1
|
Paramento M, Passarotto E, Maccarone MC, Agostini M, Contessa P, Rubega M, Formaggio E, Masiero S. Neurophysiological, balance and motion evidence in adolescent idiopathic scoliosis: A systematic review. PLoS One 2024; 19:e0303086. [PMID: 38776317 PMCID: PMC11111046 DOI: 10.1371/journal.pone.0303086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/19/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a spinal deformity that affects approximately 4% of the world's population. Several hypotheses regarding the etiology of AIS have been investigated. In the last decades, impaired visual-spatial perception, alterations in spatial body orientation and sensory integration deficits have been documented. OBJECTIVE We aimed to summarize the neurophysiological, balance, and motion evidence related to AIS published in the last fifteen years, between January 2008 and April 2023. Both observational and interventional studies were considered. Only studies using quantitative assessment methods, such as electroencephalography (EEG), electromyography (EMG), magnetic resonance imaging (MRI), somatosensory evoked potentials, force platform, or motion capture, were included. METHODS 1250 eligible records identified from online database searching were filtered by duplicate removal, title and abstract screening, and qualitative analysis. 61 articles met the inclusion criteria (i.e., Cobb range 10°-35°, age range 10-18 years) and were summarized. RESULTS We found significant evidence of impaired standing balance in individuals with AIS who greatly rely on visual and proprioceptive information to stay upright. EMG studies frequently reported an increased activity on the convex side of the intrinsic spinae muscles. EEG data show increased delta and theta power, higher alpha peak frequencies, and significant suppression in the alpha and beta bands in subjects with AIS during standing tasks. MRI studies report changes in white matter structures, differences in the vestibular system, and abnormal cortical activations over motor-related areas in subjects with AIS. Bracing appears to be an effective treatment for AIS, leading to improvements in static balance and gait. Methodological issues prevent reliable conclusions about the effects of other treatment options. CONCLUSIONS This review underscores the importance of quantitative assessment methods to explore the etiology and pathophysiology of AIS. Further research is needed to measure the impact of physical therapy and orthotic treatments on the neurophysiological mechanisms of the disease.
Collapse
Affiliation(s)
- Matilde Paramento
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Edoardo Passarotto
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Maria Chiara Maccarone
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Michela Agostini
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Paola Contessa
- Orthopedic Rehabilitation Unit, Padova University Hospital, Padova, Italy
| | - Maria Rubega
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Emanuela Formaggio
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
| | - Stefano Masiero
- Department of Neurosciences, Section of Rehabilitation, University of Padova, Padova, Italy
- Ospedale Riabilitativo di Alta Specializzazione di Motta di Livenza, Motta di Livenza, Treviso, Italy
| |
Collapse
|
2
|
He Y, Dong H, Lei M, Liu J, Xie H, Zhang Z, Pang J, Jin M, Wang J, Geng Z, Zhang J, Li G, Yang Q, Meng L, Miao J. The role of the paraspinal muscles in the development of adolescent idiopathic scoliosis based on surface electromyography and radiographic analysis. BMC Musculoskelet Disord 2024; 25:263. [PMID: 38570738 PMCID: PMC10993478 DOI: 10.1186/s12891-024-07329-w] [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: 04/04/2023] [Accepted: 03/01/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Patients with idiopathic scoliosis commonly present with an imbalance of the paraspinal muscles. However, it is unclear whether this muscle imbalance is an underlying cause or a result of idiopathic scoliosis. This study aimed to investigate the role of paraspinal muscles in the development of idiopathic scoliosis based on surface electromyography (sEMG) and radiographic analyses. METHODS This was a single-center prospective study of 27 patients with single-curve idiopathic scoliosis. Posteroanterior whole-spine radiographs and sEMG activity of the erector spinae muscles were obtained for all patients in the habitual standing position (HSP), relaxed prone position (RPP), and prone extension position (PEP). The Cobb angle, symmetrical index (SI) of the sEMG activity (convex/concave), and correlation between the two factors were analyzed. RESULTS In the total cohort, the mean Cobb angle in the HSP was significantly greater than the mean Cobb angle in the RPP (RPP-Cobb) (p < 0.001), whereas the mean Cobb angle in the PEP (PEP-Cobb) did not differ from the RPP-Cobb. Thirteen patients had a PEP-Cobb that was significantly smaller than their RPP-Cobb (p = 0.007), while 14 patients had a PEP-Cobb that was significantly larger than their RPP-Cobb (p < 0.001). In the total cohort and two subgroups, the SI of sEMG activity at the apex vertebra (AVSI) in the PEP was significantly greater than 1, revealing significant asymmetry, and was also significantly larger than the AVSI in the RPP. In the RPP, the AVSI was close to 1 in the total cohort and two subgroups, revealing no significant asymmetry. CONCLUSION The coronal Cobb angle and the SI of paraspinal muscle activity in AIS patients vary with posture changes. Asymmetrical sEMG activity of the paraspinal muscles may be not an inherent feature of AIS patients, but is evident in the challenging tasks. The potential significance of asymmetric paraspinal muscle activity need to be explored in further research.
Collapse
Affiliation(s)
- Yinchuan He
- Graduate School, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, No.406, Jiefang South Road, Hexi District, Tianjin, 300210, China
- Department of Spine Surgery, Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, No.31 Huanghe Road, Cangzhou, 061001, China
| | - Hongtao Dong
- Academy of Medical Engineering and Translational Medicine, Tianjin University, No. 92 Weijin Road, Nankai District, Tianjin, 300072, China
| | - Ming Lei
- Graduate School, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Jianan Liu
- Graduate School, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, No.406, Jiefang South Road, Hexi District, Tianjin, 300210, China
| | - Hongru Xie
- Graduate School, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Zepei Zhang
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, No.406, Jiefang South Road, Hexi District, Tianjin, 300210, China
| | - Jun Pang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, No. 92 Weijin Road, Nankai District, Tianjin, 300072, China
| | - Mengyue Jin
- Academy of Medical Engineering and Translational Medicine, Tianjin University, No. 92 Weijin Road, Nankai District, Tianjin, 300072, China
| | - Jian Wang
- Graduate School, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Ziming Geng
- Graduate School, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Jing'an Zhang
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, No.406, Jiefang South Road, Hexi District, Tianjin, 300210, China
| | - Gang Li
- The Second Department of Radiology, Tianjin Hospital, Tianjin University, No.406 Jiefang South Road, Hexi District, Tianjin, 300210, China
| | - Qilong Yang
- The Second Department of Radiology, Tianjin Hospital, Tianjin University, No.406 Jiefang South Road, Hexi District, Tianjin, 300210, China
| | - Lin Meng
- Academy of Medical Engineering and Translational Medicine, Tianjin University, No. 92 Weijin Road, Nankai District, Tianjin, 300072, China.
| | - Jun Miao
- Department of Spine Surgery, Tianjin Hospital, Tianjin University, No.406, Jiefang South Road, Hexi District, Tianjin, 300210, China.
| |
Collapse
|
3
|
Chan WWY, Fu SN, Chong TF, Singh G, Tsai DSJ, Wong MCY, Zheng YP, Parent EC, Cheung JPY, Wong AYL. Associations between paraspinal muscle characteristics and spinal curvature in conservatively treated adolescent idiopathic scoliosis: a systematic review. Spine J 2024; 24:692-720. [PMID: 38008187 DOI: 10.1016/j.spinee.2023.11.008] [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: 11/21/2022] [Revised: 10/08/2023] [Accepted: 11/12/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND CONTEXT Children with adolescent idiopathic scoliosis (AIS) may show asymmetrical paraspinal muscle characteristics. PURPOSE To summarize the evidence regarding: (1) the associations between various paraspinal muscle characteristics and spinal curvature; (2) whether paraspinal muscle properties significantly differed between children with and without AIS; and (3) whether baseline paraspinal muscle characteristics predicted curve progression. STUDY DESIGN/SETTING Systematic literature review. METHODS Five databases (CINAHL, Academic Search Premier, MEDLINE, Scopus, and PubMed) were searched from inception to May 2022. This protocol was registered in the PROSPERO database of systematic reviews CRD 42020171263. The Critical appraisal skills program, the Appraisal Tool for Cross-Sectional Studies and Quality In Prognosis Studies tool were used to evaluate the risk of bias of the included studies. The strength of evidence of each identified association was determined by the Grading of Recommendations Assessment, Development, and Evaluation System (GRADE). RESULTS Of 1,530 identified citations, four cohort, 17 cross-sectional, and 23 case-control studies including 31 with low, nine with moderate and four with high risk of bias were included. Low to very low-strength evidence supported that the convex side of the curve had more type I muscle fibers, higher muscle volume and paraspinal muscle activity, while the concavity had more intramuscular fatty infiltration. Very low-strength evidence substantiated greater side-to-side surface electromyography signals during left trunk bending in prone lying, standing, and standing with perturbation between people with and without AIS. Also, low to very low-strength evidence supported that a larger side-to-side surface electromyography ratio at the lower end vertebra predicted curve progression. CONCLUSIONS Our review highlights that paraspinal muscles on the concavity of the curve demonstrate consistent changes (ie, altered muscle-related gene expression, muscle atrophy, increased fatty infiltration, reduced type I fibers, and reduced muscle activity), which may be the cause or consequence.
Collapse
Affiliation(s)
- Winnie W Y Chan
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Siu-Ngor Fu
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Tsz-Fung Chong
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Gurjiven Singh
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Desmond S J Tsai
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Mathew C Y Wong
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Eric C Parent
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Corbett Hall, 8205 114 St NW, Edmonton, Alberta T6G 2G4, Canada
| | - Jason P Y Cheung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Arnold Y L Wong
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China.
| |
Collapse
|
4
|
Vongsirinavarat M, Kao-Ngampanich P, Sinsurin K. Electromyography of paraspinal muscles during self-corrective positions in adolescent idiopathic scoliosis. J Back Musculoskelet Rehabil 2024; 37:165-173. [PMID: 37694350 DOI: 10.3233/bmr-230055] [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: 09/12/2023]
Abstract
BACKGROUND Self-corrective exercise is commonly used in the training protocol of patients with adolescent idiopathic scoliosis (AIS). The muscle activation pattern during symmetrical and overcorrection exercises is then explored to guide the treatment. OBJECTIVE To compare the paraspinal muscle activity during three self-corrective positions and the habitual standing in AIS. METHODS Thirty-three adolescents with double curved scoliosis were examined. The curve type and Cobb's angle were determined from their whole spine X-ray. They adopted habitual standing, symmetrical correction and two overcorrected positions (O1 and O2). The surface electromyography (EMG) was monitored on both sides of paraspinal muscles at the apex areas of scoliotic curves. The EMG ratio between sides was inferred as the corrective effect. RESULTS All three self-correction positions produced greater EMG ratios compared with the habitual standing. The greatest EMG ratios were observed during the O1 position at the thoracic curve and the habitual standing at the lumbar curve. Participants with different subtypes of curves exhibited similar patterns of EMG ratios. CONCLUSION From the biomechanical viewpoint, all three self-corrective positions possibly provided therapeutic effects for the scoliotic body regardless of the subtype of scoliosis curves. The O1 position seemed to be most effective for the adjusting activation of thoracic paraspinal muscles. The symmetrical corrective position is otherwise recommended for adjusting the lumbar muscle activation.
Collapse
Affiliation(s)
| | | | - Komsak Sinsurin
- Faculty of Physical Therapy, Mahidol University, Nakornpathom, Thailand
| |
Collapse
|
5
|
Roggio F, Petrigna L, Filetti V, Vitale E, Rapisarda V, Musumeci G. Infrared thermography for the evaluation of adolescent and juvenile idiopathic scoliosis: A systematic review. J Therm Biol 2023; 113:103524. [PMID: 37055128 DOI: 10.1016/j.jtherbio.2023.103524] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 01/03/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023]
Abstract
INTRODUCTION Adolescent and Juvenile Idiopathic Scoliosis are a three-dimensional spine deformity characterized by a muscle alteration of the convex and concave sides of the scoliosis, which can be evaluated with different non-invasive and radiation-free methods such as infrared thermography. The objective of the present review is to assess infrared thermography as a potential method to evaluate alterations of the scoliosis. MATERIALS AND METHODS A systematic review was performed by collecting articles from PubMed, Web of Science, Scopus, and Google Scholar, published from 1990 to April 2022, on the use of infrared thermography to evaluate adolescent and juvenile idiopathic scoliosis. Relevant data were collected in tables, and the primary outcomes were discussed narratively. RESULTS Of the 587 articles selected, only 5 were in line with the objective of this systematic review and were eligible for the inclusion criteria. The findings of the selected articles corroborate the applicability of infrared thermography as an objective method to assess the thermal differences of the muscles between the convex and concave sides of scoliosis. The overall quality of the research was uneven in the reference standard method and assessment of measures. CONCLUSION Infrared thermography is providing promising results to discriminate thermal differences in scoliosis evaluation, albeit there are still some concerns about considering it as a diagnostic tool for scoliosis evaluation because specific recommendations for collecting data are not met. We propose additional recommendations to existing guidelines to perform thermal acquisition to reduce errors and provide the best results to the scientific community.
Collapse
Affiliation(s)
- Federico Roggio
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy; Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, Palermo, 90144, Italy
| | - Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Veronica Filetti
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Ermanno Vitale
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, Via Santa Sofia n°78, 95123, Catania, Italy
| | - Venerando Rapisarda
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, Via Santa Sofia n°78, 95123, Catania, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy; Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123, Catania, Italy; Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, 19122, PA, United States.
| |
Collapse
|
6
|
How do Paraspinal Muscles Contract during the Schroth Exercise Treatment in Patients with Adolescent Idiopathic Scoliosis (AIS)? Bioengineering (Basel) 2022; 9:bioengineering9060234. [PMID: 35735477 PMCID: PMC9219618 DOI: 10.3390/bioengineering9060234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/15/2022] [Accepted: 05/25/2022] [Indexed: 11/17/2022] Open
Abstract
The Schroth exercise can train the paraspinal muscles of patients with adolescent idiopathic scoliosis (AIS), however, muscle performance during the training remains unknown. This study applied surface electromyography (sEMG) to investigate the paraspinal muscle activities before, during and after Schroth exercise in nine AIS patients. This study found that after the Schroth exercise, the paraspinal muscle symmetry index (PMSI) was significantly reduced (PMSI = 1.3), while symmetry exercise significantly lowered the PMSI (PMSI = 0.93 and 0.75), and asymmetric exercise significantly increased the PMSI (PMSI = 2.56 and 1.52) compared to relax standing (PMSI = 1.36) in participants (p < 0.05). Among the four exercises, the PMSI of on all fours (exercise 1) and kneeling on one side (exercise 3) was the most and the least close to 1, respectively. The highest root mean square (RMS) of sEMG at the concave and convex side was observed in squatting on the bar (exercise 2) and sitting with side bending (exercise 4), respectively. This study observed that the asymmetric and symmetric exercise induced more sEMG activity on the convex and concave side, respectively, and weight bearing exercise activated more paraspinal muscle contractions on both sides of the scoliotic curve in the included AIS patients. A larger patient sample size needs to be investigated in the future to validate the current observations.
Collapse
|
7
|
Is spinal neuromuscular function asymmetrical in adolescents with idiopathic scoliosis compared to those without scoliosis?: A narrative review of surface EMG studies. J Electromyogr Kinesiol 2022; 63:102640. [DOI: 10.1016/j.jelekin.2022.102640] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 12/14/2021] [Accepted: 02/03/2022] [Indexed: 11/19/2022] Open
|
8
|
Biofeedback Posture Training for Adolescents with Mild Scoliosis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5918698. [PMID: 35141334 PMCID: PMC8820896 DOI: 10.1155/2022/5918698] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/03/2021] [Accepted: 01/18/2022] [Indexed: 01/30/2023]
Abstract
Adolescent idiopathic scoliosis (AIS) is characterized by uneven shoulders, spinal curvature, and uneven hips, and asymmetry in paraspinal muscle activities is common in AIS. This pilot study was aimed at examining the use of a surface electromyography (sEMG) biofeedback posture training program in adolescents with mild scoliosis (Cobb′s angle < 30°) to attenuate asymmetry in paraspinal muscle activities and control the curve progression. Seven female adolescents (age, 12–14 years) with mild scoliosis (Cobb′s angle < 30°) were recruited. The participants received 30 tailor-made sessions of sEMG biofeedback posture training at a rate of one to two sessions per week for approximately 6 months. The activities of the paraspinal muscles (the trapezius, latissimus dorsi, thoracic erector spinae, and lumbar erector spinae) measured by sEMG during habitual sitting postures and spinal deformity evaluated by 3D ultrasound imaging were compared before and after training. The mean values of the root-mean-square sEMG ratio, an index of symmetry in paraspinal muscle activities of the muscle pairs between the concave and convex sides of the spinal curve, revealed significant asymmetry over the trapezius and lumbar erector spinae before the training (p <0.05). After the training, all seven adolescents achieved relatively more symmetrical paraspinal muscle activities over these two muscle pairs (p < 0.05). In two adolescents, the spinal curvature decreased by 5.7° and 5.6°, respectively, whereas the remaining adolescents showed a minimal curve progression with changes in the spinal curvature controlled under 5°. To conclude, sEMG biofeedback posture training can reduce asymmetry in paraspinal muscle activities and control curve progression in adolescents with mild scoliosis and can potentially be considered an alternative early intervention for muscle reeducation in this cohort.
Collapse
|
9
|
Electromyographic Analysis of Paraspinal Muscles of Scoliosis Patients Using Machine Learning Approaches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031177. [PMID: 35162203 PMCID: PMC8835103 DOI: 10.3390/ijerph19031177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/20/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023]
Abstract
A large number of studies have used electromyography (EMG) to measure the paraspinal muscle activity of adolescents with idiopathic scoliosis. However, investigations on the features of these muscles are very limited even though the information is useful for evaluating the effectiveness of various types of interventions, such as scoliosis-specific exercises. The aim of this cross-sectional study is to investigate the characteristics of participants with imbalanced muscle activity and the relationships among 13 features (physical features and EMG signal value). A total of 106 participants (69% with scoliosis; 78% female; 9–30 years old) are involved in this study. Their basic profile information is obtained, and the surface EMG signals of the upper trapezius, latissimus dorsi, and erector spinae (thoracic and erector spinae) lumbar muscles are tested in the static (sitting) and dynamic (prone extension position) conditions. Then, two machine learning approaches and an importance analysis are used. About 30% of the participants in this study find that balancing their paraspinal muscle activity during sitting is challenging. The most interesting finding is that the dynamic asymmetry of the erector spinae (lumbar) group of muscles is an important (third in importance) predictor of scoliosis aside from the angle of trunk rotation and height of the subject.
Collapse
|
10
|
Evaluation of Symmetrical Exercises in Scoliosis by Using Thermal Scanning. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
(1) Background: Scoliosis affects about 3% of the population and the number of children diagnosed with this condition is increasing. Numerous studies have been conducted in recent years to observe the effectiveness of rehabilitation specific exercises for this condition. In the present study we aim to observe if symmetrical exercises activate the back muscles in the same way in the case of children with mild scoliosis and those without postural deviations; (2) Methods: We used the thermal imaging camera, which allows a non-invasive, painless investigation that provides real-time information about muscle activity. The study qualitatively assessed muscle activation during exercises. In this study, 30 children were divided into two groups: 15 children diagnosed with mild scoliosis and 15 children without postural deviations; (3) Results: Acquisition of images after each exercise revealed an imbalance in the functioning of the back muscles in children with scoliosis, with areas of higher temperature after exercise on the convexity side of the scoliotic curve. In the second experiment in which children with scoliosis performed the required exercises under the supervision of a physiotherapist, they showed a symmetrical activation of the back muscles on the right and left side of the back; (4) Conclusions: In children without postural deviations, symmetrical exercises activate the muscles equally on the right and left sides of the back. In the case of children with scoliosis, the symmetrical exercises indicated in the rehabilitation programs should be performed only under the supervision of a physiotherapist to properly activate the back muscles.
Collapse
|
11
|
Minjollet L, Abelin-Genevois K, De Chelle G, Sakoun L, Pujol A, Blay GL, Bernard JC. Are trunk muscles weaker in adolescent females with adolescent idiopathic scoliosis compared with their healthy counterparts? ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-200229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Adolescent Idiopathic Scoliosis (AIS) requires complex medical care because of multiple consequences especially on daily activities. Muscular involvement is part of the problem and may be treatable. OBJECTIVE: To analyze trunk muscle strength using an isokinetic dynamometer in female adolescents with AIS one year after orthopedic treatment by brace and compare the findings to a matched group of an asymptomatic cohort. METHODS: The trunk flexors and extensors strength was measured using an isokinetic dynamometer at 60, 90 and 120∘/s. Peak Moment (PM), Mean Power (MP) and the flexor/extensor ratio in 100 patients aged 14 to 18 years old were compared to a control group (N= 32) of asymptomatic age-matched females. In the AIS group, correlation analyses were computed to search for contributing factors to isokinetic performances, including morphological characteristics of patients, as well as clinical and radiological characteristics of the scoliosis. RESULTS: The trunk flexors in the AIS group were significantly but moderately (15%) weaker across speeds compared to their control counterparts at all speeds. No parallel weakness was noted for the extensors. While the MP of AIS patients was significantly weaker than that of the controls, 33% for flexors and by 31% for extensors, no significant differences were observed for the F/E ratios. The correlational analyses has indicated that weight and BMI were contributing factors at all speeds. CONCLUSION: Adolescents with AIS had weaker trunk extensors and mostly flexors compared to healthy females. Within this AIS population, weight and BMI seem to have a negative impact on muscular performances, whereas clinical and radiological characteristics of the scoliosis do not seem to contribute.
Collapse
Affiliation(s)
- Lénaïc Minjollet
- Department of Elite Sport Medicine, Centre Hospitalier Albertville-Moûtiers, Albertville, France
| | - Kariman Abelin-Genevois
- Department of Spine Surgery, Centre Médico Chirurgical et de Réadaptation des Massues, Croix Rouge Française, Lyon, France
| | | | - Liza Sakoun
- Department of Physical Medicine and Rehabilitation, SSR les Gentianes Unit, Centre Hospitalier Métropole Savoie, Chambéry, France
| | - Anne Pujol
- Department of Physical Medicine and Rehabilitation, Centre Médico Chirurgical et de Réadaptation des Massues, Croix Rouge Française, Lyon, France
| | - Grégoire Le Blay
- Department of Physical Medicine and Rehabilitation, Centre Médico Chirurgical et de Réadaptation des Massues, Croix Rouge Française, Lyon, France
| | - Jean-Claude Bernard
- Department of Physical Medicine and Rehabilitation, Centre Médico Chirurgical et de Réadaptation des Massues, Croix Rouge Française, Lyon, France
| |
Collapse
|
12
|
Analysis of the Degree of Involvement of the Lower Limb Muscles in the Pathological Process in Adolescents with Idiopathic Scoliosis. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.2.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background. The problem of the effect of adolescent idiopathic scoliosis on the functional condition of the lower limb muscles is still highlighted insufficiently.Aim. Analysis of the degree of involvement of the lower limb muscles in the pathological process in adolescents with idiopathic scoliosis.Methods. A comparative analysis has been made on the results of examination of 209 adolescents: 25 adolescents with idiopathic scoliosis; 170 normal adolescents; 14 adolescents with congenital scoliosis. The moments of force ofthe lower limb muscles were evaluated using dynamometric stands. Electrophysiological characteristics of the lower limb muscles were registered by the method of global and stimulation electroneuromyography.Results. The decrease in the amplitude of voluntary EMG of the femoral muscles in adolescents with idiopathic and congenital scoliosis is accompanied by dropping the moments of force relative to the values of the control group. The leg muscles are characterized by the preservation of the values of force at the level of normal test subjects under the conditions of the reduced voluntary EMG of high frequency. The amplitude of the M-responses of the indicator muscles and the values of the excitation propagation velocity along the motor fibers were also preserved. There are no statistically significant correlations between the amount of the spine deformity, on the one hand, and the values of asymmetry of the characteristics of the muscles in adolescents with idiopathic scoliosis.Conclusion. In adolescents with idiopathic scoliosis the function of femoral muscles is decreased, and there is no relationship between the amount of the spine deformity and the values of asymmetry of the characteristics of the lower limb muscles. The similar character of muscle function changes in adolescents with idiopathic and congenital scoliosis can testify that the cause of the observed changes is not the disease etiology, but the insufficient level of motor activity.
Collapse
|
13
|
Shear wave elastography of the lateral abdominal muscles in C-shaped idiopathic scoliosis: a case-control study. Sci Rep 2021; 11:6026. [PMID: 33727639 PMCID: PMC7966386 DOI: 10.1038/s41598-021-85552-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/03/2021] [Indexed: 01/09/2023] Open
Abstract
Considering that knowledge about lateral abdominal muscles (LAM) in idiopathic scoliosis (IS) is still very limited, the aims of this study were: (a) to compare LAM thickness and elasticity between C-shaped IS and non-scoliotic population; and (b) to compare LAM thickness and elasticity between C-shaped thoracic, thoracolumbar, and lumbar IS. A total of 259 adolescents were included in the final analysis; among these, 108 were IS and 151 were non-IS. LAM thickness and elasticity were measured at rest and during isometric contraction by an Aixplorer ultrasound scanner. Out of all LAM, only OE thickness was higher on the convex body side compared to the concave side in lumbar and thoracolumbar scoliosis. It may be related with muscle’s atrophy/hypertrophy or other tissues displacement rather than different force generated by the muscle on both body sides, because an asymmetry in the elasticity of the LAM between the convex and concave side was not presented. The only TrA was stiffer in lumbar scoliosis compared to thoracolumbar and thoracic scoliosis. LAM elasticity was similar in IS and non-IS adolescents.
Collapse
|
14
|
Effects of a Personalized Exercise Rehabilitation Device on Dynamic Postural Balance for Scoliotic Patients: A Feasibility Study. ELECTRONICS 2020. [DOI: 10.3390/electronics9122100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Scoliosis, which is defined as a 3-dimensional spine deformity, may be caused by new-onset degenerative changes that occur well after skeletal maturity and exhibit an asymmetrical postural balance pattern more common to adult deformity than adolescent scoliosis. The aim of this study was to verify whether an exercise program using a personalized exercise rehabilitation device can influence the dynamic postural balance of scoliotic patients. The personalized exercise rehabilitation device was designed to increase the efficacy of 3D postural correction for different curve patterns. 20 subjects were instructed to perform the personalized exercise program that consists of axial elongation, derotation, deflexion, facilitation and stabilization. The results of this study showed that the differences in clinical variables associated with imbalanced posture between the convex and concave side decreased after performing the personalized exercise. Consequentially, a well-designed and manufactured exercise rehabilitation device could be helpful for improving postural balance. Furthermore, the paper suggests that specific exercises using a personalized exercise rehabilitation device can provide the most appropriate exercise therapy and positively correct the asymmetrical postural balance patterns for scoliotic patients.
Collapse
|
15
|
Kwok G, Yip J, Yick KL, Cheung MC, Tse CY, Ng SP, Luximon A. Postural Screening for Adolescent Idiopathic Scoliosis with Infrared Thermography. Sci Rep 2017; 7:14431. [PMID: 29089528 PMCID: PMC5663704 DOI: 10.1038/s41598-017-14556-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/12/2017] [Indexed: 01/06/2023] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is a multifactorial, three-dimensional deformity of the spine and trunk. School scoliosis screening (SSS) is recommended by researchers as a means of early detection of AIS to prevent its progression in school-aged children. The traditional screening technique for AIS is the forward bending test because it is simple, non-invasive and inexpensive. Other tests, such as the use of Moiré topography, have reduced the high false referral rates. The use of infrared (IR) thermography for screening purposes based on the findings of previous studies on the asymmetrical paraspinal muscle activity of scoliotic patients compared with non-scoliotic subjects was explored in this study. IR thermography is performed with an IR camera to determine the temperature differences in paraspinal muscle activity. A statistical analysis showed that scoliotic subjects demonstrate a statistically significant difference between the left and right sides of the regions of interest. This difference could be due to the higher IR emission of the convex side of the observed area, thereby creating a higher temperature distribution. The findings of this study suggest the feasibility of incorporating IR thermography as part of SSS. However, future studies could also consider a larger sample of both non-scoliotic and scoliotic subjects to further validate the findings.
Collapse
Affiliation(s)
- Garcia Kwok
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Joanne Yip
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Kit-Lun Yick
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Mei-Chun Cheung
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi-Yung Tse
- Centre for Orthopaedic Surgery, Central, Hong Kong, China
| | - Sun-Pui Ng
- Division of Science & Technology, Hong Kong Community College, Hong Kong, China
| | - Ameersing Luximon
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| |
Collapse
|
16
|
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: 6] [Impact Index Per Article: 0.9] [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.
Collapse
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
| |
Collapse
|
17
|
Comparison of segmental spinal movement control in adolescents with and without idiopathic scoliosis using modified pressure biofeedback unit. PLoS One 2017; 12:e0181915. [PMID: 28753636 PMCID: PMC5533341 DOI: 10.1371/journal.pone.0181915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 06/13/2017] [Indexed: 11/19/2022] Open
Abstract
Background Postural rehabilitation emphasizing on motor control training of segmental spinal movements has been proposed to effectively reduce the scoliotic spinal deformities in adolescent idiopathic scoliosis (AIS). However, information regarding the impairments of segmental spinal movement control involving segmental spinal stabilizers in adolescent idiopathic scoliosis remains limited. Examination of segmental spinal movement control may provide a window for investigating the features of impaired movement control specific to spinal segments that may assist in the development of physiotherapeutic management of AIS. Objectives To compare segmental spinal movement control in adolescents with and without idiopathic scoliosis using modified pressure biofeedback unit. Methods Segmental spinal movement control was assessed in twenty adolescents with idiopathic scoliosis (AISG) and twenty healthy adolescents (CG) using a modified pressure biofeedback unit. Participants performed segmental spinal movements that primarily involved segmental spinal stabilizing muscles with graded and sustained muscle contraction against/off a pressure cuff from baseline to target pressures and then maintained for 1 min. Pressure data during the 1-minute maintenance phase were collected for further analysis. Pressure deviation were calculated and compared between groups. Results The AISG had significantly greater pressure deviations for all segmental spinal movements of cervical, thoracic, and lumbar spine than the CG. Conclusion Pressure biofeedback unit was feasible for assessing segmental spinal movement control in AIS. AISG exhibited poorer ability to grade and sustain muscle activities for local movements of cervical, thoracic, and lumbar spine, suggesting motor control training of segmental spinal movements involving segmental spinal stabilizing muscles on frontal, sagittal, and transverse planes were required.
Collapse
|
18
|
Abstract
ABSTRACT Scoliosis is characterized by three-dimensional changes of the spine and is estimated to be present in 4% of the population worldwide. The most common form is the adolescent idiopathic. The purpose of this study is to identify the major muscle abnormalities found in patients with adolescent idiopathic scoliosis through a literature review. We conducted an electronic search of the national databases PubMed, Lilacs, PEDro, and EMBASE using the keywords "scoliosis", "biomechanics", "exercise", "physical therapy specialty", "idiopathic", and "muscles", from January 2003 to April 2015. The most relevant articles in English, Portuguese and Spanish were selected by title and abstract. It was also performed a manual search of the references of the selected articles. From a total of 4,319 articles, 11 were selected. We conclude that individuals with AIS have changes in the paraspinal muscles, with a difference in activation between the concave and convex sides, suggesting an increase in EMG activity on the convex side, although there is still no consensus among the authors.
Collapse
|
19
|
Evaluation of Myoelectric Activity of Paraspinal Muscles in Adolescents with Idiopathic Scoliosis during Habitual Standing and Sitting. BIOMED RESEARCH INTERNATIONAL 2015; 2015:958450. [PMID: 26583151 PMCID: PMC4637075 DOI: 10.1155/2015/958450] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/06/2015] [Accepted: 07/21/2015] [Indexed: 11/20/2022]
Abstract
There is a number of research work in the literature that have applied sEMG biofeedback as an instrument for muscle rehabilitation. Therefore, sEMG is a good tool for this research work and is used to record the myoelectric activity in the paraspinal muscles of those with AIS during habitual standing and sitting. After the sEMG evaluation, the root-mean-square (RMS) sEMG values of the paraspinal muscles in the habitual postures reflect the spinal curvature situation of the PUMC Type Ia and IIc subjects. Both groups have a stronger average RMS sEMG value on the convex side of the affected muscle regions. Correction to posture as instructed by the physiotherapist has helped the subjects to achieve a more balanced RMS sEMG ratio in the trapezius and latissimus dorsi regions; the erector spinae in the thoracic region and/or erector spinae in the lumbar region. It is, therefore, considered that with regular practice of the suggested positions, those with AIS can use motor learning to achieve a more balanced posture. Consequently, the findings can be used in less intrusive early orthotic intervention and provision of care to those with AIS.
Collapse
|