ssessment of the impact of the corrective-compensatory exercises and the elements of Vojta therapy on the angle of trunk rotation in children with idiopathic scoliosis – preliminary study

Michał Olba, Anna Mickiewicz


Michał Olba, Anna Mickiewicz – Assessment of the impact of the corrective-compensatory exercises and the elements of Vojta therapy on the angle of trunk rotation in children with idiopathic scoliosis – preliminary study. Fizjoterapia Polska 2022; 22(2); 102-110

Abstract
Introduction. Scoliosis is a term encompassing a group of heterogeneous diseases in which changes in the shape and position of the spine, chest and torso occur. The term idiopathic scoliosis refers to the patients with structural scoliosis with an undetermined cause. Scoliosis, which is defined as idiopathic, must fulfil the following criteria: to be characterized by a three-dimensional spinal deformity and a Cobb angle of 10 degrees or more.
The measurement of angle of trunk rotation (ATR) is one of the basic parameters used in the assessment of the effectiveness of treatment in patients with idiopathic scoliosis.
In the conservative treatment of idiopathic scoliosis, which is characterized by a Cobb angle of less than 25º, Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) recommends mainly scoliosis-specific exercises (SSE). Some authors show in their scientific reports that also by using the corrective and stabilizing exercises, not only SSE exercises, the asymmetry of the torso is diminished, the angular values of the curvature are reduced and the functioning of patients with idiopathic scoliosis improves.
The International Vojta Society indicates idiopathic scoliosis as one of the areas of application of this therapy. Nevertheless, there is a limited number of scientific reports on the applicability and effectiveness of Vojta therapy in the treatment of idiopathic scoliosis.
Aim of the study. The aim of this study was to evaluate the impact of applied corrective-compensatory and corrective-compensatory exercises in the combination with the elements of Vojta therapy on the value of ATR in the group of children aged 10-12 years, diagnosed with idiopathic scoliosis with a low Cobb angle value (10-19º).
Material and methods. A total number of 30 children aged 10-12 years, diagnosed with idiopathic scoliosis with a low Cobb angle (10-19º), who were patients of the rehabilitation clinic, participated in the study. Children were randomly assigned to two experimental groups. The first group (group K), consisting of 15 persons, took part in a 3-week rehabilitation programme and participated daily only in corrective-compensatory exercises. The second group (group KV), also consisting of 15 persons, joined daily the corrective-compensatory exercises for 3 weeks and additionally received Vojta therapy 3 times per week. In all children the ATR was measured before and after therapy.
Results. The results of the statistical analysis did not show any significant differences in the ATR values measured in group K (children who received only corrective-compensatory exercises) before and after the rehabilitation programme (p = 0.306). There were statistically significant differences observed in the ATR measured in the KV group (children who received corrective-compensatory exercises and the elements of Vojta therapy) before and after the rehabilitation programme (p = 0.005). There were no statistically significant differences observed between the two studied groups in the values of the ATR measured before (p = 0.069) or after the rehabilitation programme (p = 0.774).
Conclusions. 1. A significant reduction in the value of the ATR was observed in the group of children with idiopathic scoliosis with a low Cobb angle who received corrective-compensatory exercises in combination with the elements of Vojta therapy.
2. No significant changes in the value of the ATR were observed in the group of children with idiopathic scoliosis with a low Cobb angle who received only corrective-compensatory exercises.
Key words:
scoliosis, angle of trunk rotation, Vojta therapy
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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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