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The effectiveness of core stabilization exercise in adolescent idiopathic scoliosis: A randomized controlled trial:

Background: Core stabilization training is used to improve postural balance in musculoskeletal problems. Objectives: The purpose of this study was to investigate the effectiveness of stabilization training in adolescent idiopathic scoliosis. Study design: A randomized controlled trial, pretest–posttest design. Methods: In total, 25 subjects with adolescent idiopathic scoliosis were randomly divided into two groups: stabilization group (n = 12) and control group (n = 13). The stabilization group received core stabilization in addition to traditional rehabilitation, and the control group received traditional rehabilitation for 10 weeks. Assessment included Cobb’s angle on radiograph, apical vertebral rotation in Adam’s test, trunk asymmetry (Posterior Trunk Symmetry Index), cosmetic trunk deformity (Trunk Appearance Perception Scale), and quality of life (Scoliosis Research Society-22 questionnaire). Results: Inter-group comparisons showed significantly greater improvements in the mean change in lumbar apical vertebral rotation degree and the pain domain of Scoliosis Research Society-22 in the stabilization group than those in the control group (p < 0.05). No significant differences were observed for other measurements between the groups; however, trends toward greater improvement were observed in the stabilization group. Conclusion: Core stabilization training in addition to traditional exercises was more effective than traditional exercises alone in the correction of vertebral rotation and reduction of pain in adolescent idiopathic scoliosis. Clinical relevance Stabilization exercises are more effective in reducing rotation deformity and pain than traditional exercises in the conservative rehabilitation of adolescent idiopathic scoliosis. These improvements suggest that stabilization training should be added to rehabilitation programs in adolescent idiopathic scoliosis.

Is there any relationship between orthotic usage and functional activities in children with neuromuscular disorders

Background: Contractures of Achilles tendons and gastrocnemius muscle deteriorate the performance in daily living activities of patients with neuromuscular diseases. Ankle–foot orthoses help to prevent the progression of deformities and to obtain optimal position of the joints to support standing and walking. Objective: To investigate the relationship between orthotic usage and functional activities in pediatric patients with different neuromuscular diseases. Study design: Retrospective study. Methods: A total of 127 subjects’ physical assessment forms were analyzed. Functional level, type of orthoses, falling frequencies, ankle joint range of motion, and timed performance tests were examined in two consecutive dates with an interval of 3 months. Results: A total of 91 patients were using orthoses while 36 patients were not within assessment dates. A total of 64 of 91 (70.3%) patients were diagnosed with Duchenne muscular dystrophy. A total of 81 (89.0%) subjects were using plastic ankle–foot orthoses for positioning at nights and 10 (11%) were using different types of the orthoses (knee–ankle–foot orthoses, dynamic ankle–foot orthoses, and so on) for gait in the study group. Conclusions: Night ankle–foot orthoses were not found to be effective directly on functional performance in children with neuromuscular diseases, although they protect ankle from contractures and may help to correct gait and balance. Clinical relevance This retrospective study shows that the positive effects of using an ankle–foot orthosis at night are not reflected in the functional performance of children with neuromuscular diseases. This may be due to the progressive deteriorating nature of the disease.

Validity and Reliability of Visual Analog Scale Foot and Ankle: The Turkish Version

ABSTRACT The present study tested the reliability and validity of the Turkish version of the visual analog scale foot and ankle (VAS‐FA) among healthy subjects and patients with foot problems. A total of 128 participants, 65 healthy subjects and 63 patients with foot problems, were evaluated. The VAS‐FA was translated into Turkish and administered to the 128 subjects on 2 separate occasions with a 5‐day interval. The test–retest reliability and internal consistency were assessed with the intraclass correlation coefficient and Cronbachs &agr;. The validity was assessed using the correlations with Turkish versions of the Foot Function Index, the Foot and Ankle Outcome Score, and the Short‐Form 36‐item Health Survey. A statistically significant difference was found between the healthy group and the patient group in the overall score and subscale scores of the VAS‐FA (p < .001). The internal consistency of the VAS‐FA was very good, and the test–retest reliability was excellent. Adequate to good correlations were found between the overall VAS‐FA score and the Foot Function Index, Foot and Ankle Outcome Score, and Short‐Form 36‐item Health Survey scores in the healthy and patient groups both. The Turkish version of the VAS‐FA is sensitive enough to distinguish foot and ankle‐specific pathologic conditions from asymptomatic conditions. The Turkish version of the VAS‐FA is a reliable and valid method and can be used for foot‐related problems.

One-year follow-up study of serial orthotic treatment in two cases with arthrogrypotic syndromes who have bilateral knee flexion contractures

Background: The aim of this pilot study was to investigate the effectiveness of serial splinting in two children with bilateral knee flexion contractures due to arthrogrypotic syndrome. Case description and methods: We evaluated the infants’ passive knee extension limitation and motor development levels. Serial orthotic treatment was applied to decrease bilateral knee flexion contractures in the knees of the subjects. The follow-up period was up to 1 year. Findings and outcomes: At the end of serial orthotic treatment, improvement in bilateral passive extension limitation (for the first case, the increase in passive range of extension was approximately 75°, for the second case it was 45°) was achieved in both cases. Conclusion: We believe that serial orthotic intervention is effective in patients with arthrogrypotic syndrome at the preoperative period or in patients who cannot be operated on. Further studies are needed for evaluation of effectiveness of this method. Clinical relevance Our pilot study aimed to investigate the effectiveness of serial orthotic treatment in knee contractures due to arthrogrypotic syndrome in two infants which showed an improvement in range of extension.

The Turkish version of the Brace Questionnaire in brace-treated adolescents with idiopathic scoliosis

Background: Evaluation of the effects of brace treatment on quality of life in adolescent idiopathic scoliosis is important. Objectives: To analyze the validity and reliability of the Turkish version of the Brace Questionnaire. Study design: Cohort study, evaluation of reliability and validity of the Turkish version of the Brace Questionnaire. Methods: Twenty-eight patients undergoing brace treatment for adolescent idiopathic scoliosis (median age: 14.6 years) were included in the study. The Brace Questionnaire was translated into Turkish and administered to the patients twice at an interval of 5 days. Reliability was assessed using the test–retest method (Pearson’s correlation coefficient); internal consistency was analyzed using Cronbach’s alpha. Validity was assessed by correlating the Brace Questionnaire with the Bad Sobernheim Stress Questionnaire-Brace and Scoliosis Research Society-22 questionnaire. Results: The mean Cobb angles were 31.1° ± 8.3° and 29.7° ± 9° for thoracic and lumbar regions, respectively. Cronbach’s alpha was 0.94. Intraclass correlation coefficient was 0.95 in test–retest reliability analysis. The correlations between Brace Questionnaire and Bad Sobernheim Stress Questionnaire-Brace and Scoliosis Research Society-22 were r = 0.67 and r = 0.64, respectively. Conclusion: The Turkish version of the Brace Questionnaire to measure the effects of brace treatment on quality of life in adolescent idiopathic scoliosis was found to have good validity, excellent reliability, and high internal consistency. Clinical relevance We recommend routine use of the Brace Questionnaire in scoliosis patients to evaluate brace-related quality of life and relevant factors and to support the individual when necessary during such treatment.

Effects of A Spinal Brace on the Functional Profile of the Feet in Adolescent Idiopathic Scoliosis

Purpose: To assess the impact of a spinal brace on the functional profile of the feet in patients with adolescent idiopathic scoliosis (AIS). Patients and Methods: The subjects were 21 female AIS patients with double curves (range: 20°–45°). Baropodometry and stabilometry analysis during standing and walking and were performed without bracing and after 7 days of bracing. Plantar force distribution, contact area, foot angle, mean and peak foot pressures, step length, step width, cadence, and gait speed, center of pressure path length and sway velocities and confidence ellipse area were recorded. Results: Bracing did not affect baropodometry parameters during standing (p > 0.05). However, left foot plantar contact area was greater, mean pressure and peak pressures on the left foot were lower with bracing compared to without bracing (p < 0.05) during walking. Cadence decreased with bracing. There was no change in stabilometry results (p > 0.05). Conclusion:spinal bracing created more symmetrical plantar pressure distribution between the feet during gait. However, bracing tends to alter temporal-spatial walking parameters and disrupt gait in patients with double curve scoliosis.

The Comparison of Postural Stability in Adolescents with Mild and Moderate Idiopathic Scoliosis

Objective: Postural stability organizes body orientation in the upright stance and daily activities. Postural stability is affected by the trunk asymmetry and deformity in adolescent idiopathic scoliosis (AIS). The aim of this study was to compare mild and moderate curves in terms of postural stability in patients with AIS. Material and Methods: Thirty subjects, with right thoracic and left lumbar scoliosis, and in the age range of 13 15 years, were included in the study. Fifteen subjects had mild curves (10-20o of Cobb) while the other fifteen had moderate curves (21-45o of Cobb). Postural stability was tested with the Computerized Dynamic Posturography Somatosensorial Organization Test. Inter-group comparisons were performed with Mann-Whitney U test statistics. Results: Thoracic curve magnitude was 13.46 ± 1.98o and lumbar curve magnitude was 11.8 ± 6.18o for the mild group. For the moderate group, thoracic curve magnitude was 30.6 ± 10.0o and lumbar curve magnitude was 28.1 ± 7.6o. Higher scores were observed in the “eyes open, swayed vision” and “eyes open, swayed vision and swayed support” conditions for the moderate group (p < 0.05). No significant differences were observed for other test conditions between the groups. conclusion: This study demonstrated that patients with moderate curves had better equilibrium reactions and postural stability adaptations when compared to patients with mild curves in AIS.

Scapular kinematics in adolescent idiopathic scoliosis: A three-dimensional motion analysis during multiplanar humeral elevation

The scapula plays a critical role in supporting shoulder function. Considering the closed anatomical relationship between the scapula and the thoracic cage, the presence of postural disturbances could be linked to alterations in the scapular position and orientation in adolescent idiopathic scoliosis (AIS). However, currently there is a lack of descriptive research and detailed assessment of scapular kinematics in AIS. The aim of this study was to investigate the three-dimensional scapular kinematics in AIS. Nineteen AIS patients and fourteen healthy controls participated in this study. Bilateral shoulder kinematics were measured with an electromagnetic tracking device during shoulder elevation in the sagittal, scapular, and frontal planes. Data for the scapular orientation were analyzed in the resting position and at 30°, 60°, 90°, and 120° of humerothoracic elevation. Scapular behavior was different in participants with AIS, compared to healthy controls, with different patterns observed on convex and concave sides. While examining all three planes of elevation, the scapula was more internally and anteriorly tilted on the convex side, while the scapula was more externally, downwardly rotated, and posteriorly tilted on the concave side in participants with AIS. Furthermore, there was a decreased peak humerothoracic elevation and altered scapular posterior tilt in participants with AIS in the resting position. These findings increase our knowledge and understanding of scapular alterations and the reported scapular alterations can be considered as adaptive compensation strategies in AIS.

Effects of Corrective Taping on Balance and Gait in Patients With Hallux Valgus

Background: Taping is an effective temporary therapy for improving hallux valgus (HV) in adults. Although HV has been demonstrated to impair postural balance, there is a lack of information about how corrective taping affects balance and gait patterns in adults with HV deformity. Methods: Eighteen middle-aged female patients (average age, 53.5 years) with HV were included. Corrective tape was applied to correct HV angulation. A series of balance and gait stability tests were performed before applying tape and 1 hour after the tape was applied with a Balance Master computerized posturography device. The study involved the following tests: modified clinical test of sensory interaction and balance (mCTSIB), unilateral stance (US), limit of stability (LoS), step up/over (SUO), and walk across (WA) tests. Results: No significant difference was found between the no-tape and taped condition in the static balance mCTSIB and US tests (P > .05). The taping intervention resulted in significant improvement in the dynamic balance measures for the LoS test’s backward reaction time and left maximum excursion (P < .05), a significantly higher impact index bilaterally in the SUO assessment (P < .05), and an increase in step width mean and variability in the WA test (P < .05). Conclusions: Taping for correcting HV angulation had negative acute effects on dynamic balance in the SUO and WA tests and positive effects in the LoS test. Clinical Relevance: Corrective taping, although a form of conservative treatment for hallux valgus, has been insufficiently studied in terms of effects on balance. Our results show that taping, as an acute effect, may impair balance in middle-aged adults when walking or ascending and descending stairs.

Acute effects of spinal bracing on scapular kinematics in adolescent idiopathic scoliosis

Background Bracing is the most common nonsurgical treatment for adolescent idiopathic scoliosis. Spinal braces affect glenohumeral and scapulothoracic motion because they restrict trunk movements. However, the potential spinal‐bracing effects on scapular kinematics are unknown. The present study aimed to investigate the acute effects of spinal bracing on scapular kinematics in adolescent idiopathic scoliosis. Methods Scapular kinematics, including scapular internal/external rotation, posterior/anterior tilting, and downward/upward rotation during scapular plane elevation, were evaluated in 27 in‐brace and out‐of‐brace adolescent idiopathic scoliosis patients with a three‐dimensional electromagnetic tracking system. Data on the position and orientation of the scapula at 30°, 60°, 90°, and 120° humerothoracic elevation were used for statistical comparisons. The paired t‐test was used to assess the differences between the mean values of in‐brace and out‐of‐brace conditions. Findings The in‐brace condition showed significantly increased (P < 0.05) scapular anterior tilting and decreased internal rotation in the resting position on the convex and concave sides; increased scapular downward rotation at 120° humerothoracic elevation on the convex side and at 30°, 60°, 90°, and 120° humerothoracic elevation on the concave side; increased scapular anterior tilt at 30°, 60°, 90°, and 120° humerothoracic elevation on the convex and concave sides; and decreased (P < 0.05) maximal humerothoracic elevation of the arm. Interpretation Spinal bracing affects scapular kinematics. Observed changes in scapular kinematics with brace may also affect upper extremity function for adolescents with idiopathic scoliosis. Therefore, clinicians should include assessments of the glenohumeral and scapulothoracic joints when designing rehabilitation protocols for patients with adolescent idiopathic scoliosis. HighlightsSpinal bracing altered scapular kinematics in adolescent idiopathic scoliosis patients.Spinal bracing increased scapular anterior tilting and decreased internal rotation in rest.Spinal bracing increased scapular downward rotation and anterior tilting during arm elevation.Spinal bracing decreased the maximum humerothoracic elevation level.