Thoracic Deformity in the Transverse Plane among Adults with Severe Cerebral Palsy

Abstract

Thoracic deformity (TD) secondary to severe kyphoscoliosis occurs frequently in adults with severe cerebral palsy (CP) and can eventually result in pneumonia. To determine the severity of TD, we used two protocols to examine and compare the anteroposterior (AP) and laterolateral (LL) diameters of the thorax in the transverse plane among adults with severe CP. [Subjects and Method] The study examined 20 adults with severe CP. Computed tomographic scans were acquired at the level of the xiphisternal junction in each patient, and two protocols were used to measure the AP and LL diameters. The largest AP diameters were measured along the gravity line (protocol 1) and along the line where the middle point of the sternum connects with the spinous process of the vertebra (protocol 2). The largest LL diameters were measured along the lines perpendicular to each AP diameter. The ratios of the AP to LL diameters were calculated. [Results] The AP diameter of protocol 1 was significantly shorter than that of protocol 2, and the LL diameter of protocol 1 was significantly longer than that of protocol 2. There was a significant difference in the ratio of AP to LL between the protocols. [Conclusions] Our results suggest that differences between protocols in the AP and LL diameters show the severity of TD.

The effects of backpack loads and spinal stabilization exercises on the dynamic foot pressure of elementary school children with idiopathic scoliosis

“…This disease is accompanied by several symptoms, such as back pain, deformation of the thoracic cage, weakening of the respiratory muscles, and limited range of motion. Therefore, scoliosis subsequently results in a reduced quality of life 2 , 3 , 4 , 5 , 6 , 7 ) . While the causes of idiopathic scoliosis have not been identified, various hypotheses exist, including genetic, biochemical, mechanical, neurological, myological, and hormonal factors 8 ) .…”

Relationship between the Degree of Thoracic Deformity and the Angle Formed by a Line Connecting the Sternum and the Spinous Process of the Vertebrae in Individuals with Severe Motor and Intellectual Disorders

“…We recently devised 2 protocols to measure TD in the transverse plane and demonstrated that they are highly reliable 3 ) . In addition, we demonstrated that DIFFERENCE is related to the degree of TD 4 ) . Kyphoscoliosis and TD are not congenital deformities in individuals with SMID.…”

“…We recently developed 2 protocols for the measurement of TD in individuals with SMID, and these protocols were demonstrated to be highly reliable 3 ) . In addition, the degree of TD was shown to be indicated by the differences in the ratios of the anteroposterior (AP) to laterolateral (LL) diameters obtained using our protocols 4 ) .…”

Comparison of pulmonary function and back muscle strength according to the degree of spinal curvature of healthy adults

“…Many previous studies have reported that abnormal curvature of the spine has a negative effect on pulmonary function in various ways, including cardiorespiratory impairment, decrease in lung volume, and chest wall movement 3 , 10 , 11 , 13 , 14 , 15 , 16 ) . These possible items of pulmonary dysfunction are suggested to be caused by thoracic deformity due to abnormality of the spinal curvature 17 ) . However, our findings show that the degree of spinal curvature did not negatively affect pulmonary function.…”