Postural Equilibrium in Adolescent Idiopathic Scoliosis

Sahlstrand, Tage; Örtengren, Roland; Nachemson, Alf

doi:10.3109/17453677809050088

Cited by 172 publications

(102 citation statements)

References 8 publications

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“…Several authors have found alterations of proprioception and equilibrium control in scoliotic patients [1,[3][4][5][6][7][8][9][10]28]. Yamada [29] suggested that any disruption in the postural reflex system might induce scoliosis.…”

Section: Discussionmentioning

confidence: 99%

“…Some clinical studies have shown abnormalities in the balance control and proprioception in scoliotic patients as compared with age-and gender-matched healthy controls. Patients with IS have been found to have abnormal postural perception [1][2][3][4], impaired dynamic balance control [5], as well as angle joint reproduction asymmetries [6,7]. Vibratory sensitivity has also been found to be abnormal, increased [8,9] or decreased [10] in IS patients.…”

Section: Introductionmentioning

confidence: 99%

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Motor cortical hyperexcitability in idiopathic scoliosis: could focal dystonia be a subclinical etiological factor?

et al. 2009

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The aetiology of idiopathic scoliosis (IS) remains unknown; however, there is a growing body of evidence suggesting that the spine deformity could be the expression of a subclinical nervous system disorder. A defective sensory input or an anomalous sensorimotor integration may lead to an abnormal postural tone and therefore the development of a spine deformity. Inhibition of the motor cortico-cortical excitability is abnormal in dystonia. Therefore, the study of cortico-cortical inhibition may shed some insight into the dystonia hypothesis regarding the pathophysiology of IS. Paired pulse transcranial magnetic stimulation was used to study corticocortical inhibition and facilitation in nine adolescents with IS, five teenagers with congenital scoliosis (CS) and eight healthy age-matched controls. The effect of a previous conditioning stimulus (80% intensity of resting motor threshold) on the amplitude of the motor-evoked potential induced by the test stimulus (120% of resting motor threshold) was examined at various interstimulus intervals (ISIs) in both abductor pollicis brevis muscles. The results of healthy adolescents and those with CS showed a marked inhibitory effect of the conditioning stimulus on the response to the test stimulus at interstimulus intervals shorter than 6 ms. These findings do not differ from those reported for normal adults. However, children with IS revealed an abnormally reduced cortico-cortical inhibition at the short ISIs. Cortico-cortical inhibition was practically normal on the side of the scoliotic convexity while it was significantly reduced on the side of the scoliotic concavity. In conclusion, these findings support the hypothesis that a dystonic dysfunction underlies in IS. Asymmetrical cortical hyperexcitability may play an important role in the pathogenesis of IS and represents an objective neurophysiological finding that could be used clinically.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Motor cortical hyperexcitability in idiopathic scoliosis: could focal dystonia be a subclinical etiological factor?

et al. 2009

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“…These sensory issues can be explained by static or dynamic adaptive strategies. The static upright posture results from an increase of both the oscillation range [23] and the centre of pressure displacement [8,22]. Spinal deformity has no effect on trunk motion but influences movement between body segments (spine and limbs) [22].…”

Section: Introductionmentioning

confidence: 99%

Dynamical asymmetries in idiopathic scoliosis during forward and lateral initiation step

et al. 2009

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Adolescent idiopathic scoliosis (AIS) is characterized by morphological trunk modifications acting on body mass distribution. Some specific biomechanical strategies during postural regulation have been reported. Given that spinal deformity is three-dimensional, some strategy analysis resulting from different stepping directions should lead to a better understanding of the dynamic adaptation of behaviour. The aim of this study is to identify dynamic strategies of AIS patients stepping in lateral and forward directions. Ten AIS patients with a right thoracic curve and 15 controlled volunteers have been tested. Ground reaction forces (GRF) have been recorded for rightlimb stepping and for left-limb stepping associated to forward and lateral directions. Force amplitudes, corresponding occurrences, impulses of stepping phases and an asymmetry index have been computed. Asymmetry and variability increased in the AIS group, compared to the control group, whatever the stepping direction is. Asymmetry for AIS patients systematically provides an increased left initiation GRF compared to a right initiation. Nevertheless, for both groups, lateral initiation shows the largest asymmetry index reported for a forward initiation. More precisely, adaptive dynamic strategies for the AIS group have been characterized by an asymmetry between right and left limbs for lateral and forward initiation. These results can be explained by the influence of scoliosis pathology on dynamic movements due to spinal deformity. A right thoracic curve leads to an extra weight on the limb, which needs to be moved; consequently, stepping initiation with the right limb was more challenging for patients than stepping with the left limb. For the AIS group, the observed variability can also depend on the ontogenesis of adaptive strategies. Lateral step initiation has to be considered as the most relevant paradigm to study scoliosis and may also serve as a clinical basis for treatment to analyse the dynamic postural control and asymmetry strategies of the scoliosis patient.

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“…The interpretation of this trend was a natural process of maturation. We did not encounter the abnormal findings in postural control in children with scoliosis reported by other investigators [8,12,22,23].…”

Section: Discussionmentioning

confidence: 51%

“…T o understand the development of IS, the postural control system has been studied. This system is an important factor in the stabilization of the body posture [23,23]. Next to the equilibrium system the orientation system of the brain also exerts control over the stabilization of body posture [13].…”

Section: Introductionmentioning

confidence: 99%

Perception of vertical and horizontal orientation in children with scoliosis

Cheung¹,

Sluiter²,

Veldhuizen³

et al. 2002

Journal Orthopaedic Research

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To determine whether the perception of body posture is altered in idiopathic scoliosis, a simple neurophysiologic experiment through laser line projection was conducted to test this hypothesis in three groups of individuals: 89 children with idiopathic scoliosis (IS), 50 children with congenital scoliosis (CS) and 45 controls without scoliosis. The subjects were instructed to adjust a laser line projection to the direction of gravity in vertical and in horizontal projections in a dark environment. The performance, expressed as the deviation from the earth vertical (measured in degrees), was calculated by a computer. The three groups fiilfilled the vertical and horizontal adjustments within the same accuracy. No relation with age, sex or severity of scoliotic deformity was found. Yet. the angle between vertical and horizontal laser lines was significantly related with the severity of scoliosis, both in IS and CS. In contrast to our hypothesis, it was concluded that perception of postural control in IS is not altered. Therefore, this study indicates that IS is not likely to be caused by a dysfunction of postural control.

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Postural Equilibrium in Adolescent Idiopathic Scoliosis

Cited by 172 publications

References 8 publications

Motor cortical hyperexcitability in idiopathic scoliosis: could focal dystonia be a subclinical etiological factor?

Motor cortical hyperexcitability in idiopathic scoliosis: could focal dystonia be a subclinical etiological factor?

Dynamical asymmetries in idiopathic scoliosis during forward and lateral initiation step

Perception of vertical and horizontal orientation in children with scoliosis

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