3D Quantitative Evaluation of Posture and Spine Proprioceptive Perception Through Instinctive Self-Correction Maneuver in Adolescent Idiopathic Scoliosis

Abstract

BackgroundConservative treatment in the adolescent idiopathic scoliosis (AIS) population is based on individual proprioceptive and motor control training. Such training includes physiotherapeutic scoliosis-specific exercises (PSSEs) stimulating the individual capacity to perceive and control his/her posture, particularly the shape of the spine. However, limited knowledge about basic proprioception capability in AIS patients is reported in the literature.Questions(1) How do AIS patients, who did not receive any previous specific postural education treatment, perceive their posture and 3D spine shape? Are they able to modify their posture and 3D spine shape correctly through an instinctive self-correction (ISCO) maneuver? (2) Are posture and ISCO maneuver ability gender dependent in AIS patients? (3) Do AIS patients present different posture and spine shape characteristics as well as different ISCO ability compared with the healthy young adult population?MethodsCross-sectional observational study. 132 (75 females, 57 males) AIS patients’ posture and 3D spine shape have been measured comparing indifferent orthostasis (IO) (neutral erect posture) to ISCO using a non-ionizing 3D optoelectronic stereophotogrammetric approach. Thirteen quantitative biomechanical parameters described the AIS patients body posture. The statistical analysis was performed using a multivariate approach to compare genders in IO, ISCO, and AIS patients vs. healthy young adults–previously published data (57 females, 64 males).ResultsMales (87.7%) and females (93.3%) of AIS patients were unable to modify posture and 3D spine shape globally. AIS patients gender differences were found in IO, ISCO, and the comparison vs. healthy young adults. When changes occurred, subjects could not focus and control their posture globally, but only in a few aspects at a time.ConclusionSelf-correction maneuver producing an improvement in body posture and spine shape is not instinctive and must be trained. In such characteristics, AIS patients are not so dissimilar to healthy young adults. Sagittal plane control is the highest, but ISCO in AIS patients led to worsening in this plane. Control at the lumbar level is neglected in both genders. Such outcomes support the necessity of customized PSSEs to treat AIS patients. The 3D stereo-photogrammetric approach is effective in quantitatively describing the subject’s posture, motor control, and proprioception.

3D Stereophotogrammetric Quantitative Evaluation of Posture and Spine Proprioception in Subacute and Chronic Nonspecific Low Back Pain

“…The performance of the ISCO manoeuvre by the NSLBP sample showed the same proprioception and motor control ability found in healthy young adults, i.e., a flattening of thoracic kyphosis (TKA), an unmovable lumbar lordosis (LLA), an increase in sacral angle (SA), and a general tendency to increase forward leaning of the trunk. Interestingly, the same behaviour in the sagittal plane postural modification during ISCO was recently observed in adolescent idiopathic scoliosis patients [27].…”

“…As for healthy young adults, the percentage of improved/worsened summarising indices (FPI, SPI, GPI) resulted in general far below that obtained for every single postural parameter. The same was confirmed for adolescent idiopathic scoliosis patients [27]. The lumbar level showed the largest unmodified behaviour.…”

“…Definitely, intra-subject analysis confirmed that, when changes occurred, NSLBP patients could not focus and control their posture globally, but they could focus only on a few aspects at a time, individually. This was also demonstrated for healthy young adults [26] and very recently for adolescent idiopathic scoliotic patients [27].…”

“…Laird et al [14], in their review, showed a reduced lumbar range of movement and proprioception in a population with LBP. Given the results obtained in previous studies [26,27], regardless of sex and healthy or pathological condition, subjects presented an individually managed poor proprioception and postural control capacity both globally and in the trunk. Furthermore, the instinctive self-correction manoeuvre induced similar postural reactions in all groups with greater involvement in the thoracic tract and neglect of the lumbar tract.…”

“…A recent study confirmed the association between poor proprioception and motor control and nonoptimal upright posture and spine balance by analysing the ISCO capabilities of adolescents with idiopathic scoliosis. Surprisingly, it has also been discovered that, while the posture of scoliotic patients was worse than that of healthy young adults, conversely, no significant differences were found in ISCO performances between the two populations [27].…”