The importance of the size of the trunk inclination angle in the early detection of scoliosis in children

Background Early detection of idiopathic scoliosis is one factor in determining treatment effectiveness. Therefore, the aim of this study was to assess the importance of the size of the trunk inclination angle (ATI) for the early detection of scoliosis in preschool- and school-age children, taking into account the location and size of the spine curvature. Methods The study included a group of 216 children (mean age 11.54 years, standard deviation ± 3.05), who had previously untreated idiopathic scoliosis and a Cobb angle of ≥ 10°. The ATI values were compared with the corresponding Cobb angle values. The results of the ATI-Cobb correlation were compared to the ATI thresholds of 5° and 7°. Results In the age groups 6–9, 10–12 and 13–17 years, the method sensitivity for the ATI ≥ 7° criterion was low at 33.90%, 27.69% and 51.29% (p < 0.05), respectively, while for the ATI ≥ 5° criterion, it was 67.8%, 69.23% and 93.48% (p < 0.05), respectively. With respect to location, significantly more frequent misdiagnoses (p < 0.05) were related to the lumbar and thoracolumbar (regions) sections of the spine in the groups aged 6–9 and 10–12 for ATI ≥ 7°; while no significant relationship was found at ATI ≥ 5°. For both ATI levels, the most frequent cases of mis- or undiagnosed scoliosis were observed among children with a Cobb angle of 10°-14° (p = 0.004). Conclusion A low predictive ATI value was demonstrated regarding scoliosis detection for the ATI 7° criterion in children aged 6–9 and 10–12 years, particularly for the lumbar and thoracolumbar locations. Adoption of the threshold of ATI 5° in screening tests for children aged 6–12 years, as well as for lower locations of scoliosis, may be more effective in the early detection of scoliosis. Trial registration. This study was approved by the Jan Dlugosz University in Czestochowa Ethics Committee KE-U/7/2021, and conducted under the Declaration of Helsinki.

How Does the pH of Tree Bark Change with the Presence of the Epiphytic Bryophytes from the Family Orthotrichaceae in the Interaction with Trunk Inclination?

The pH of tree bark is affected by many factors, amongst them epiphytic bryophytes changing in their active state environment. Thus, we hypothesized that bryophytes can change bark acidity, dependently of the inclination of the branches, as inclination affect the water regime and particle deposition. We measured the pH under bryophyte cushions and compared it to nearby naked bark. Additionally, we compared results with experimental bark covering with neutral cover. We found that the pH of naked bark declines with decreasing inclination of trunks. Although bryophyte cover did not generally change the pH of the bark, there was a significant interaction with inclination: with higher inclination, bryophytes decrease the pH reaction of bark, while with lower inclination they increase it. One possible explanation may lie in changes to alkaline particle deposition, or conversely in the acidification of the bark by leaching. In addition, an experiment with a neutral cover showed that naked bark covering would substantially increase pH. As, on average, bryophytes do not change the pH of bark, there can be mutual interference between the alkalizing effect of the bark cover itself and the acidifying biological effect of bryophytes.

Effect of Low Versus High-Heeled Footwear on Spinopelvic Alignment at Different Phases of Menstrual Cycle in Young Adult Women: A Biopsychosocial Perspective

High-heeled shoes adversely affect spinal curvature, increase the risk of low back pain, and disturb the normal gait pattern. The purpose of this study was to examine, from a biopsychosocial point of view, the combined effect of wearing two different heel heights and of hormonal oscillation throughout different phases of the menstrual cycle on spinopelvic alignment. Notably, 70 females with an average age of 20.42 ± 1.51 years participated in this study, wearing each female two different heel heights as follows: low (2.5 cm) and high (7 cm). Spinopelvic alignment was evaluated by rasterstereography formetric 3D analysis during early follicular, ovulatory, and mid-luteal phases of the menstrual cycle. Statistical analysis showed that there was no significant difference (p &gt; 0.05) on spinopelvic alignment [kyphotic angle (KA), trunk inclination (TI), and pelvic inclination] between wearing low- or high-heeled shoes during early follicular, ovulatory, and mid-luteal phases of the menstrual cycle. Considering that high-heeled shoes are traditionally associated with femininity, body image, beauty, and charm, this research has important biopsychosocial implications that should be explored in detail in future studies.

Control Strategies for Gait Tele-Rehabilitation System Based on Parallel Robotics

Among end-effector robots for lower limb rehabilitation, systems based on Stewart–Gough platforms enable independent movement of each foot in six degrees of freedom. Nevertheless, control strategies described in recent literature have not been able to fully explore the potential of such a mechatronic system. In this work, we propose two novel approaches for controlling a gait simulator based on Stewart–Gough platforms. The first strategy provides the therapist direct control of each platform using movement data measured by wearable sensors. The following scheme is designed to improve the level of engagement of the patient by enabling a limited degree of control based on trunk inclination. Both strategies are designed to facilitate future studies in tele-rehabilitation settings. Experimental results have illustrated the feasibility of both control interfaces, either in terms of system performance or user subjective evaluation. Technical capacity to deploy in tele-rehabilitation was also verified in this work.

EFFECTS OF SCHROTH EXERCISE ON COBB’S ANGLE, VITAL CAPACITY AND THE IMPROVEMENT OF DAILY ACTIVITIES ON PATIENTS WITH ADOLESCENT IDIOPATHIC SCOLIOSIS

The aim of this study was to investigate the effects of Schroth exercise on Cobb's angle, vital capacity as well as the improvement of daily activities on patients with idiopathic adolescent scoliosis. Forty patients with idiopathic scoliosis with a Cobb thoracic vertebral angle of 15-30 degrees or higher and the Risser sign stage 3 or higher. The Schroth exercise was applied 3 times a week for 12 weeks. We measured the chest trunk inclination, Cobb angle and vital capacity before and after exercise program. A comprehensive search for all published review articles for spinal deformity was undertaken on PubMed, PEDRO, Google Scholar, Physiopedia up to December 2018. All full-text articles reporting evaluation, validation, surgical, orthotic, and/or physiotherapeutic scoliosis specific exercises (PSSE) treatment outcomes of these spinal deformities were retrieved and analyzed by us and methodology for functional assessment of patients with AIS was developed. Forty patients with idiopathic scoliosis with a Cobb thoracic vertebral angle of 15-30 degrees or higher and the Risser sign stage 3 or higher. The Schroth exercise was applied 3 times a week for 12 weeks. We measured the chest trunk inclination, Cobb angle and vital capacity before and after exercise program. For a period of 12 weeks we accessed adolescents with AIS. All adolescents make Schroth PSSE. The analysis of the results confirms the positive effect of the PSSE to improve muscle endurance, balance and correction of the scoliosis. Within a month from the beginning, patients reported no back pain and within 2 months – a respiratory improvement, an enlargement of the chest, a reduced Cobb angle, an increased vital capacity. PSSE seem to have positive effects by reducing the symptoms and improving functions and body asymmetries. Schroth method is effective of preventing the scoliosis’ progression. The conservative method of treating scoliosis was found to be effective even at a Cobb angle of 35 degrees or higher. In the future, universal methods of approaching exercises and preventive training for the treatment of scoliosis needs to be further developed.

Comparison of Flexion Relaxation Phenomenon Between Female Yogis and Matched Non- Athlete Group

Background: Trunk flexion is a common exercise during daily activities. Flexion relaxation phenomenon (FRP) occurs during forward bending in which there is a sudden silence of erector spinae (ES) muscles. The pattern of forward bending differs in yoga practitioners. This learned pattern probably predisposes yogis to injuries.The hypothesis of this study was that FRP differs in yogis in comparison to non-yogis individuals.Methods: This observational cross-sectional study was performed on 60 women assigned into yogis and non-athlete groups. Each participant was asked to bend forward and then return to the initial position. ES activity was recorded at L3 level, 4 cm from mid line during the trial. Trunk inclination and lumbar flexion angles were calculated at FRP onset and cessation moments. Results: The FRP phenomenon occurred in 80% of yoga practitioners in comparison to 96.7% in the control group. Trunk inclination angle was significantly greater at FRP initiation in yogis compared to control group. Lumbar flexion angle was not different between the groups. Conclusions: It is concluded that the altered pattern of forward bending observed in yogis may change patterns of ES muscles activity if it becomes part of a person's daily lifestyle which might predispose these muscles to fatigue and subsequent injuries.

Machine Learning to Improve Orientation Estimation in Sports Situations Challenging for Inertial Sensor Use

In sports, inertial measurement units are often used to measure the orientation of human body segments. A Madgwick (MW) filter can be used to obtain accurate inertial measurement unit (IMU) orientation estimates. This filter combines two different orientation estimates by applying a correction of the (1) gyroscope-based estimate in the direction of the (2) earth frame-based estimate. However, in sports situations that are characterized by relatively large linear accelerations and/or close magnetic sources, such as wheelchair sports, obtaining accurate IMU orientation estimates is challenging. In these situations, applying the MW filter in the regular way, i.e., with the same magnitude of correction at all time frames, may lead to estimation errors. Therefore, in this study, the MW filter was extended with machine learning to distinguish instances in which a small correction magnitude is beneficial from instances in which a large correction magnitude is beneficial, to eventually arrive at accurate body segment orientations in IMU-challenging sports situations. A machine learning algorithm was trained to make this distinction based on raw IMU data. Experiments on wheelchair sports were performed to assess the validity of the extended MW filter, and to compare the extended MW filter with the original MW filter based on comparisons with a motion capture-based reference system. Results indicate that the extended MW filter performs better than the original MW filter in assessing instantaneous trunk inclination (7.6 vs. 11.7° root-mean-squared error, RMSE), especially during the dynamic, IMU-challenging situations with moving athlete and wheelchair. Improvements of up to 45% RMSE were obtained for the extended MW filter compared with the original MW filter. To conclude, the machine learning-based extended MW filter has an acceptable accuracy and performs better than the original MW filter for the assessment of body segment orientation in IMU-challenging sports situations.

Lunges activate the gluteus maximus muscles more than back squats when both exercises are standardized

BACKGROUND: Squats are considered one of the main exercises for the lower limbs and are used in resistance training under different contexts, including rehabilitation and sports performance. OBJECTIVE: To compare the EMG activity of different muscles in back squat and lunge exercises in trained women. METHODS: Ten healthy women experienced in resistance training performed back squat and lunge exercises on a Smith machine (total work: 70% of 1RM, 1 set, 10 repetitions and 2-s/2-s of execution speed) with an interval of 20-min between exercises. Both exercises were standardized in relation to the trunk inclination and were performed with an erect trunk parallel to the cursor of the guided bar. RESULTS: The EMG activity of the vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and gluteus maximus (GM) were analyzed. There were no significant differences in the EMG activity of the VM, VL, and BF muscles between the back squat and lunge exercises (P> 0.05); however, GM activation was greater during the lunge exercise (effect size = 1.15; P= 0.001). CONCLUSIONS: Lunges were more effective in recruiting the GM when compared to back squats. However, both exercises can be recommended when the goal is knee extensor and flexor muscle activity.

Physical and psychological effects of postural educational intervention for students experienced school refusal

Poor posture has been shown to decrease both visceral and respiratory/circulatory function as well as to increase neuro-musculoskeletal system stress. Improper postures of children at school and in daily life can affect their physical and psychological development. In particular, many children who refuse to go to school or who have experienced school refusal have physical and mental problems. Given that posture is closely related to one’s psychological state, modifying one’s posture can improve both physical and psychological health problems. This study examined the changes to school-refusing students’ physical and psychological condition after attending an intervention to improve their posture. The participants were 65 high school students who have experienced school refusal and were attending a program to modify their posture for 2 months. Their posture and psychological states were recorded both pre- and post-intervention with the following measurements: postural alignment and spinal curve according to a sagittal plane, the General Health Questionnaire 30 (GHQ), and the Subjective Adjustment Scale (SAS). Post-intervention, most of the participants saw improvement in their postural alignment (e.g., trunk inclination in standing position, P < 0.001, 95%CI [2.00, 4.00]). Participants with improved standing posture post-intervention had higher SAS scores (e.g., feeling of acceptance and trust, P < 0.05, 95%CI [−3.00, −0.00]). We found that easy-to-implement postural interventions have a positive effect on students’ mental health. Furthermore, it was suggested that their adjustment to school would also improve as their posture improved. The contribution of this study shows that it is possible to care for the physical and mental health of students without using special facilities and techniques. It is hoped that the findings of this study will lead to an improved adjustment to both school or novel environments, as well as prevent health-based school refusal.