The Effects of Shockwave Therapy Combined with Neural Mobilization on Adolescents with Idiopathic Scoliosis

Sallam Ali Shoura Sallam, Amir Mohamed Saleh, Hesham Mohamed Abdel Raheem, Wael M. Wagdy, Ahmed Ebrahim Ahmed Elerian

Sallam Ali Shoura Sallam, Amir Mohamed Saleh, Hesham Mohamed Abdel Raheem, Wael M. Wagdy, Ahmed Ebrahim Ahmed Elerian – The Effects of Shockwave Therapy Combined with Neural Mobilization on Adolescents with Idiopathic Scoliosis. Fizjoterapia Polska 2021; 21(1); 120-125

Abstract
Purpose. To examine the effects of ESWT combined with neural mobilization in Adolescents with Idiopathic Scoliosis (AIS). Study Design. Randomized Controlled Experimental design. Methods. Forty-five patients were assigned randomly into three equal groups; their ages were between 10 to 18 years and Cobb degrees from 15 to 30°. Group (A): received a physiotherapeutic scoliosis-specific exercises (PSSE). Group (B): received PSSE in addition to ESWT. Group (C): received treatment program as in group (B) combined with neural mobilization program. The Cobb angle, Angle of Trunk Rotation and the functional ability were investigated by x- ray, scoliometer device, and the Arabic version of the scoliosis research society-22r (SRS-22r) questionnaire respectively, at the beginning and at the end of the treatment program. Results. there was significant decrease of both ATR and cobb angles at post treatment in compare to pre-treatment in all groups (P-value < 0.001). Also, there was a significant difference of the mean values of the “post” test between (group A versus C only) for both ATR and cobb angle (P = 0.01 & 0.003 respectively) and this significant decrease in favor of group (C) than other groups. However, for SRS-22r scores, there was no significant difference of the mean values of the “post” test among groups (P = 0.85).
Conclusion. Adding ESWT combined with neural mobilization program to PSSE in management of AIS have significant improvements in cobb angle and Angle of Trunk Rotation.
Key words:
scoliosis, shockwave therapy, neural mobilization
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Angle of trunk rotation in 10-year-old primary school children in Poznań

Katarzyna Adamczewska, Marzena Wiernicka, Łukasz Michałowski, Lech Furmaniuk, Magdalena Goliwąs, Marta Flis-Masłowska, Jacek Lewandowski

K. Adamczewska, M. Wiernicka, Ł. Michałowski, L. Furmaniuk, M. Goliwąs, M. Flis-Masłowska, J. Lewandowski – Angle of trunk rotation in 10-year-old primary school children in Poznań. FP 2017; 17(3); 96-102

Abstract

Introduction. Changes in spinal geometry should be assessed in three planes, and accounting for the movement of spinous processes. An assessment of the angle of trunk rotation allows for early and non-invasive detection of scoliosis and its prevention.
Purpose. The purpose of this study was to assess the angle of trunk rotation (ATR) in the population of 10-year-old primary school children in Poznań.
Materials and methods. The participants included 1533 children aged 10 years (759 girls and 774 boys). The ATR was measured with the Bunnell scoliometer at three levels of the spine: Th1-Th4, Th5-Th12, Th12-L4. On the basis of the measurements conducted in this study, a group of children with ATR at 0, 1-3˚, 4-6˚ and ≥ 7˚ (including rotation to the left and to the right) was identified.
Results: The lowest values of ATR in both groups (boys and girls) were found at the level of Th1-Th4 with ATR ≥ 7˚ occurring in 0.2% of the participants. 4% of all participants also presented with a clinical suspicion of lateral curvature of the spine. Values of the ATR measured at the Th5-Th12 and Th12-L4 levels increased considerably. At the Th level of the spine, 10% of the participants presented with a clinical suspicion of scoliosis, and the diagnosis was confirmed for 2.5% of all primary school children. At the lowest level of the spine, 9% of the participants were identified as being at an increased risk of scoliosis, and 2.7% of children exhibited an ATR ≥ 7˚.
Conclusions:
1. The highest angle of trunk rotation (ATR ≥ 7˚) was found in girls at the Th5-12.level of the spine. Both genders exhibited primarily rotation to the right.
2. Scoliosis poses a significant diagnostic challenge in a school environment. If left untreated, it increases the risk of pathological changes in the trunk and disease progression.
3. The Bunnell scoliometer allows for early and non-invasive assessment of the angle of trunk rotation, and should be permanently included in screening procedures.
4. Using appropriate instruments for posture assessment is necessary for diagnosing musculoskeletal disorders accurately.

Key words:

angle of trunk rotation, scoliometer, scoliosis, posture in children

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Block coincidence of sacroiliac joints in lateral curvature of the spine as well as the effect of the therapy on the size of scoliosis

Daniel Olędzki, Tomasz Sajko, Andrzej Sadowski, Marek Kiljański

D. Olędzki, T. Sajko, A. Sadowski, M. Kiljański – Block coincidence of sacroiliac joints in lateral curvature of the spine as well as the effect of the therapy on the size of scoliosis. FP 2015; 15(2); 22-38

Abstract

In the presentation the authors try to estimate dependencies between lateral curvature of the spine occurrence and the dysfunction of sacroiliac joints as blocks. It was pointed out that scoliosis as a phenomenon can be widely observed in a human body.  The position itself as well as the course of the delivery may lead to different types of muscle tone disorders and positional asymmetry in effect of fascia continuity damaging of the neonate during the delivery or perinatal period.
It may be assumed that the pathology of embryonic development and later in neonatal period can be the origin of the spine statics disorder, and consequently cause overloads of sacroiliac joints manifested in blocks. The secondary effect of the dysfunction of sacroiliac joints may be an asymmetric arrangement of hip bones, and this could lead to asymmetric position of the sacrum and compensatory scoliosis (the term coined by the authors).
Authors underline the important role of the dysfunction of the sacroiliac joint – the strongest proprioreceptor in the joint system – in causing other joints to disfunction, even those which are distant to the pelvis as well as causing muscle tone disorders.
The authors described the following phenomena:
1) how occurrence of sacroiliac joints blocks correlate with the asymmetry of the pelvis position,
2) the relation of lateral curvature of the spine size with the rotation of the spine with a sacroiliac joint block.
In the group of tested children with the scoliosis of a little degree (up to 5 degrees of the rotation) it was noticed that there was a high percentage of the sacroiliac joint dysfunction going with the asymmetric pelvis position. After the therapy of sacroiliac joints blocks there was a statistically substantial improvement in the position of the pelvis as well as the decrease in the scoliosis degree (with connected to it vertebra rotation) was observed.

Key words:
sacroiliac joint, manual therapy, scoliosis, block

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Phenomenon of the dominant and latent blocks of the sacroiliac joint in lateral curvature of the spine – problems related to the pelvis therapy

Daniel Olędzki, Andrzej Sadowski, Tomasz Sajko, Marek Kiljański

D. Olędzki, A. Sadowski, T. Sajko, M. Kiljański: Phenomenon of the dominant and latent blocks of the sacroiliac joint in lateral curvature of the spine – problems related to the pelvis therapy. Fizjoterapia Polska 2015;15(3);12-22

Abstract

The deviation of the spine from the long vertical line of the body can be detected from the early years of a child. The deviation is closely related to the position of the pelvic bones to each other and sacroiliac joints, especially their disfunction, play an important part in this process.
Even a slight shift of the sacrum relative to a hip bone causes the change in the spatial arrangement of the pelvis complex, spine segments located above as well as the hip bones. Early intervention by early diagnosis of the disfunction in little children gives us a chance to correct efficiently the pelvis relative to the spine at the level of so-called “compensatory scoliosis” when the problem lies only in the asymetric arrangement of the pelvis that affect the spatial arrangement of the vertebrae and is totally reversable.
The research team confirmed the fact of occurring “the dominant phenomenon and latent blocks of sacroiliac joints”. Its existance has been proven in 50% of subjects.
The examination and therapy of joints is relatively difficult taking into consideration the phenomenon described in this work. In case of a therapy of only one joint, no intended results can be expected in every second case.
There should be at least two manual examinations to assess the condition of both sacroiliac joints and comparing them with the primal examination. The rule of the manual therapy and examination before and after the therapy is applied in such a case.

Key words:
sacroiliac joint, manual therapy, scoliosis, block

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Monitoring the results of scoliosis improvement using the DIERS system

Agnieszka Książek-Czekaj, Marek Wiecheć, Grzegorz Śliwiński, Zbigniew Śliwiński

A. Książek-Czekaj, M. Wiecheć, G. Śliwiński, Z. Śliwiński – Monitoring the results of scoliosis improvement using the DIERS system. FP 2016;16(3);124-134

Abstract

The aim of the study was to present a modern method of imaging the posture of the human body, namely, the DIERS Formetric 4D system. This method is used, among others, for non-invasive evaluation of the effects of treatment of patients diagnosed with scoliosis. Using the DIERS Formetric 4D device, the test of body posture can be done almost any time without the use of a temporary regime between studies. This allows assessment of both the effects of the treatment carried out in the short term, as well as the assumptions of the plan for further treatment.
According to the authors, the use of the DIERS Formetric 4D method to control the effects of scoliosis treatment is extremely important because of the possibility of frequent performance this test, its short duration and repeatability of the achieved results.  They are available very quickly and there is a possibility to compare them with the results of previous tests, thereby greatly facilitating the work of physiotherapists.

Key words:
scoliosis, the Formetric 4D system, DIERS, SOSORT

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