Effects of a Home-Based Exercise Intervention (E-Fit) on Bone Density, Muscle Function, and Quality of Life in Girls with Adolescent Idiopathic Scoliosis (AIS): A Pilot Randomized Controlled Trial

Lau, Rufina Wing-Lum; Cheuk, Ka Yee; Ng, Benjamin; Tam, Eric; Hung, Alec Lik-Hang; Cheng, Jack; Hui, Stanley Sai-chuen; Lam, TP

doi:10.3390/ijerph182010899

Cited by 12 publications

(9 citation statements)

References 29 publications

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“…After removing 419 duplicated and 1019 unrelated studies, we finally included 56. There were 30 studies [6, on genetic risk factors related to low BMD in children with IS, eight studies on endocrine risk factors [57][58][59][60][61][62][63][64], and 18 studies [5,[65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81] on lifestyle-related risk factors. A total of 10,768 participants with IS were included in the 56 included studies, consisting of 295 male patients with IS in 14 studies [30,31,33,38,40,43,44,48,51,56,[63][64][65][66].…”

Section: Resultsmentioning

confidence: 99%

Risk factors associated with low bone mineral density in children with idiopathic scoliosis: a scoping review

Yang

Chen

Huang

et al. 2023

BMC Musculoskelet Disord

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Background Children with idiopathic scoliosis (IS) have a high risk of osteoporosis and IS with low bone mineral density (BMD) are susceptible to curve progression. This review aims to explore the risk factors of low BMD in children with IS. Methods Studies were retrieved from 5 databases that were published up to January 2022. Search terms are keywords in titles or abstracts, including subject headings related to “Scoliosis”, “Bone Mineral Density”, and “Risk Factors”. Observational studies on risk factors of low BMD in children with IS were enrolled in this review. The number of studies, sample size, outcome measures, research type, endocrine, and lifestyle-related factors, gene/signal pathway, and other contents were extracted for qualitative analysis. Results A total of 56 studies were included in this scoping review. Thirty studies involved genetic factors that may affect BMD, including the Vitamin-D receptor gene, RANK/RANKL signal pathway, the function of mesenchymal stem cells, Runx2, Interleukin-6 (IL-6), and miR-145/β-catenin pathway. Eight studies mentioned the influence of endocrine factors on BMD, and the results showed that serum levels of IL-6, leptin and its metabolites, and ghrelin in children with IS were different from the age-matched controls. In addition, there were 18 articles on lifestyle-related factors related to low BMD in children with IS, consisting of physical activity, calcium intake, Vitamin D level, and body composition. Conclusions Genetic, endocrine, and lifestyle-related factors might relate to low BMD and even osteoporosis in IS. To prevent osteoporosis, the effectiveness of regular screening for low BMD risk factors in children with IS needs to be investigated. Additionally, clear risk factors suggest strategies for bone intervention. Future studies should consider the effectiveness of calcium and vitamin D supplements and physical activity in BMD improvement.

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Section: Resultsmentioning

confidence: 99%

Risk factors associated with low bone mineral density in children with idiopathic scoliosis: a scoping review

Yang

Chen

Huang

et al. 2023

BMC Musculoskelet Disord

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“…Another important consideration is that methods to prevent BMD loss should be proposed. Exercise is believed to increase BMD and prevent BMD loss 21 . A network meta‐analysis 22 concluded that combined exercise, resistance exercise, aerobic exercise, and mind–body exercise significantly improve the BMD of the lumbar spine, among which mind–body exercises are considered the most effective.…”

Section: Discussionmentioning

confidence: 99%

“…Exercise is believed to increase BMD and prevent BMD loss. 21 A network metaanalysis 22 concluded that combined exercise, resistance exercise, aerobic exercise, and mind-body exercise significantly improve the BMD of the lumbar spine, among which mindbody exercises are considered the most effective. Mind-body exercise is an emerging concept that involves the mind, body, psychology, and behavior.…”

Section: Prevention For Bone Mineral Density Lossmentioning

confidence: 99%

The Effect of Halo‐Pelvic Traction on Bone Mineral Density of Vertebrae and Corresponding Risk Factors

Huang,

Xiu,

Shu

et al. 2023

Orthopaedic Surgery

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ObjectivesDecreased bone mineral density (BMD) is associated with complications in implantation surgery for severe spinal deformity. In this quantitative study, we aimed to investigate the impact of halo‐pelvic traction on vertebral bone mineral density (BMD) and identify the risk factors for a decrease in BMD.MethodsPatients who underwent halo‐pelvic traction at our hospital between 2019 and 2022 were included in the study. Patients’ data, including height, weight, and BMD pre‐ and post‐traction, were collected and analyzed. Quantitative computed tomography (QCT) was used to determine the BMD. The paired rank sum test was used to evaluate the changes in each measurement parameter. Linear regression was used to identify risk factors for a decrease in BMD.ResultsFifteen patients were included in the study, nine women and six men, with an average age of 21.2 ± 7.3 years. Eleven patients had severe rigid scoliosis, while four had tuberculotic kyphosis. One expert measured the BMD values of 345 vertebrae using QCT. The average traction time was 143.3 ± 44.4 days. The average pre‐traction BMD was 183.1 ± 73.8 mg/cm3, and the average post‐traction BMD was 140.5 ± 61.3 mg/cm3 (p < 0.01) Patients’ height increased from an average of 151.3 ± 12.8 cm pre‐traction to 165.5 ± 13.7 cm post‐traction (p < 0.01), with traction length averaging 14.3 ± 6.2 cm (p < 0.01). The Cobb angle of the main curve declined from an average of 112.5° ± 24.4° pre‐traction to 67.7° ± 19.8° post‐traction (p < 0.01). Linear regression revealed a positive correlation between BMD loss and traction length and a negative correlation between BMD loss and correction rate.ConclusionsHalo‐pelvic traction can lead to a decrease in the BMD of the spinal vertebrae, with traction length positively correlated with BMD loss and correction rate negatively correlated with BMD loss. To prevent osteoporosis, physicians should ensure a limited traction length while utilizing better management techniques.

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“…Some specific exercise programs for scoliosis, including E-Fit, xinmiao treatment system, and Schroth scoliosis-specific exercises, have been reported to be effective in controlling curve progression and postponing or avoiding surgical treatment. [39][40][41] The exercise-regulated serum myokine levels, whose levels in patients experiencing curve progression were reduced, not only highlight the importance of exercise-based treatment for AIS but also help to explain the underlying mechanism of myokine involvement. Extending research on how myokines halt the curve progression of patients with AIS may be beneficial in prescribing more tailored exercise prescriptions as well as myokine-based drugs.…”

Section: Discussionmentioning

confidence: 99%

Higher Baseline Serum Myokine of FSTL1 may Serve as a Potential Predictive Biomarker for Successful Brace Treatment in Girls with Adolescent Idiopathic Scoliosis

Feng

et al. 2023

Spine

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Study Design. A retrospective case-control study. Objective. This study aimed to investigate whether myokine, which is related to exercise and muscle mass, could serve as a biomarker for predicting bracing outcomes. Summary of Background Data. Several risk factors have been documented to be associated with bracing failure in patients with adolescent idiopathic scoliosis (AIS). However, serum biomarkers have not been extensively explored. Patients and Methods. Skeletally immature females with AIS, without previous histories of bracing or surgery, were included. Peripheral blood was collected at the time of the bracing prescription. Baseline serum concentrations of 8 myokines [apelin, fractalkine, brain-derived neurotrophic factor, erythropoietin, osteonectin, fatty-acid-binding protein 3, follistatin-like 1 (FSTL1), and musclin] were measured by multiplex assays. Patients were followed up until weaned from bracing and then designated as a “failure” (defined as Cobb angle progression >5°) or “success.” A logistic regression analysis was performed that accounted for serum myokines and skeletal maturity. Results. We included 117 patients, with 27 in the failure group. Patients in the failure group had lower initial Risser sign and lower baseline serum levels of myokines, including FSTL1 (2217.3 ± 617.0 vs. 1369.3 ± 704.9, P = 0.002), apelin [116.5 (12.0, 335.9) vs. 83.5 (10.5, 221.1), P = 0.016], fractalkine (979.6 ± 457.8 vs. 743.8 ± 456.1, P = 0.020), and musclin [211.3 (16.3, 370.3) vs. 67.8 (15.5, 325.6), P = 0.049]. Following adjusted analysis, serum FSTL1 [odds ratio = 10.460; (2.213–49.453)] was determined to be predictive of bracing effectiveness. Conclusion. Patients who failed AIS bracing had significantly lower mean baseline levels of FSTL1 than those who achieved success. FSTL1 may serve as a biomarker that can inform outcomes after bracing.

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Effects of a Home-Based Exercise Intervention (E-Fit) on Bone Density, Muscle Function, and Quality of Life in Girls with Adolescent Idiopathic Scoliosis (AIS): A Pilot Randomized Controlled Trial

Cited by 12 publications

References 29 publications

Risk factors associated with low bone mineral density in children with idiopathic scoliosis: a scoping review

Risk factors associated with low bone mineral density in children with idiopathic scoliosis: a scoping review

The Effect of Halo‐Pelvic Traction on Bone Mineral Density of Vertebrae and Corresponding Risk Factors

Higher Baseline Serum Myokine of FSTL1 may Serve as a Potential Predictive Biomarker for Successful Brace Treatment in Girls with Adolescent Idiopathic Scoliosis

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