A concept of asymmetric exercises for the correction of scoliosis by Ryszard Harężlak

Ryszard Harężlak, Paweł Kowalski, Jan Ślężyński

Ryszard Harężlak, Paweł Kowalski, Jan Ślężyński – A concept of asymmetric exercises for the correction of scoliosis by Ryszard Harężlak. Fizjoterapia Polska 2008; 8(4); 401-409

Abstract
Background. Rational correction of scoliosis should be characterised by a detailed analysis of every patient and individualized selection of initial, corrected, hypercorrected and isolated positions, involving all three planes. The concept of asymmetric exercises with asymmetric elongation as a significant added element in the treatment of scoliosis meets all these conditions. Popularisation of long-term experiences in the correction of scoliosis with asymmetric exercises supplemented with asymmetric elongation was the aim of this study.Material and methods. A new and unique set of asymmetric elongation exercises combined with the concept of asymmetric exercises allows for successful correction of advanced scoliosis. The basis for analysis and conclusions is long-term follow-up of children (7-18 years of age) participating in corrective exercise classes in the School Centre for Corrective and Compensatory Gymnastics in Bielsko-Biala.Results. The successful correction and stabilization of 30°-60° (Cobb) scolioses that has been achieved during the last two years indicate that the system of asymmetric exercises supplemented by asymmetric elongation is effective, examples including Marta, 13, with correction from 40° to 25° over one year; and Laura, 14, from 50° and 60° to 45° and 50°, respectively, over six months.Conclusions. Clinical and radiological evidence confirms the effectiveness of asymmetric exercises supplemented by asymmetric elongation in the correction of scoliosis. This tried-and-tested system should therefore be popularised through educational curricula for teachers and physiotherapists.
Key words:
scoliosis, asymmetric exercises, asymmetric elongation
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Variation in bioelectric activity of trunk extensors during loading with symmetric gravity torques in children with idiopathic scoliosis

Wiesław Chwała, Marianna Białek, Maciej Płaszewski

Wiesław Chwała, Marianna Białek, Maciej Płaszewski – Variation in bioelectric activity of trunk extensors during loading with symmetric gravity torques in children with idiopathic scoliosis. Fizjoterapia Polska 2008; 8(4); 393-400

Abstract
Background. Conflicting evidence is available on trunk erectors’ bioelectrical activity patterns during loading with symmetrical gravity torques in subjects with idiopathic scoliosis. This represents a significant hindrance to utilizing such information in scoliosis therapy. To identify the pattern of bioelectrical activity of trunk extensors during static contractions against symmetrical loading with body mass in subjects with idiopathic single- and double-curve scolioses of different Cobb angles. Material and methods. Biopotential activity was measured in 192 subjects aged 10-16 years with Cobb angles of 12-62°, of whom 59 had double-curve and 133 had single-curve thoracic scoliosis. Results. Biopotentials from dominant and non-dominant sides differed significantly in both tasks in patients with single-curve scoliosis (p<0.001). Muscle contraction patterns in double-curve scoliosis at the level of the primary curvature differed significantly in both tasks (p<0.001). Differences in contraction patterns at the level of the secondary curve were not significant (p<0.05). Conclusions. Significant differences were found in activity patterns of the muscles investigated between patients with singleand double-curve scolioses. The pattern of asymmetry is not directly connected with either severity or location of the curve (p<0.05, non-significant).
Key words:
electromyography, scoliosis, trunk extensors
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The effect of derotation exercises on correction of spinal alignment

Anna Brzęk, Olga Nowotny-Czupryna, Janusz Nowotny

Anna Brzęk, Olga Nowotny-Czupryna, Janusz Nowotny – The effect of derotation exercises on correction of spinal alignment. Fizjoterapia Polska 2008; 8(4); 384-392

Abstract
Background. Scoliosis is a three-plane defect. The correction of scoliosis should therefore be a global process involving all three planes, which, however, is not always the case with postural reeducation. More emphasis, especially in corrective exercises in schools, is placed on the correction of lateral curvatures in the frontal plane, elongation exercises, and exercises to strengthen the postural muscles, while the rotary component is usually ignored. The aim of this paper was to analyse derotation exercises and answer the question whether and how the correction of spinal alignment during derotation exercises results in immediate changes in body posture. Material and methods. 73 persons in two age groups (schoolchildren and adults) were examined. All participants had been diagnosed with scoliosis of the thoracic spine. Posture was assessed photogrammetrically in various free positions, following active spinal correction and during a derotation exercise using the bancho device.Results. There were considerable differences regarding active spinal correction between the children and adults. There was also a statistically significant correlation between age and the ability to actively correct spinal alignment during a derotation exercise. Conclusions. 1. The possibilities of active scoliosis correction are increased if the rotational component is also involved. 2. Derotation exercises are a significant element of corrective gymnastics, particularly in school-age patients.
Key words:
scoliosis, arrangement of body, derotation exercises
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Somatic differentiation in rural girls and boys with low-level scoliosis

Krystyna Górniak, Helena Popławska, Adam Wilczewski

Krystyna Górniak, Helena Popławska, Adam Wilczewski – Somatic differentiation in rural girls and boys with low-level scoliosis. Fizjoterapia Polska 2008; 8(4); 361-370

Abstract
Background. The aim of the study was to describe the body build of rural girls and boys with low-level scoliosis. Material and methods. The study involved 2070 pupils aged 7-19 years from selected rural schools of southern Podlasie. Body statics disorders were diagnosed in 312 girls (29.9%) and 334 boys (32.6%), and were most common at early puberty. Body posture was assessed in an orthopaedic examination. Somatic measurements included basic parameters such as body weight and height, elbow and knee width, arm and shank circumference as well as thickness of six adipocutaneous flaps. The findings as well as calculated indices served to define cardinal somatic traits in the children. Results. Most scoliotic children had medium or low BMI (41.8% and 32.5%, respectively). Pupils with high BMI were also numerous (25.7%). Children with scoliosis and high values of BMI were characterised by the highest values of the somatic parameters, with the exception of ectomorphy. Conclusions. Early stages of disorders of body statics in the coronal plane occur both in children and adolescents of slender body build (medium and low BMI) as well as in those with high BMI.
Key words:
scoliosis, body build, children and adolescents
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The influence of the pelvis position on body posture changes

Andrzej Mroczkowski

Andrzej Mroczkowski – The influence of the pelvis position on body posture changes. Fizjoterapia Polska 2009; 9(3); 258-265

Abstract
In scoliosis, a slanting pelvis position in the frontal plane may give rise to a mechanical link leading to inappropriate distribution of the gravity force on individual spinal components and, ultimately, to the development of a force rotating the vertebrae. The author analysed gravity-induced variations in load on the hip joint as a result of a slanting pelvis position. The resulting formulas indicate an uneven load on the hip joints associated with this pelvis position. Uneven bone load in the hip joints may lead to a difference in length increments between the lower limbs. A persistent pelvic slant causes changes in the distribution of the gravity force acting on individual spinal components. Pelvic slant is often the cause of lumbar scoliosis. The scoliosis, initially functional, may become structural due to the asymmetrical load on bones. It seems obvious that the main goal of corrective and compensatory management of pelvic slant should consist in exercises to strengthen the muscles responsible for pelvis position.
Słowa kluczowe
pelvis, scoliosis, body posture
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Efficacy of Kinesiology Taping in the rehabilitation of children with low–angle scoliosis

Aneta Bac, Łukasz Stagraczyński, Elżbieta Ciszek, Maciej Górkiewicz, Andrzej Szczygieł

Aneta Bac, Łukasz Stagraczyński, Elżbieta Ciszek, Maciej Górkiewicz, Andrzej Szczygieł – Efficacy of Kinesiology Taping in the rehabilitation of children with low–angle scoliosis. Fizjoterapia Polska 2009; 9(3); 202-210

Abstract
Background. There are a number of methods of conservative management of idiopathic scoliosis, including Kinesiology Taping, which utilises elastic tapes to reduce pain or correct joint alignment. The goal of this study was to determine the effect of Kinesio Taping on selected parameters in children with low-angle scoliosis. Material and methods. The subjects were two groups of 22 children each, all diagnosed with low angle scoliosis on the basis of a physical examination and radiographic evidence. The patients from the control group were subjected to a special therapeutic programme. Sessions were held three times a week for 45 minutes for a total of three weeks. During the other 2 days the children exercised at home twice a day. In the experimental group Kinesiology Taping was additionally applied. Spinal mobility, the rounding of the back, the intensity of pain, the degree of muscular tension and the level of activity and regularity of doing the exercises were evaluated in both groups. Results. In the experimental group, Kinesiology Taping had the most marked effect on back rounding, muscular tension and increasing the children’s average level of activity. Pain intensity was reduced initially but later returned to baseline levels (short-lasting effect). According to the parents and the therapist, the children fitted with Kinesio-Tex tapes (experimental group) were better motivated to do the exercises regularly. Conclusions. The results of this preliminary study seem to support the hypothesis that Kinesiology Taping can be a good adjunct to traditional therapy in children with low-angle scoliosis.
Key words:
scoliosis, Kinesiology Taping, rehabilitation
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Evaluation of the effect of station-based corrective exercises on changes in parameters of musculoskeletal system function in chiidren with Grade 1° scoliosis

Katarzyna Barczyk, Magdalena Łata, Arletta Hawrylak, Dominika Zawadzka, Dorota Wojna

Katarzyna Barczyk, Magdalena Łata, Arletta Hawrylak, Dominika Zawadzka, Dorota Wojna – Evaluation of the effect of station-based corrective exercises on changes in parameters of musculoskeletal system function in chiidren with Grade 1° scoliosis. Fizjoterapia Polska 2010; 10(1); 49-59

Abstract
Background. The aim ofofthe study was to evaluate the influence of station-based corrective exercises in the gym setting in children with idiopathic scoliosis. Materiał and methods. The study group comprised 67 children aged 10-12 years with single-arch left-sided idiopathic thoracolumbar Grade 1° scoliosis. Children were evaluated three time: before beginning corrective exercises (Examination I), and after 3 months (Examination II) and 6 months (Examination III) ofexercises. Station-based exercises using the SYNKOPA system and Thera-Band taping. Spinał mobility in the sagittal, frontal and horizontal piane, and shoulder and pelvic girdle mobility was evaluated in all children.Results. The comparison ofconsecutive examinations revealed statistically significant differences. Significant differences between Examinations I and II were revealed with respect to spinał mobility in all planes and mobility of the shoulder girdle and the pelvic girdle in some planes. Significant differences between Examinations I and III were revealed with regard to all parameters studied.Conclusions. Station-based corrective exercises increased mobility of the spine and of the shoulder and pelvic girdles in all planes.
Key words:
scoliosis, station-based systems, spinal mobility, pelvic girdle, shoulder girdle
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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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Stopień rotacji tułowia dziesięcioletnich dzieci szkół poznańskich

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

Streszczenie

Wstęp. Zmiany w obrębie geometrii kręgosłupa należy oceniać trójpłaszczyznowo uwzględniając wszystkie kierunki przemieszczeń wyrostków kolczystych. Ocena kąta rotacji tułowia pozwala na wczesne i nieinwazyjne wykrycie skolioz oraz ich prewencji.
Cel pracy. Celem pracy była ocena wartości kąta rotacji tułowia na przykładzie populacji dziesięcioletnich dzieci szkół poznańskich.
Materiał i metody badań. Materiał badań obejmował 1533 dzieci w wieku 10 lat (759 dziewcząt oraz 774 chłopców). Za pomocą skoliometru Bunnella oceniono kąt rotacji tułowia na trzech poziomach pomiarowych Th1-Th4, Th5-Th12, Th12-L4. Na podstawie uzyskanych wartości wyodrębniono grupę dziewcząt i chłopców, u których odnotowano KRT na poziomie 0, 1-3˚,4-6˚ oraz ≥ 7˚ z uwzględnieniem prawo i lewostronności rotacji.
Wyniki. Najniższe wartości kąta rotacji tułowia odnotowano zarówno w grupie dziewcząt, jak i chłopców na poziomie Th1-Th4 gdzie KRT ≥ 7˚ wystąpił u 0,2% badanych, natomiast podejrzenie bocznego skrzywienia kręgosłupa zdiagnozowano u 4% ogółu. Wartości KRT pozostałych odcinków pomiarowych na poziomie Th5-Th12, Th12-L4 zdecydowanie wzrosły. Na poziomie Th głównym podejrzenie skoliozy odnotowano u 10% badanych, natomiast skoliozę potwierdzono u 2,5% ogółu uczniów. Na najniższym poziomie pomiarowym kręgosłupa odsetek uczniów, u których wzrastało ryzyko wystąpienia skrzywienia bocznego kręgosłupa wynosił 9%, a KRT ≥ 7˚wystąpił u 2,7% dzieci.
Wnioski.
1. Najwyższy odsetek kąta rotacji tułowia KRT ≥ 7˚ zaobserwowano u dziewcząt na poziomie Th5-12. U obu płci dominowała rotacja prawostronna.
2. Skolioza stanowi istotny problem diagnostyczny w środowisku szkolnym, nieleczona zwiększa ryzyko progresji i zmian patologicznych tułowia.
3. Skoliometr Bunnella pozwala na wczesne i nieinwazyjne określenie kąta rotacji tułowia dlatego powinien być włączony na stałe w procedury przesiewowe.
4. Odpowiedni dobór metod oceny postawy ciała warunkuje prawidłową diagnozę zaburzeń mięśniowo-szkieletowych.

Słowa kluczowe:
kąt rotacji tułowia, skoliometr, skolioza, postawa ciała dzieci

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Koincydencja zablokowań stawów krzyżowo-biodrowych w bocznym skrzywieniu kręgosłupa oraz wpływ ich terapii na wartość skoliozy

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

Streszczenie
Autorzy przedstawiają  próbę określenia zależności między występowaniem  skrzywienia bocznego kręgosłupa a dysfunkcją stawów krzyżowo-biodrowych pod postacią zablokowania. Zwrócono uwagę, że skolioza obserwowana jest znamiennie w organizmie człowieka.  Samo ułożenie dziecka jak i przebieg porodu  mogą doprowadzić do różnego rodzaju zaburzeń napięcia mięśniowego i asymetrii ułożeniowej między innymi w wyniku uszkodzenia ciągłości powięziowej noworodka w trakcie samego porodu lub okresu okołoporodowego. Należy przypuszczać, że patologia okresu rozwoju embrionalnego a następnie noworodkowego może stanowić genezę zaburzeń statyki kolumny kręgosłupa oraz przeciążeń stawów krzyżowo-biodrowych, pod postacią ich zablokowań. Skutkiem wtórnym  dysfunkcji stawów krzyżowo-biodrowych może być asymetryczne ustawienie kości biodrowych względem siebie, co w dalszym przebiegu warunkuje asymetryczne ustawienie kości krzyżowej i mobilną skoliozę kompensującą (określenie A.Sadowskiego).
Podkreślono ważną rolę dysfunkcji stawu krzyżowo-biodrowego –  najsilniejszego proprioreceptora stawowego ustroju – w powstawaniu dysfunkcji innych stawów w organizmie ludzkim, często znacznie oddalonych od miednicy, jak i w  powstawaniu zaburzeń równowagi napięć (dysbalansu) mięśniowych.
Autorzy opisali tu następujące zjawiska:
1) zależność występowania zablokowania stawów krzyżowo-biodrowych (SKB)  z asymetrią ustawienia miednicy
2) związek wielkości bocznego skrzywienia i rotacji kręgosłupa z zablokowaniem SKB
W grupie badanych dzieci ze skoliozą niedużego stopnia (do 5 stopni rotacji) stwierdzano w dużym procencie, jednocześnie  współwystępowanie dysfunkcji stawów krzyżowo-biodrowych i asymetryczne  ustawienie miednicy. Po przeprowadzonej terapii zablokowań stawów krzyżowo-biodrowych stwierdzono znamienną i istotną statystycznie poprawę w zakresie symetrii miednicy jak i znamienne zmniejszenie stopnia skoliozy i – związanej z nią – zjawiska rotacji kręgów.

Słowa kluczowe:
staw krzyżowo-biodrowy, terapia manualna, skolioza, zablokowanie

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