Association between the increased thoracic curvature and the prevalence of pain in the shoulder complex on roping practitioners

Background: The roping practice is a sporting the practitioner aims to throw a type of rope with a loop over the head or around the horns of the steer during the horse riding. The movement of looping is performed by repeated rotations of the shoulder above the shoulder girdle line, and this action, associated with changes in the thoracic spine, can overwhelm the structures of the shoulder complex and the muscles. Objective: Analyze the association between changes in increased thoracic curvature and the prevalence of pain in the shoulder complex in roping practitioners. Methods: The sample was intentionally with 20 male roping practitioners who were submitted to assessment of shoulder pain using the shoulder pain and disability index (spadi), three shouder’s orthopedic test, the jobe’s test, the yergason’s test, the neer’s test, and also the measurement of the thoracic curvature angle through the flexicurve method. The statistical data were processed using the SPSS version 20.0, and the Chi-Squared test was applied to evaluate the association between the variables. The level of significance adopted was 5%. Results: 70% of the sample presented pain in the shoulder joint complex and 45% of the practitioners presented hyperkyphosis. There is a moderate association between the variables (p = 0.008 / contingency coefficient = 0.510). Conclusion: The results showed a moderate association between the prevalence of pain in the shoulder complex and the increase of the thoracic curvature angle.

SAGITTAL BALANCE IN ADOLESCENT IDIOPATHIC SCOLIOSIS

ABSTRACT Objective The objective of this study is to achieve a better understanding of the parameters that influence sagittal balance in a population with adolescent idiopathic scoliosis (AIS). Methods A retrospective study of 80 patients with adolescent idiopathic scoliosis (AIS) was conducted. The parameters evaluated were: age, sex, pelvic incidence (PI), sacral slop (SS), pelvic tilt (PT), sagittal balance (SB), coronal balance (CB), lumbar lordosis (LL), thoracic kyphosis (TK) divided into upper (between T1 and T5) and lower (between T5 and T12), cervical spine alignment (CSA), and Cobb’s coronal angle (CCA) of primary scoliotic curvature. Results Regarding the sagittal balance, this study demonstrated a significant statistical positive correlation with cervical shape (p<0.01) and upper thoracic kyphosis (from T1 to T5) (p<0.05), but not with the other variables. LL had a strong influence on lower thoracic curvature (from T5 to T12) and was strongly influenced by the PI and SS. Conclusions Sagittal balance is a parameter that is influenced by multiple factors. In fact, it is closely related to cervical shape and the upper thoracic curvature (from T1 to T5), which in turn, is closely linked to the severity of the scoliotic kyphosis. The Cobb angle of the lower thoracic spine (from T5 to T12) is more closely correlated with the angle of lumbar lordosis than with the upper thoracic kyphosis (from T1 to T5). Level of evidence IV; Case Series.

Curvatura del raquis en escolares y relación del peso de sus mochilas con el grado de incapacidad física en función del sexo (Spine curvature in school children and the relation between backpack weight and degree of physical disability by gender)

Objetivo: Analizar la morfología del raquis en escolares, comparar su forma en función del género y relacionar la aparición de anomalías con el peso de sus mochilas y el grado de incapacidad física. Material y Métodos: Se sometió a 219 escolares de entre 12 y 15 años (127 chicos y 92 chicas) a una medición de la situación de los cuerpos vertebrales y de la angulación de la columna torácica, lumbar y sacro-cadera mediante el uso del Spinal Mouse®, se pesaron sus mochilas y respondieron el cuestionario de Roland-Morris. Resultados: Las chicas presentaron mayor angulación en la zona torácica con unos valores de 24.4 ± 16.4º frente a 11.4 ± 17.9º de los chicos (p<0.05). No se encontraron diferencias entre chicos y chicas en la angulación de la zona lumbar, en la angulación de la zona sacro-cadera ni en la longitud de la columna vertebral. Las chicas presentaron mayor número de alteraciones en el raquis (p<0.001) y un mayor peso de las mochilas (p=0.007) que los chicos. En el cuestionario de Roland-Morris no se encontraron diferencias entre el grupo de chicas (1.0 ± 1.6 puntos) y de chicos (0.7 ± 1.3 puntos). Conclusiones: Las diferencias morfológicas encontradas entre chicos y chicas nos indican que los chicos escolares analizados presentan una rectificación de la zona torácica y que las chicas tienen una mayor curvatura entre la mayoría de las vértebras dorsales y lumbares, así como un mayor número de alteraciones en el raquis. Abstract. Objective: To analyze the morphology of the spine in school children, to compare spinal shape depending on gender, and to relate the appearance of anomalies with the weight of their backpacks and the degree of physical disability. Materials and methods: The position of the spinal vertebrae, as well as the thoracic, lumbar, and pelvic curvatures in standing position in 219 school children between 12 and 15 years old (127 boys and 92 girls) were measured using a Spinal Mouse®. Their backpacks were weighed and the students responded the Roland-Morris questionnaire. Results: Girls showed greater values on the thoracic curvature of the spine, with scores of 24.4 ± 16.4º versus 11.4 ± 17.9º in boys (p<0.05). No significant differences were found between boys and girls in the angulation of the lumbar area, in the pelvis tilt, or in the length of the spine. Girls showed more alterations in the spine (p<0.001) and greater backpack weight (p=0.007) than boys. No differences were found in the Roland-Morris questionnaire scores between girls (1.0 ± 1.6 points) and boys (0.7 ± 1.3 points). Conclusions: The morphological differences found between boys and girls indicate that the former present a rectification of the thoracic area, whereas the latter present a greater curvature between most of the thoracic and lumbar vertebrae, as well as a greater number of spine alterations.

An Eight-Week Thoracic Stabilization Exercise Program Improves Postural Back Pain and Spine Alignment of University Students with Back Pain

Objectives: The study aimed to investigate effects of thoracic stabilization exercises on postural back pain, spinal alignment and inclination in university students who had postural back pain. Methods: University students who had minor to moderate postural back pain (18-25 years) were randomly allocated into Exercise (n = 28) and Control (n = 25) Groups. The programs were carried out 8 weeks and 3 days/week. The postural back pain intensity was assessed by Visual Analogue Scale. Spinal alignment and spinal inclination were evaluated with the Spinal Mouse® (Idiag, Fehraltorf, Switzerland). Assessments were applied before (BP) and after program (AP). Wilcoxon and Mann Whitney U tests were utilized. Results: The significant differences were observed for postural back pain (BP: 1.33 (1.16); AP: 0.33 (1.16)), thoracic curvature (BP: 44.50 (11.75); AP: 36.50 (13.25)), lumbar curvature (BP: -29.00 (10.00); AP: -7.00 (19.50)) and spinal inclination (BP: 5.00 (5.25); AP: 0.00 (4.00)) in Exercise Group between BP and AP (p<0.05). No significant differences were observed in Control group for all the parameters (p>0.05). The intergroup comparison showed that postural back pain, thoracic curvature, lumbar curvature and spinal inclination decreased in Exercise Group in comparison to Control Group (p<0.05). Conclusion: The exercise program with eight weeks regular practice was effective on improving postural back pain, spinal alignment and inclination in university students with postural back pain.

Effects of 8-months yoga training on shaping the spine in people over 55

Summary Study aim: The aim of this study was to evaluate the influence of hatha yoga practices on the shaping of the anteroposterior (AP) spinal curvatures in students of the University of the Third Age, who participated in hatha yoga classes. Material and methods: 20 women and 5 men took part in the study. Hatha yoga classes were held once a week for 90 minutes over a period of 8 months along with additional exercises including basic positions of hatha yoga in home conditions 1-2 times a week for about 30 minutes. The inclination of the AP curvatures of the spine was measured twice, before and after the end of the classes. A Rippstein plurimeter was used for the measurements. R esults: Measurements of the angle of thoracic kyphosis before starting the series of hatha yoga classes and after finishing them showed a decrease in thoracic curvature in female (p < 0.01). In case of the angle of lumbar lordosis, a reduction in this curvature as a result of yoga techniques has been observed in women (p < 0.01) too. Amounts of AP curvatures of the spine, measured after completing the series of hatha yoga classes, fluctuated around correct values better than before taking them up. Conclusion: This study has shown that yoga training leads to an improvement in the habitual body posture in case of aggravating (excessive) AP curvatures of the spine.

Comparison of 5-year outcomes between pedicle screw and hybrid constructs in adolescent idiopathic scoliosis

Object Pedicle screw fixation has been theorized to provide better correction of scoliotic deformity, but controversy over the benefits of pedicle screw–only constructs remains, and the longer-term impact of pedicle screw fixation as compared with hybrid constructs is unclear. In this study, a retrospective review of a prospectively collected database was conducted to determine the longer-term impact of pedicle screw fixation as compared with hybrid constructs in patients with adolescent idiopathic scoliosis (AIS). Methods The authors retrospectively reviewed a multicenter database of pediatric patients (ages ≤ 18) from 1995 to 2006 and identified 127 patients with Lenke Type 1–4 AIS curves with a minimum 5 years of follow-up. Patients were divided into 2 cohorts based on whether they had undergone pedicle screw fixation or fixation with hybrid constructs. Results The mean main thoracic curvature of 56.1° ± 13.0°, which corrected to 14.9° ± 9.3°, translated into a mean correction of 73% (p < 0.01). The curve was 19.4° ± 10.6° at 2-year follow-up and 20.5° ± 10.4° at 5 years. When comparing preoperative parameters between the groups, differences were noted in the magnitude of the main thoracic curve (p = 0.04), flexibility of the main thoracic curve (p = 0.02), coronal balance (p = 0.04), T2–12 kyphosis (p = 0.02), and sex (p = 0.02). The pedicle screw cohort had fewer spinal segments instrumented (p < 0.01), fewer anterior releases performed (p = 0.02), and fewer thoracoplasties performed (p < 0.01). By 5 years of follow-up, significant differences were apparent between the two cohorts with respect to upper thoracic curvature (p = 0.01), T2–12 (p = 0.02) and T5–12 (p = 0.02) kyphosis, lumbar lordosis (p < 0.01), and sagittal balance (p = 0.01). Conclusions Although some preoperative differences did exist, outcomes were comparable between hybrid and screw constructs at 2 and 5 years. However, hybrid constructs required more concurrent anterior releases and thoracoplasties to achieve similar results.

Thoracic Kyphosis Affects Spinal Loads and Trunk Muscle Force

Background and Purpose Patients with increased thoracic curvature often come to physical therapists for management of spinal pain and disorders. Although treatment approaches are aimed at normalizing or minimizing progression of kyphosis, the biomechanical rationales remain unsubstantiated. Subjects Forty-four subjects (mean age [±SD]=62.3±7.1 years) were dichotomized into high kyphosis and low kyphosis groups. Methods Lateral standing radiographs and photographs were captured and then digitized. These data were input into biomechanical models to estimate net segmental loading from T2–L5 as well as trunk muscle forces. Results The high kyphosis group demonstrated significantly greater normalized flexion moments and net compression and shear forces. Trunk muscle forces also were significantly greater in the high kyphosis group. A strong relationship existed between thoracic curvature and net segmental loads (r =.85–.93) and between thoracic curvature and muscle forces (r =.70–.82). Discussion and Conclusion This study provides biomechanical evidence that increases in thoracic kyphosis are associated with significantly higher multisegmental spinal loads and trunk muscle forces in upright stance. These factors are likely to accelerate degenerative processes in spinal motion segments and contribute to the development of dysfunction and pain.