A scoping review of the different types of exercise programs proposed for the improvement of postural balance in adolescents with idiopathic scoliosis

BACKGROUND

Adolescent idiopathic scoliosis (AIS), which is the most common type of scoliosis, is a progressive disease that occurs in children aged 10-16 years. Abnormal curvature in AIS provokes spinal asymmetry of the upper body alignment and might deteriorate postural balancing and control ability.

OBJECTIVE

To evaluate the effect of exercise interventions on balance and postural stability in patients with adolescent idiopathic scoliosis.

METHODS

Embase, Scopus, Pubmed (Medline) and Web of Science databases were searched using the terms idiopathic scoliosis, physiotherapy, and balance. The articles selected were published in English in peer-reviewed journals from 2012 to July 2022.

RESULTS

Ten studies met the inclusion criteria. The PEDro scale values ranged from 2 to 6 (mean, 3.6), indicating a low level of scientific rigor. In the sample studies, spinal stabilization exercises were most often trialed (n= 3), followed by Schroth's exercise (n= 2), stretching and self-elongation exercise (n= 2), the exercise protocol of Blount and Moe, physiotherapeutic scoliosis-specific exercise, and proprioceptive neuromuscular facilitation exercise (all n= 1).

CONCLUSIONS

Physical therapists will be able to apply hippotherapy, Schroth exercise, physiotherapy scoliosis-specific exercise, trunk stabilization, proprioceptive neuromuscular facilitation exercise, spinal stabilization exercise, core stabilization exercise, and body awareness therapy to manage balance impairments in patients with adolescent idiopathic scoliosis, and further studies are needed to provide stronger evidence.

Effect of side-sling plank exercise on trunk and hip muscle activation in subjects with gluteus medius weakness

BACKGROUND

The effectiveness of side-sling plank (SSP) exercises on trunk and hip muscle activation in subjects with gluteus medius (Gmed) weakness is unclear.

OBJECTIVE

To quantify muscle activation of the rectus abdominis (RA), external oblique (EO), erector spinae (ES), lumbar multifidus (LM), Gmed, gluteus maximus (Gmax), and tensor fasciae latae (TFL) during SSP with three different hip rotations compared to side-lying hip abduction (SHA) exercise in subjects with Gmed weakness.

METHODS

Twenty-two subjects with Gmed weakness were recruited. SHA and three types of SSP exercises were performed: SSP with neutral hip (SSP-N), hip lateral rotation (SSP-L), and hip medial rotation (SSP-M). Surface electromyography was used to measure the activation of the trunk and hip muscles.

RESULTS

The trunk and hip muscles activations were generally significantly higher level during three SSP than SHA. SSP-M showed significantly lower EO activation while significantly higher ES and LM activation than SSP-L. Gmed activation was significantly higher during SSP-M than during SSP-L. TFL activation was significantly lower during SSP-M than during SSP-N and SSP-L.

CONCLUSIONS

SSP could be prescribed for patients who have reduced Gmed strength after injuries. Especially, SSP-M could be applied for patients who have Gmed weakness with dominant TFL.

Effects of Log-Rolling Position on Hip-Abductor Muscle Activation During Side-Lying Hip-Abduction Exercise in Participants With Gluteus Medius Weakness

CONTEXT

Weakness of the gluteus medius and gluteus maximus is associated with a variety of musculoskeletal disorders. However, activation of synergistic muscles that are not targeted should be considered when prescribing side-lying hip-abduction (SHA) exercises. Log-rolling positions may affect hip-abductor activity during SHA.

OBJECTIVE

To determine the effects of log-rolling positions on gluteus medius, gluteus maximus, and tensor fasciae latae activity during SHA in participants with gluteus medius weakness.

DESIGN

Controlled laboratory study.

SETTING

University research laboratory.

PATIENTS OR OTHER PARTICIPANTS

Twenty-one participants with gluteus medius weakness.

INTERVENTION(S)

Three types of SHA were performed: frontal-plane SHA in neutral position (SHA-neutral), frontal-plane SHA in anterior log-rolling position (SHA-anterior rolling), and frontal-plane SHA in posterior log-rolling position (SHA-posterior rolling).

MAIN OUTCOME MEASURE(S)

Surface electromyography was used to measure hip-abductor activity. One-way repeated-measures analysis of variance was calculated to assess the statistical significance of the muscle activity.

RESULTS

The SHA-anterior rolling showed greater gluteus medius and gluteus maximus activation than the SHA-neutral (P = .003 and P < .001, respectively) and SHA-posterior rolling (P < .001 and P < .001, respectively). The SHA-neutral demonstrated greater gluteus medius and gluteus maximus activation than the SHA-posterior rolling (P < .001 and P = .001, respectively). The SHA-anterior rolling produced less tensor fasciae latae activation than the SHA-neutral (P < .001) and SHA-posterior rolling (P < .001). The SHA-neutral showed less tensor fasciae latae activation than the SHA-posterior rolling (P < .001).

CONCLUSIONS

The SHA-anterior rolling may be an effective exercise for increasing activation of the gluteus medius and gluteus maximus while decreasing activation of the tensor fasciae latae in participants with gluteus medius weakness.