Background Musculoskeletal disorders are often observed in patients with spinal muscular atrophy (SMA). The aim of the study was to assess passive ranges of rotation in the cervical spine, chest deformity and pelvic obliquity in SMA patients, and to compare these results to the norms obtained in the group of healthy individuals. The second aim was to review these measurements and Cobb angle values for correlations in SMA patients. Methods The study included 74 patients with SMA and 89 healthy individuals aged 2 to 18 years. Cervical Rotation (CR), Supine Angle of Trunk Rotation (SATR) and Pelvic Obliquity (PO) tests were carried out. Results Cervical rotation ranges were significantly higher in the control group than in SMA patients (p < 0.05). Differences between cervical rotation ranges to the left and to the right were significantly larger in SMA I and SMA II groups than in healthy individuals (p = 0.000). Chest asymmetry and pelvic obliquity were bigger in SMA groups than in the control (p < 0.05). Significant correlations between cervical rotation measurements, chest deformity, pelvic obliquity and Cobb angle were found in SMA individuals, depending on the type. Conclusions The results of the study suggest that CR, SATR and PO tests may assist in the assessment of SMA patients in addition to the radiographic evaluation of the spine. Biomechanical relationships between disorders located in various skeletal structures should be taken into account in the treatment of SMA patients. Special attention should be given to assessing postural parameters in non- sitters and sitters. Treatment of patients with SMA and associated musculoskeletal disorders requires a multi-specialist approach.
Introduction: Recommendations for management of spinal muscular atrophy (SMA) do not contain detailed information about the position of lower limbs during support standing. It has been observed that during the measurement of the range of extension in the hip joint (HE) in SMA patients, the examined limb was often naturally abducted. Aim: The main aim of the study was to compare the values of HE in the sagittal plane and in abduction, and to assess the correlation between the duration of supported standing and HE in SMA patients. Material and methods: The study group consisted of 75 SMA individuals aged 2–22 years and control group consisted of 202 healthy participants. The measurements were performed with the Rippstein plurimeter and goniometer. Results and discussion: Range of HE in SMA patients was larger in abduction than in the sagittal plane. A correlation was noted between the duration of supported standing and HE. Conclusions: Supported standing with hip joint abduction should be used in SMA patients. The obtained results broaden the knowledge about the biomechanics of hip joints in SMA patients.
Introduction: Obesity is a common health issue among children and adolescents leading to serious consequences later in life. There are reports on postural stability in children in relation to their nutritional status, but there are few studies involving a stabilometric platform. Aim: A comparison of postural stability in children with normal body mass and obese children. Material and methods: The stabilometric study involved 166 subjects. The postural stability evaluation was performed with the use of the Biodex Balance System platform. The following four postural stability tests were carried out: (1) eyes open, stable platform (SI0); (2) eyes open, level 4 unstable platform (SI4); (3) eyes open, level 4 unstable platform with the screen covered (SI4SC); (4) eyes closed, level 4 unstable platform (SI4EC), and the fall risk test (FRT). Results and Discussion: There were statistically significant differences found in the SI4, SI4SC, SI4EC, and FRT tests in all the inspected parameters. Only in the postural stability test on a stable platform (SI0) no differences were noted. The most marked differences between arithmetic means obtained for both groups were observed in the postural stability test on an unstable platform with closed eyes. Conclusions: Children with obesity are characterised by increased instability on a moving surface compared to children of normal body mass. Obese children experience the biggest problem when regaining balance with their eyes closed. It is advisable to include training on an unstable surface in physiotherapy programmes for obese children.
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