Postural control in girls with adolescent idiopathic scoliosis while wearing a Chêneau brace or performing active self-correction: a pilot study

Abstract

Background It is known that adolescent idiopathic scoliosis (AIS) is often accompanied by balance deficits. This reciprocal relationship must be taken into account when prescribing new therapeutic modalities because these may differently affect postural control, interacting with therapy and influencing its results. Objective The purpose was to compare postural control in girls with AIS while wearing the Chêneau brace (BRA) or performing active self-correction (ASC) with their postural control in a quiet comfortable stance. Methods Nine subjects were evaluated on a force plate in three series of two 20-s quiet standing trials with eyes open or closed; three blocks were randomly arranged: normal quiet stance (QST), quiet stance with BRA, and quiet stance with ASC. On the basis of centre-of-pressure (COP) recordings, the spatial and temporal COP parameters were computed. Results and Discussion Performing ASC was associated with a significant backward excursion of the COP mean position with eyes open and closed (ES = 0.56 and 0.65, respectively; p < 0.05). This excursion was accompanied by an increase in the COP fractal dimension (ES = 1.05 and 0.98; p < 0.05) and frequency (ES = 0.78; p = 0.10 and ES = 1.14; p < 0.05) in the mediolateral (ML) plane. Finally, both therapeutic modalities decreased COP sample entropy with eyes closed in the anteroposterior (AP) plane. Wearing BRA resulted in ES = 1.45 (p < 0.05) while performing ASC in ES = 0.76 (p = 0.13). Conclusion The observed changes in the fractal dimension (complexity) and frequency caused by ASC account for better adaptability of patients to environmental demands and for their adequate resources of available postural strategies in the ML plane. These changes in sway structure were accompanied by a significant (around 25 mm) backward excursion of the mean COP position. However, this improvement was achieved at the cost of lower automaticity, i.e. higher attentional involvement in postural control in the AP plane. Wearing BRA may have an undesirable effect on some aspects of body balance.

Postural control through force plate measurements in female AIS patients compared to their able-bodied peers

“…A reasonable explanation of these results assumes that the increased entropy of AIS in the three easier trials is a consequence of the specific experiences of these girls. This group, quite physically active, built their postural strategies in the presence of additional requirements, such as wearing a brace and performing exercises 9 . Adjusting to these additional difficulties caused the need to use more attentional resources, reducing their share in the balance itself.…”

“…There is still too little research in the literature that would examine the posture control system in relation to healthy. Our previous work dealt with how girls with AIS do during active self-correction (ASC) and the possibility of scoliosis impact on posture control 9 , 10 . Results seem to account for the desirable changes in postural control that were generated by learned ASC movements.…”

Case Report: Conservative Treatment of Adolescent Idiopathic Scoliosis Can Alter the Perception of Verticality. A Preliminary Study

“…Patients with moderate curvatures were treated with a Cheneau Brace. This type of brace orthosis has been shown to be effective in treating scoliosis in the mid to long term ( 9 ) and may produce relevant changes in CoP sway ( 10 ).…”

The Effects of Active Self-Correction on Postural Control in Girls with Adolescent Idiopathic Scoliosis: The Role of an Additional Mental Task

“…Recently, Piątek et al [6] reported that performing ASC resulted in a significant backward excursion of the center of pressure (COP) mean position with the concomitant increase in the COP fractality and frequency in the mediolateral (ML) plane. These results seem to account for desirable changes in postural control that were generated by learned ASC movements.…”

“…An individual's attention resources and information processing capacity are presumably limited and must be shared among all the tasks being concurrently performed [8]. The everyday routine of AIS patients often requires the simultaneous performance of ASC with other activities of daily living; therefore, a possibility of conflict arises that may adversely affect posture control, as indicated in the recent study by Piątek et al [6]. Accordingly, when two tasks are being performed at the same time, the performance of one or both can be impaired if together, they require attention that exceeds an individual's capacity.…”