Kinematics of the Chest Cage and Spine During Breathing in Healthy Individuals and in Patients With Adolescent Idiopathic Scoliosis

Leong, Jcy; Lü, Wei; Luk, Kdk; Karlberg, Eva M.

doi:10.1097/00007632-199907010-00007

Cited by 95 publications

(56 citation statements)

References 14 publications

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“…The motion restriction found in our study can be interpreted in several different ways. First, as reported by several authors, it could be due to the 3D structural changes of spine [9,19,21,22,30], pelvis [15,29,32], and hip components [3,37,38], which provide a clinically observed stiffness of the human body. However, we did not have any hypothesis for the hip transversal restriction, except as a consequence of the prolonged contraction of the GM and S muscles.…”

Section: Discussionmentioning

confidence: 99%

Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis

et al. 2009

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Adolescent idiopathic scoliosis (AIS) is a progressive growth disease that affects spinal anatomy, mobility, and left-right trunk symmetry. Consequently, AIS can modify human locomotion. Very few studies have investigated a simple activity like walking in a cohort of well-defined untreated patients with scoliosis. The first goal of this study is to evaluate the effects of scoliosis and scoliosis severity on kinematic and electromyographic (EMG) gait variables compared to an able-bodied population. The second goal is to look for any asymmetry in these parameters during walking. Thirteen healthy girls and 41 females with untreated AIS, with left thoracolumbar or lumbar primary structural curves were assessed. AIS patients were divided into three clinical subgroups (group 1 \ 20°, group 2 between 20 and 40°, and group 3 [ 40°). Gait analysis included synchronous bilateral kinematic and EMG measurements. The subjects walked on a treadmill at 4 km/h (comfortable speed). The tridimensional (3D) shoulder, pelvis, and lower limb motions were measured using 22 reflective markers tracked by four infrared cameras. The EMG timing activity was measured using bipolar surface electrodes on quadratus lumborum, erector spinae, gluteus medius, rectus femoris, semitendinosus, tibialis anterior, and gastrocnemius muscles. Statistical comparisons (ANOVA) were performed across groups and sides for kinematic and EMG parameters. The step length was reduced in AIS compared to normal subjects (7% less). Frontal shoulder, pelvis, and hip motion and transversal hip motion were reduced in scoliosis patients (respectively, 21, 27, 28, and 22% less). The EMG recording during walking showed that the quadratus lumborum, erector spinae, gluteus medius, and semitendinosus muscles contracted during a longer part of the stride in scoliotic patients (46% of the stride) compared with normal subjects (35% of the stride). There was no significant difference between scoliosis groups 1, 2, and 3 for any of the kinematic and EMG parameters, meaning that severe scoliosis was not associated with increased differences in gait parameters compared to mild scoliosis. Scoliosis was not associated with any kinematic or EMG left-right asymmetry. In conclusion, scoliosis patients showed significant but slight modifications in gait, even in cases of mild scoliosis. With the naked eye, one could not see any difference from controls, but with powerful gait analysis technology, the pelvic frontal motion (right-left tilting) was reduced, as was the motion in the hips and shoulder. Surprisingly, no asymmetry was noted but the spine seemed dynamically stiffened by the longer contraction time of major spinal and pelvic muscles. Further studies are needed to evaluate the origin and consequences of these observations.

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Section: Discussionmentioning

confidence: 99%

Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis

et al. 2009

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“…However, it has been reported that displacement of the ventral part of the rib cage during quiet breathing primarily occurred in the anteroposterior and craniocaudal directions. 19 Leong et al 16 showed that the mean displacements of thoracic and abdominal markers were greater in the craniocaudal direction than in other directions during deep breathing. We think that measuring only unidirectional displacements would be insufficient for assessments of breathing movements for various breathing patterns.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is limited to measuring the anteroposterior diameters of breathing movements. Although several previous studies have assessed the 3-dimensional motions of the thorax and abdomen during breathing using infrared cameras 15,16 and an electromagnetic device, 17 there is no reported literature on the 3-dimensional distances of the observational points on the thorax and abdomen during breathing.…”

Section: Introductionmentioning

confidence: 99%

Breathing Movements of the Chest and Abdominal Wall in Healthy Subjects

2012

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BACKGROUND: Physical assessment of breathing is an important component of physical therapy evaluations. However, there are no standardized reference values of breathing movements available for use in clinical practice. The purpose of this study was to determine the 3-dimensional distances of observational points on the thorax and abdomen during breathing in healthy subjects and to assess the effects of age, posture, and sex on breathing movements. METHODS: We studied the 3-dimensional breathing movement distances of the thorax and abdomen in 100 healthy subjects (50 males, 50 females). Breathing movements were measured with a 3-dimensional motion system during quiet and deep breathing with subjects in supine and sitting positions. Thirteen reflective markers were placed on the upper (the clavicles, 3rd ribs, and sternal angle) and lower thorax (the 8th ribs, 10th ribs, and xiphoid process) and the abdomen (upper abdomen and lateral abdomen). Range of movement in both breathing conditions was measured as the 3-dimensional distance at half respiratory cycle. Respiratory rates were calculated based on the breathing movements analyzed. One-way analysis of variance, t tests, and multiple regression were used for statistical analysis. RESULTS: The average marker distances for the thorax and abdomen during quiet breathing were less than one third of those during deep breathing. Upper thoracic movement was significantly decreased with age. There was less abdominal movement in females than in males, except during quiet breathing in the supine position. The distances between the thoracic markers were greater and those of the abdomen were less during quiet and deep breathing in the sitting position, compared with those in the supine position. CONCLUSIONS: We found that the observed breathing movements were related to the effects of age, sex, and posture. These findings are in agreement with those reported in previous studies. The results may be helpful in assessing breathing movement by physical examination.

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“…he scoliotic spinal deformity of lateral flexion and rotation of the involved vertebrae around a vertical axis and the attached ribs causes chest cage stiffness, reduced hemidiaphragmatic movement, and uneven distribution of the inhaled air on the concave side resulting in a decrease in pulmonary function [1][2][3] . The effect of surgical correction on the pulmonary function of patients with adolescent idiopathic scoliosis is controversial.…”

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confidence: 99%

Pulmonary Function in Adolescent Idiopathic Scoliosis Relative to the Surgical Procedure

Kim

Lenke

KIM

et al. 2005

The Journal of Bone and Joint Surgery-American Volume

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Kinematics of the Chest Cage and Spine During Breathing in Healthy Individuals and in Patients With Adolescent Idiopathic Scoliosis

Abstract: The range of movement of the chest cage and spine is more limited in the scoliotic cases. This overall stiffness of the chest cage and the spine may contribute to the mechanical inefficiency and impairment of pulmonary function found in scoliotic patients.

Cited by 95 publications

References 14 publications

Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis

Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis

Breathing Movements of the Chest and Abdominal Wall in Healthy Subjects

Pulmonary Function in Adolescent Idiopathic Scoliosis Relative to the Surgical Procedure

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