for Flexible Thoracic Curves in Adolescent Idiopathic Scoliosis: A Prospective, Randomized Study. Spine Deform 2014; 2:367-373. [PMID: 27927334 DOI: 10.1016/j.jspd.2014.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 04/29/2014] [Accepted: 05/08/2014] [Indexed: 10/24/2022]
Abstract
STUDY DESIGN Prospective, computer-randomized design. OBJECTIVE Compare screw and hybrid constructs in flexible, thoracic curves for adolescent idiopathic scoliosis (AIS) in a prospective randomized fashion. SUMMARY OF BACKGROUND The consensus in scientific literature is that all-screw constructs correct AIS better than hooks in the lumbar and in large, stiff thoracic curves. However, debate continues whether all-screw constructs outperform hybrid constructs in small, flexible thoracic AIS. To our knowledge, this is the first prospective, randomized scoliosis study that examines measures of correction and patient satisfaction with the Scoliosis Research Society-30 (SRS-30) questionnaire. METHODS A total of 45 enrolled AIS patients with flexible, thoracic curves were given an identification number with an associated computer-generated randomization to the hybrid (n = 22) or screw group (n = 23). The treating surgeon received the randomization 2-3 days before surgery. Data including major Cobb (MC), truncal rotation (TR), rib index (RI), secondary curve (SC), and SRS-30 questionnaire were collected preoperatively and postoperatively at 4 weeks and 3, 6, 12, and 24 months. RESULTS Thirty-seven patients in the hybrid (n = 18) and screw (n = 19) groups completed the study with a mean follow-up of 26 months (range, 24-49 months). Hybrid versus screw group means for preoperative, postoperative, and final follow-up were: MC 58° ± 8° versus 55° ± 6°, 18° ± 8° versus 15° ± 7°, and 23°± 8° versus 14° ± 6°; TR 14° ± 6° versus 16° ± 4°, 10° ± 5° versus 7° ± 3°, and 11° ± 5° versus 7° ± 4°; RI 3.0° ± 1.2° versus 3.4° ± 1.4°, 2.5° ± 0.7° versus 1.8° ± 0.6°, and 2.5° ± 0.8° versus 2.0° ± 0.5°; SC 35° ± 13° versus 31° ± 8°, 13° ± 11° versus 7° ± 9°, and 13° ± 12° versus 7° ± 7°; and SRS-30 3.9 ± 0.2 versus 3.9 ± 0.2, 4.1 ± 0.4 versus 4.0 ± 0.3, and 4.1 ± 0.3 versus 4.0 ± 0.2. CONCLUSIONS Intergroup preoperative and early postoperative values were comparable (p > .05). At final follow-up, owing to loss of correction in the hybrid group, differences in MC (9°; p = .000), RI (0.54; p = .016), and TR (4°; p = .039) correction were statistically significant as SC trended toward significance (6°; p = .052). All-screw constructs outperformed hybrid constructs, especially over time. No differences in SRS-30 scores occurred between groups.
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Affiliation(s)
- Lawrence L Haber
- Department of Orthopaedic Surgery and Rehabilitation, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
| | - Joshua D Hughes
- Department of Neurosurgery, Mayo Graduate School of Medical Education, 200 1st Street SW, Rochester, MN 55905, USA
| | - Erika D Womack
- Department of Orthopaedic Surgery and Rehabilitation, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA
| | - Rowland M Roberson
- Department of Orthopaedic Surgery and Rehabilitation, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA
| | - Patrick B Wright
- Department of Orthopaedic Surgery and Rehabilitation, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA
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Linek P, Saulicz E, Wolny T, Myśliwiec A, Kokosz M. Lateral abdominal muscle size at rest and during abdominal drawing-in manoeuvre in healthy adolescents. ACTA ACUST UNITED AC 2014; 20:117-23. [PMID: 25088309 DOI: 10.1016/j.math.2014.07.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 07/03/2014] [Accepted: 07/10/2014] [Indexed: 01/11/2023]
Abstract
Lateral abdominal wall muscles in children and adolescents have not been characterised to date. In the present report, we examined the reliability of the ultrasound measurement and thickness of the oblique external muscle (OE), oblique internal muscle (OI) and transverse abdominal muscle (TrA) at rest and during abdominal drawing-in manoeuvre (ADIM) on both sides of the body in healthy adolescents. We also determined possible differences between boys and girls and defined any factors-such as body mass, height and BMI-that may affect the thickness of the abdominal muscles. B-mode ultrasound was used to assess OE, OI and TrA on both sides of the body in the supine position. Ultrasound measurements at rest and during ADIM were reliable in this age group (ICC3,3 > 0.92). OI was always the thickest and TrA the thinnest muscle on both sides of the body. In this group, an identical pattern of the contribution of the individual muscles to the structure of the lateral abdominal wall (OI > OE > TrA) was observed. At rest and during ADIM, no statistically significant side-to-side differences were demonstrated in either gender. The body mass constitutes between 30% and <50% of the thickness differences in all muscles under examination at rest and during ADIM. The structure of lateral abdominal wall in adolescents is similar to that of adults. During ADIM, the abdominal muscles in adolescents react similarly to those in adults. This study provided extensive information regarding the structure of the lateral abdominal wall in healthy adolescents.
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Affiliation(s)
- Pawel Linek
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Mikolowska 72B, 40-065 Katowice, Poland.
| | - Edward Saulicz
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Mikolowska 72B, 40-065 Katowice, Poland
| | - Tomasz Wolny
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Mikolowska 72B, 40-065 Katowice, Poland
| | - Andrzej Myśliwiec
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Mikolowska 72B, 40-065 Katowice, Poland
| | - Mirosław Kokosz
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Mikolowska 72B, 40-065 Katowice, Poland
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Destieux C, Gaudreault N, Isner-Horobeti ME, Vautravers P. Use of Postural Reconstruction® physiotherapy to treat an adolescent with asymmetric bilateral genu varum and idiopathic scoliosis. Ann Phys Rehabil Med 2013; 56:312-26. [PMID: 23541175 DOI: 10.1016/j.rehab.2013.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Revised: 02/21/2013] [Accepted: 02/26/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To document the effect of Postural Reconstruction® physiotherapy on two postural disorders commonly observed in adolescents: genu varum and idiopathic scoliosis. PATIENT AND METHODS A case report on a 16-year-old boy suffering from knee pain and presenting with bilateral genu varum and mild scoliosis. At the initial evaluation (T0), the intercondylar space was 7 cm and the Cobb angles for the right lumbar curve and left thoracic curve were 18° and 13°, respectively. The boy was treated with Postural Reconstruction(®), a neuromuscular physiotherapy intervention using facilitation/inhibition techniques. The outcomes used to quantify the effect of 6 months (T1), 12 months (T2) and 26 months (T3) of treatment were pain levels, the intercondylar space, the lumbar gibbosity and the lumbar and thoracic Cobb angles. RESULTS The knee pain disappeared rapidly. At T3, the intercondylar space had decreased by 4 cm, the lumbar gibbosity angle had decreased by 2° and the lumbar and thoracic Cobb angles had decreased by 8° and 7°, respectively. CONCLUSION This non-invasive physiotherapy intervention appears to have considerable promise for the long-term correction of postural disorders.
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Affiliation(s)
- C Destieux
- École de réadaptation, faculté de médecine et des sciences de la santé, université de Sherbrooke, 3001, 12e, avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada
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Abstract
BACKGROUND Surgeons and software developers recognize that apps can improve patient care by replicating the function of existing medical devices. However, the incorporation of new tools requires that the clinical data being recorded is accurate and valid. This study attempts to validate a new iPhone app to measure scoliotic rotation. The objective of this study was to validate the scoliogauge iPhone application by comparing the results to simultaneous readings from a standard Scoliometer. METHODS Four orthopaedic medical providers (attending surgeon, fellow, resident, and nurse practitioner) each read a standard scoliometer at 60 randomly selected angular measurements between -30 and 30 degrees, whereas a blinded observer simultaneously recorded the angular measurement derived from the scoligauge app. The correlation between the 2 measurements were calculated using a Pearson correlation coefficient with a P-value set to < 0.05 for significance. RESULTS The Pearson correlation values ranged from 0.9994 to 0.9996 for all providers and all P-values < 0.001. There was no increase in time associated with using the app compared with the standard device. CONCLUSIONS The scoligauge app is a convenient novel tool that replicates the function of a standard clinical scoliometer but with a potentially decreased financial cost and greater convenience for providers. CLINICAL RELEVANCE Validation of this new device demonstrates the potential to increase the distribution of cost-effective scoliosis screening tools to a broad population of medical providers.
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Izatt MT, Bateman GR, Adam CJ. Evaluation of the iPhone with an acrylic sleeve versus the Scoliometer for rib hump measurement in scoliosis. SCOLIOSIS 2012; 7:14. [PMID: 22846346 PMCID: PMC3479427 DOI: 10.1186/1748-7161-7-14] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 07/12/2012] [Indexed: 11/23/2022]
Abstract
Background Vertebral rotation found in structural scoliosis contributes to trunkal asymmetry which is commonly measured with a simple Scoliometer device on a patient's thorax in the forward flexed position. The new generation of mobile 'smartphones' have an integrated accelerometer, making accurate angle measurement possible, which provides a potentially useful clinical tool for assessing rib hump deformity. This study aimed to compare rib hump angle measurements performed using a Smartphone and traditional Scoliometer on a set of plaster torsos representing the range of torsional deformities seen in clinical practice. Methods Nine observers measured the rib hump found on eight plaster torsos moulded from scoliosis patients with both a Scoliometer and an Apple iPhone on separate occasions. Each observer repeated the measurements at least a week after the original measurements, and were blinded to previous results. Intra-observer reliability and inter-observer reliability were analysed using the method of Bland and Altman and 95% confidence intervals were calculated. The Intra-Class Correlation Coefficients (ICC) were calculated for repeated measurements of each of the eight plaster torso moulds by the nine observers. Results Mean absolute difference between pairs of iPhone/Scoliometer measurements was 2.1 degrees, with a small (1 degrees) bias toward higher rib hump angles with the iPhone. 95% confidence intervals for intra-observer variability were +/- 1.8 degrees (Scoliometer) and +/- 3.2 degrees (iPhone). 95% confidence intervals for inter-observer variability were +/- 4.9 degrees (iPhone) and +/- 3.8 degrees (Scoliometer). The measurement errors and confidence intervals found were similar to or better than the range of previously published thoracic rib hump measurement studies. Conclusions The iPhone is a clinically equivalent rib hump measurement tool to the Scoliometer in spinal deformity patients. The novel use of plaster torsos as rib hump models avoids the variables of patient fatigue and discomfort, inconsistent positioning and deformity progression using human subjects in a single or multiple measurement sessions.
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Affiliation(s)
- Maree T Izatt
- Paediatric Spine Research Group, Queensland University of Technology and Mater Health Services, Level 2, Mater Children's Hospital, Raymond Terrace, South Brisbane, Queensland, 4101, Australia.
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Feiz HH, Afrasiabi A, Parvizi R, Safarpour A, Fouladi RF. Scoliosis after thoracotomy/sternotomy in children with congenital heart disease. Indian J Orthop 2012; 46:77-80. [PMID: 22345811 PMCID: PMC3270610 DOI: 10.4103/0019-5413.91639] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
CONTEXT Congenital heart disease (CHD) patients bear a higher risk of scoliosis during their lifetime compared to their normal counterparts. On the other hand, operation on chest wall has been shown to increase the risk of scoliosis. However, the data are inconclusive. The present retrospective analysis is undertaken to determine the frequency of post-thoracotomy/sternotomy scoliosis in children with CHD. MATERIALS AND METHODS One hundred and eighty children with CHD who underwent thoracotomy/sternotomy and had a minimum followup of 3 years in a teaching center from 1997 to 2010 were recruited. After operation, all the patients were regularly examined for the development of scoliosis. 102 patients underwent thoracotomy and 78 sternotomy. Student's t test, Chi-square test, Fisher's exact test were used for statistical analyses. RESULTS Eighty-eight males and 92 females with a mean age of 9.95 ± 2.31 (range: 5-15) years were enrolled. The mean age at operation was 2.59 ± 1.66 (range: 0-9) years and the mean follow-up period was 7.36 ± 2.12 (range: 5-13) years. Scoliosis was confirmed in two patients (1.1%): 1 (1%) in the thoracotomy group (a 12-year-old female operated 2 years earlier with a spinal 22° convexity to the right and 78° kyphosis) and another (1.1%) in the sternotomy group (an 8-year-old female operated during her neonatal period with a spinal 23° convexity to the left). CONCLUSION Scoliosis is not a common finding among the operated children with CHD in our center.
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Affiliation(s)
- Hojjat Hosseinpour Feiz
- Department of Orthopedics, Tabriz University of Medical Sciences, Shohada Hospital, Tabriz, Iran
| | - Abbas Afrasiabi
- Department of Cardiac Surgery, Tabriz University of Medical Sciences, Madani Hospital, Tabriz, Iran
| | - Rezayat Parvizi
- Department of Cardiac Surgery, Tabriz University of Medical Sciences, Madani Hospital, Tabriz, Iran
| | - Ahad Safarpour
- Department of Orthopedics, Tabriz University of Medical Sciences, Shohada Hospital, Tabriz, Iran
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