A REVIEW ON UNDERSTANDING OF SCOLIOSIS AND ITS AYURVEDIC ASPECTS

The spinal curvatures are important for balancing the body and it help us to stand upright. If any one of the curves become too large or small, our posture may appear abnormal. There are three main types of spinal curvature disor- ders, viz: scoliosis, kyphosis and lordosis. Among these, scoliosis is the common one. Scoliosis is a lateral curvature of the spine that occurs most often during the growth spurt just before puberty. In 80% of scoliosis patients, the cause is unknown. In most of the cases the curve is mild, but in some children the curve continues to worsen as the child grows. Children who have mild scoliosis need to be monitored closely. In such cases, no treatment is usually necessary. Some of them will need to wear a brace. The ultimate treatment for a progressive curve in children is surgery. While going through Ayurveda literature, we see the word Kubja, and is a common term used by Acharyas to describe a hump like appearance. This article is intended to review scoliosis, its classification, symptoms, diag- nosis and treatment and its Ayurvedic aspects. Keywords: Scoliosis, Brace, Kubja

Spinal curvatures of yoga practitioners compared to control participants—a cross-sectional study

Purpose The angles of thoracic kyphosis and lumbar lordosis determine the spinal alignment in the sagittal plane. The aim of this study was to compare the thoracic kyphosis and lumbar lordosis of male and female yoga practitioners with non-practicing participants and to determine the possible dependencies between sagittal spinal curvatures and somatic parameters, time spent on yoga exercise, and undertaking other physical activities in yoga practitioners. Methods The study involved 576 women and 91 men ages 18–68 years (mean = 38.5 ± 9) who were practicing yoga, and 402 women and 176 men ages 18–30 years (mean = 20.2 ± 1.3) as a control group. The angles of thoracic kyphosis and lumbar lordosis were measured using a Plurimeter-V gravity inclinometer. Results The two-way ANOVA demonstrated the influence of group (p < .0001) and sex (p = .03) on the angle of thoracic kyphosis, as well as the influence of group (p < .0001) and sex (p < .0001) on the angle of lumbar lordosis. It was noted that yoga practitioners had less pronounced thoracic kyphosis and lumbar lordosis and were more often characterized by normal or smaller thoracic kyphosis and lumbar lordosis than students from the control group. In yoga practitioners, the angle of thoracic kyphosis was positively correlated with age, body mass, BMI, and undertaking other forms of physical activity. The angle of lumbar lordosis was negatively correlated with body height and body mass. Conclusions The results suggest that yoga exercises can affect the shape of the anterior-posterior curves of the spine and may be an efficient training method for shaping proper posture in adults.

Variability of Body Build and Physiological Spinal Curvatures of Young People in an Accelerated Longitudinal Study

The human body is characterized by the variability of the characteristics of body build, which is expressed in the instability of spinal curvatures, which change during ontogeny. This phenomenon leads to a phylogenetic evolution of the human body build and posture. The aim of the study was to assess the dynamics of the variability of traits and indices of body build and posture and their mutual relations. It was assumed that over the 10-year observation period, a significant variability and relationships will be observed between the characteristics of body build and posture in young adults. Between 2006 and 2016, 2154 women and men aged 19.6 ± 0.8 were examined (first-year students at the University of Economics in Katowice, Poland). Measurements of basic anthropometric measurements and angular values of lumbar lordosis and thoracic kyphosis were performed. The collected data were analysed statistically, and the intergroup and intragroup differences were evaluated (ANOVA with repeated measures). The dynamics of variability (by building time series) and absolute and single-base increments were determined. The body build of young men and women in the period of ontogenetic stabilization in the study group has changed statistically significantly over the decade. A prediction of the increases in body weight and hip circumference was recorded over a period of 10 years, especially in men. The characteristics of body posture have also undergone a significant progressive change. In women, thoracic kyphosis increased by 96.15%, whereas in men, lumbar lordosis decreased by 52.65%. Significant sexual differentiation was shown for such characteristics as body height, waist circumference and the angle of lumbar lordosis. The relationships between the characteristics of body build and posture were verified. There was a moderate relationship between the hip circumference and lumbar lordosis in women and a weak relationship between body height and the angle of thoracic kyphosis in men.

Prediction of Scoliosis Curve Correction Using Apical Fulcrum Bending Radiographs in Adolescent Idiopathic Scoliosis (AIS)

Background: Scoliosis is defined as a three-dimensional deformity of spine. Surgical treatment is indicated for curves equal to/or more than 40 degrees in magnitude. Curve flexibility is determined preoperatively through bending films, which help in the selection of fusion levels. Surgical treatment for fully-grown spine is a spinal fusion use to inhibit the progress of deformity which further helps in balancing of both sagittal and coronal planes. Therefore, this study aimed to find out the association between predicted via bending films after correction and final surgical correction of skeletally mature patients with Adolescent Idiopathic Scoliosis (AIS). Methods: Thirty-three patients with Adolescent Idiopathic Scoliosis (AIS) were recruited for the study. Those patients were operated at Dr. Ziauddin University Hospital, Karachi from June 2016 to June 2020. Using Pre- and post-operative radiographs of the spine, Cobb values were used to calculate the percentage of correction achieved. Percentage correction (surgical) was then compared to correction possible (predicted) to find association via an independent t-test with p<0.05 considered as statistically significant. Results: Out of total 33 patients, 24 (72.7%) were females and 9 (27.2%) were males. The mean age of the patients was 17.2±3.0 years. Using bending films, correction of the scoliotic deformity was predicted through measured angles with 78±18°. The corrections’ difference was 84.5±11°. This difference was found to be statistically insignificant (p=0.0769) which showed no difference in predicted and actual correction achieved. Conclusion: In skeletally mature patients with AIS, bending films have been shown to accurately predict the amount of postoperative correction of Cobb’s angle which is possible. Keywords: Age Determination by Skeleton; Scoliosis; X-Ray Film; Spinal Curvatures.

Is ultrasound accurate for radiation-free quantitative assessment of spinal curvatures in patients with idiopathic scoliosis – a systematic review and meta-analysis

Despite application of ultrasound for quantitative measurement of spinal curvatures has been reported with various studies, a systematic review for such is lacking. This systematic review aimed to evaluate (1) reliability of ultrasound; (2) validity of ultrasound using radiographic measurement as gold standard in idiopathic scoliosis patients; and (3) the use of various anatomical landmarks for measurement of spinal curvatures. MEDLINE, EMBASE, CINAHL, and CENTRAL databases were searched. QUADAS-2 quality assessment tool was adopted. Reliability of ultrasound in terms of intra-class correlation coefficient was recorded. Pearson correlation coefficients between ultrasound and radiographic measurements were extracted for meta-analysis. Subgroup analyses based on ultrasound measurement protocols of spinous process (SP), transverse processes (TP) and center of lamina (COL) were conducted. Eleven articles reporting 18 correlation analyses on 766 subjects were eligible for meta-analysis. The mean inter-rater reliability of ultrasound measurement was 0.87±0.07. Pooled correlation for all studies was 0.918 (95% CI: 0.868–0.949), exhibiting substantial heterogeneity (I2=90.50%, p<0.001). Subgroup analyses showed that pooled correlations were 0.887 for COL method (comprising 356 subjects); 0.924 for SP method (255 subjects); and 0.941 for TP method (117 subjects); all with notable heterogeneity (I2>90%, p<0.001). The overall risk of bias was rated moderate; yet publication bias was noted. Evidences showed that ultrasound was a promising non-invasive method with satisfactory validity and reliability for measuring coronal curvatures utilizing the SP, TP or COL methods. Further development of three-dimensional ultrasound towards scoliosis assessment will facilitate its translational application for managing scoliosis.

The Influence of Nordic Walking on Isokinetic Trunk Muscle Endurance and Sagittal Spinal Curvatures in Women after Breast Cancer Treatment: Age-Specific Indicators

Nordic walking (NW) is a popular form of rehabilitation. NW improves psychophysical condition in breast cancer (BC) survivors. This study aimed to analyze the effects of NW on functional and postural changes of the trunk in women of different ages after BC. We hypothesized that an age relationship would be found. BC survivors (n = 39) were stratified by age as “middle- aged” (45–59 years) or “older” (60–75 years), then randomly allocated to the training intervention. A study group (SG, n = 19) participated in NW and a control group (CG, n = 20) performed general gymnastics. The sagittal spinal curvatures and isokinetic trunk muscle endurance were recorded at two time points, pre- and post-training intervention. Significant within NW group changes (p < 0.05) were found for the total work (TW) and average power (AP) of trunk flexors and extensors and the upper thoracic angle in middle-aged women. In older Nordic walkers, significant increases in TW and AP of the trunk flexor muscles were observed, with a negative increase in the trunk inclination angle. In CG, no significant functional or postural changes were observed in response to general gymnastics. NW improved both functional and postural changes in middle-aged women. This study identified the limitations of NW training in older women.