Effect of taping on posture of thoracic region in patients with thoracic kyphosis using acceleration

BACKGROUND

In the working environment of modern society, a poor sitting posture for a prolonged time may lead to abnormal spinal alignment such as thoracic kyphosis (TK).

OBJECTIVE

This study aimed to evaluate the efficacy of taping for posture correction of patients with TK, providing theoretical and empirical guidance for clinicians attempting to rectify TK posture.

METHODS

The study included 15 subjects aged 30-60 years, all with a TK angle of ⩾ 40∘. Subjects were required to ascend and descend a set of three steps (a low step, high step, and second low step) under three different conditions: without tape assistance, with taping assistance using 20% elongation, and with taping assistance using 40% elongation. A triaxial accelerometer was employed to measure and compare the anterior-posterior (AP), vertical (VT), and medial-lateral (MIL) movements of the thoracic vertebrae in the different conditions.

RESULTS

There were no significant differences in the MIL (P= 0.903) or AP (P= 0.114) movements between the no tape assistance and 20% elongation taping conditions. However, a significant difference was found in the VT movement (P= 0.017). Comparing the no assistance condition to the 40% elongation taping condition, no significant changes were noted in the MIL movement (P= 0.650), but significant differences were detected in both the VT (P= 0.003) and AP movements (P= 0.016). No significant differences were found in any of the three measurements between 20% and 40% elongation taping.

CONCLUSION

Taping serves as an effective method for immediately improving kyphotic posture. It corrects the position of the scapula and cervicothoracic line and exerts passive retraction on the relevant muscles, thus mitigating trunk imbalance.

Comparative Study of Post-Surgical Outcomes in Pain, Disability, and Health-Related Quality of Life for Adult Spinal Deformity in Patients Aged above and below 75 Years

(1) Background: Adult spinal deformity (ASD) surgery is known to improve clinical and radiological parameters; however, it may also cause more complications in elderly patients. The purpose of this study was to compare the outcomes of ASD surgery, specifically regarding pain, disability, and health-related quality of life (HRQOL) in patients aged 75 years and over and patients aged under 75 years; (2) Methods: A total of 151 patients who underwent ASD surgery between August 2014 and September 2020 were included. Patients were divided into two groups based on whether they are 75 years and over or under. Radiological parameters measured included sagittal vertical axis (SVA), pelvic tilt (PT), and pelvic incidence (PI)- lumbar lordosis (LL). Data were collected 3, 6, and 12 months after surgery; (3) Results: At 12 months postoperatively, visual analog scale (VAS) for low back pain (p = 0.342), Oswestry disability index (ODI) (p = 0.087), and EuroQol 5-Dimensions (EQ-5D) (p = 0.125) did not differ between patients under 75 years and those 75 and above 75 group. PT (p = 0.675), PI-LL (p = 0.948), and SVA (p = 0.108) did not differ significantly 12 months after surgery in the two groups. In the entire patient group, compared to preoperative data, significant improvements were demonstrated for clinical and radiological parameters 12 months after surgery (all p < 0.001). The rate of medical complications did not correlate with age, but the rates of proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) did (p = 0.638, p < 0.001, and p = 0.001, respectively); (4) Conclusions: In terms of clinical and radiological improvements, ASD surgery should be considered for patients regardless of whether they are younger than or older than 75 years. The clinical and radiological improvements and the risk of complications and revision surgeries must be considered in ASD patients who are 75 years or older.

Clinical and radiographic parameters for patients with adult spinal deformity

Background: Improved medical care and increased life expectancy have led to a focus on the impact of adult spinal deformity (ASD) on health-related quality of life (HRQoL) in the field of the spine. Recently, there has been a paradigm shift in the evaluation and management of ASD regarding the important correlation between sagittal imbalance and clinical outcomes.Current Concepts: Loss of lumbar lordosis is recognized as a key driver of ASD followed by forward-leaning of the trunk, reducing thoracic kyphosis, pelvic retroversion, and knee flexion. Radiological assessment has been critical for evaluating ASD from the anteroposterior and lateral view of the whole spine radiograph. Important parameters include coronal, regional, global, and sagittal spinopelvic parameters. Especially, sagittal spinopelvic parameters significantly correlate with disability and HRQoL in patients with ASD, which can influence the process of decision-making with respect to the choice between conservative treatment and surgery.Discussion and Conclusion: Sagittal imbalance has been recently emphasized in patients with ASD. Therefore, the decision-making of ASD treatment should be focused on restoring harmonious alignment to prevent catastrophic complications and improvement of HRQoL.

Effects of lower trunk movement in flat-back syndrome during stair climbing: A technical note

OBJECTIVE

This study investigated the differences in trunk sway during stair climbing between people with normal spinal alignment and people with flat-back syndrome.

METHODS

Twelve male volunteers with flat-back syndrome (global angle < 20 degrees) and 12 male volunteers with normal spinal alignment (global angle between 20 degrees and 30 degrees) were enrolled. An accelerator was attached to the third lumbar spine and the sway of each participant's trunk was measured during stair climbing.

RESULT

Participants with flat-back syndrome showed significant differences in vector, anteroposterior sway, and vertical sway of the trunk during stair climbing (p< 0.05). However, mediolateral sway of the trunk and gait time did not significantly differ between groups (p> 0.05).

CONCLUSION

Our findings can be used as baseline data for prevention of back pain. Furthermore, increased trunk sway can cause increased energy usage, leading to inefficient gait. Further research is needed to prevent this problem.

The effectiveness and safety of Chuna manual therapy on scoliosis: A protocol for systematic review and meta-analysis

BACKGROUND

Scoliosis is a spinal deformity and is diagnosed as Cobb angle being greater than 10°. Because it is accompanied with structural dysfunction, it can cause pain, worsen the patient's general health and quality of life. The prevalence of scoliosis has been increasing and many treatments, including surgical treatment and conservative treatment, such as observation, bracing, physiotherapy, and Chuna manual therapy (CMT), have been suggested. CMT is a manual therapy in Korean medicine that provides effective stimulation to the patient's body structure to treat structural dysfunction. After Korean national health insurance's coverage of CMT in 2019, the application of CMT for scoliosis has increased, and many studies have been reported. There have been attempts to elucidate the effectiveness of CMT on scoliosis; however, its effectiveness still remains unconfirmed. Therefore, the aim of this study is to evaluate the effectiveness and safety of CMT on scoliosis.

METHODS

The published randomized controlled trials that evaluated the effectiveness and safety of CMT for scoliosis will be searched for in multiple electronic databases without the limitation of country and language. Data on characteristics of studies, interventions, comparators, outcome measures, results, and information for assessment of study quality will be extracted. The primary outcome will be the Cobb angle and the secondary outcomes will be the scales of pain, function, quality of life and disability, and adverse events. Data synthesis and analysis will be conducted using the Review Manager software for Windows (RevMan ver. 5.3.; Copenhagen; The Nordic Cochrane Center, The Cochrane Collaboration, 2014). Subgroup analysis to identify the differences between different CMT maneuvers will also be performed. For risk of bias assessment, the "risk of bias" tool from Cochrane Collaboration will be used.

RESULTS

This study will present the clinical evidence on the effectiveness and safety of CMT on scoliosis.

CONCLUSION

This study will propose useful evidence for treatment, further research, and health policies in the future.