[Show abstract][Hide abstract] ABSTRACT: X-rays are the gold standard evaluation for sagittal plane deformities even if, to see the spine, it's necessary to move the arms from the resting position to a forward one. The postural impact of arm positions has never been verified. The aim of this study is to measure the effect of arm positioning on surface topography measure.
Study Design: cross sectional.
83 consecutive adolescents (50 hyperkyphosis, 33 scoliosis). Hardware: 4-D Formetric. Methods: each subject has been consecutively evaluated in normal standing, then with progressive extension of the shoulders with extended arms (45°, 90°, 135°, 180°), then with arms crossed on the chest (CROSS) and with flexion of the shoulders and elbows, with hands steady on the shoulders (REST). All sagittal parameters given by Formetric have been considered. Statistics: ANOVA for total and sub-groups. Results. The absolute differences of angles from the standing position ranged from 4.8° to 13.3° (kyphosis) and from 4.6° to 10.4° (lordosis): they were statistically significantly different with rare exceptions. The biggest differences have been found with REST and 180°; the lowest with 45°, and CROSS. Lordosis and kyphosis did not change in the same direction, nor symmetrically: while kyphosis decreased with progressive arm extension, lordosis reached a maximum increase at 90-135°; REST and CROSS did not show consistent variations of lordosis and kyphosis. Changes were not consistent in several adolescents, and did not allow to find an ideal position.
These results showed that arm position changes spinal posture, at least when measuring with surface topography. According to these results, it does not exist an optimal position comparable with the normal standing; moreover, it is not possible to reconstruct in individual patients what the real standing angles would be without moving the arms. Surface devices may possibly be more ecologic measurement instruments than radiographs because they allow the patient to maintain the normal position of their arms and so are more reliable.
Full-text · Article · Jun 2012 · Studies in health technology and informatics
[Show abstract][Hide abstract] ABSTRACT: This report is the SOSORT Consensus Paper on Terminology for use in the treatment of conservative spinal deformities. Figures are provided and relevant literature is cited where appropriate.
The Delphi method was used to reach a preliminary consensus before the meeting, where the terms that still needed further clarification were discussed.
A final agreement was found for all the terms, which now constitute the base of this glossary. New terms will be added after being discussed and accepted.
When only one set of terms is used for communication in a place or among a group of people, then everyone can clearly and efficiently communicate. This principle applies for any professional group. Until now, no common set of terms was available in the field of the conservative treatment of scoliosis and spinal deformities. This glossary gives a common base language to draw from to discuss data, findings and treatment.
[Show abstract][Hide abstract] ABSTRACT: : Thoracic hyperkyphosis is a frequent problem and can impact greatly on patient's quality of life during adolescence. This condition can be idiopathic or secondary to Scheuermann disease, a disease disturbing vertebral growth. To date, there is no sound scientific data available on the management of this condition. Some studies discuss the effects of bracing, however no guidelines, protocols or indication's of treatment for this condition were found. The aim of this paper was to develop and verify the consensus on managing thoracic hyperkyphosis patients treated with braces and/or physiotherapy.
The Delphi process was utilised in four steps gradually modified according to the results of a set of recommendations: we involved the SOSORT Board twice, then all SOSORT members twice, with a Pre-Meeting Questionnaire (PMQ), and during a Consensus Session at the SOSORT Lyon Meeting with a Meeting Questionnaire (MQ).
There was an unanimous agreement on the general efficacy of bracing and physiotherapy for this condition. Most experts suggested the use of 4-5 point bracing systems, however there was some controversy with regards to physiotherapeutic aims and modalities.
The SOSORT panel of experts suggest the use of rigid braces and physiotherapy to correct thoracic hyperkyphosis during adolescence. The evaluation of specific braces and physiotherapy techniques has been recommended.