A 10-Week Program of Combined Hippotherapy and Scroth’s Exercises Improves Balance and Postural Asymmetries in Adolescence Idiopathic Scoliosis: A Randomized Controlled Study

Introduction: The most frequent type of spine abnormality throughout adolescence was adolescent idiopathic scoliosis (AIS). Hippotherapy improved posture, balance and gait of different musculoskeletal conditions. Therefore, this study aims to see how hippotherapy combined with Schroth exercises affected postural asymmetry and dynamic balance in AIS compared to traditional physiotherapy (Schroth exercises) alone. Materials and methods: In this randomized controlled trial, fifty-two patients with AIS (10–18 years, 37 girls and 15 boys) participated. They were arbitrarily allocated into two groups: experimental (19 female/8 male; aged 14.74 ± 1.79 years; Cobb angle 18.59 ± 2.66 degrees) and control (18 female/7 male; aged 15.04 ± 1.81 years; Cobb angle 19.32 ± 2.69 degrees) groups. Both groups received Schroth exercises for 10 weeks, three days/week. The experimental group additionally received hippotherapy training. Pre-treatment and post-treatment assessment for the scoliotic, kyphotic angle, pelvic obliquity, pelvic torsion and vertical spinal rotation and the anteroposterior, mediolateral and overall stability indices were assessed using the formetric system 4D and Biodex Balance System, respectively. Results: After intervention, both groups illustrated significant improvements in all examined variables (p < 0.05). The experimental group illustrated significant improvements in scoliotic angle, kyphotic angle, pelvic obliquity, pelvic torsion and vertical spinal rotation and the stability indices compared to the control group (p < 0.05). Conclusion: In adolescence idiopathic scoliosis, hippotherapy training combined with Schroth exercises improves posture asymmetry and balancing ability more effectively than Schroth exercises alone.

Relationship between back posture and early orthodontic treatment in children

Background The purpose of this study was to analyze the relationship between body posture and sagittal dental overjet in children before and after early orthodontic treatment with removable functional orthodontic appliances. Methods Angle Class II patients (mean age 8.2 ± 1.2 years; 29 males and 25 females) with a distinctly enlarged overjet (> 9 mm) were retrospectively examined regarding body posture parameters before and after early orthodontic treatment. In addition, changes in overjet were investigated with the aid of plaster models. Forms of transverse dysgnathism (crossbite, lateral malocclusions) and open bite cases were excluded. Body posture parameters kyphosis, lordosis, surface rotation, pelvic tilt, pelvic torsion and trunk imbalance were analyzed by means of rasterstereographical photogrammetry to determine, if the orthodontic overjet correction is associated with specific changes in posture patterns. Results In nearly all patients an overjet correction and an improvement regarding all body posture and back parameters could be noted after early orthodontic treatment. Overjet reduction (− 3.9 mm ± 2.1 mm) and pelvic torsion (− 1.28° ± 0,44°) were significantly (p < 0.05) and moderately correlated (R = 0.338) with no significant associations found for the other posture and back parameters (p > 0.05). Conclusion Overjet reduction during early orthodontic treatment may be associated with a detectable effect on pelvic torsion.

The Effect of Wearing a Customized Mouthguard on Body Alignment and Balance Performance in Professional Basketball Players

The present study examined the influence of a customized mouthguard on body alignment and balance performance in professional basketball players. Twenty-three professional male basketball players, aged 25.8 ± 8.6 years old, were voluntarily assigned to participate in three treatments, including no treatment (no mouthguard), acute treatment (wearing a mouthguard), and repeated treatments (8 weeks follow-up). Body alignment status, such as spinal and pelvic posture and balance performance, were measured at each time point using a 3D Formetric III (Germany) and a postural control device (Posturomed 202, Germany), respectively. A repeated MANOVA analysis with a Bonferroni post hoc test was applied, and the adjusted p-value was set at 0.02. No significant treatment effect was observed in body alignment (p = 0.302). However, univariate analysis showed a significant difference in pelvic torsion, where it was decreased after acute and repeated mouthguard treatments compared to no treatment (p < 0.001). Kyphotic angle also increased significantly following 8 weeks of treatment compared to no treatment (p < 0.001) and acute treatment (p < 0.002). There was a significant treatment effect on balance performance (p < 0.001). Both static and dynamic balance performance improved following 8 weeks of treatment (p < 0.001). Our study revealed that a customized mouthguard provides a benefit to balance performance. Notably, repeated treatment impacts on balance performance more than acute treatment. Although our findings did not show a significant effect on body alignment, some positive results, such as pelvic torsion and kyphotic angle, may provide substantial information for developing future longitudinal studies with large sample sizes.

Impact of Quadriceps/Hamstrings Torque Ratio on Three-Dimensional Pelvic Posture and Clinical Pubic Symphysis Pain-Preliminary Results in Healthy Young Male Athletes

Pain in the pubic symphysis is of significance, especially in high-performance sports. Pelvic torsion, possibly caused by muscular imbalances, is discussed as a pathogenic mechanism. This study examined a possible interrelationship between the maximum torques of quadriceps femoris and hamstrings and the spatial positioning of the hemi-pelvises, as well as the tenderness to palpation of the pubic symphysis. The three-dimensional pelvic contour of 26 pain free adolescents (age 16.0 ± 0.8 years, weight 66.3 ± 9.9 kg, height 176.2 ± 6.0 cm) was registered by means of an 3D optical system and the torsion of both hemi-pelvises against each other was calculated based on a simplified geometrical model. Tenderness on palpation of the pubic symphysis was assessed by means of a visual analogue scale, and isometric torques of knee extensors and flexors were measured for both legs. The torque ratio between knee extensors and flexors was calculated for both sides, as was the crossed torque ratio between the two legs. On the basis of a MANOVA, possible significant differences in torques and torque ratios between subgroups with lower and higher pelvic torsion were analyzed. The crossed torque ratio (F = 19.55, p < 0.001, partial η2 = 0.453) and the tenderness to palpation of the pubic symphysis (F = 10.72, p = 0.003, partial η2 = 0.309) were significantly higher in the subgroup with higher pelvic torsion. The results indicate the crossed torque ratio of knee flexors and extensors as a potential biomechanical-pathogenic mechanism to be considered in the primary prevention and diagnosis of symphyseal pain.

Effects on posture by different neuromuscular afferent stimulations and proprioceptive insoles: Rasterstereographic evaluation

Background: Proprioceptive neuromuscular stimulating insoles are increasingly applied in treating functional complaints, chronic pain, foot disorders and so on. Objectives: To evaluate rasterstereography as a tool in objectifying postural changes resulting from neuromuscular afferent stimulation and proprioceptive neuromuscular stimulating insoles and to compare the respective effects on posture. Study design: This is a prospective experimental study. Methods: A total of 27 healthy volunteers were consecutively exposed to six different varying intense neuromuscular afferent stimulating test conditions at three different times. One test condition featured proprioceptive neuromuscular stimulating insoles. In each test condition, a sequence of 12 rasterstereographic recordings of back shape was documented. Changes between six different test conditions and over time for 14 posture characterising parameters were investigated, for example, trunk inclination, pelvic torsion, lateral deviation of the spine’s amplitude or sagittal spinal curve. Results: Standard deviation of our rasterstereographic measurements (±2.67 mm) was better than in most comparable reference values. Different neuromuscular stimuli were found to provoke significant changes to various posture parameters, including trunk inclination, pelvic torsion and so on ( each p < 0.001, F-tests). Proprioceptive neuromuscular stimulating insoles induced significant changes for parameter lateral deviation of the spine’s amplitude (p = 0.03). Conclusion: Neuromuscular afferent stimulation and proprioceptive neuromuscular stimulating insoles induce postural changes, which can be detected reliably by rasterstereography. Clinical relevance We demonstrated that rasterstereography – a radiation-free imaging modality – enables visualisation and documentation of subtle postural changes induced by varying intense neuromuscular afferent stimulation and the application of proprioceptive neuromuscular stimulating insoles.

Intra- and Interday Reliability of Spine Rasterstereography

To determine intra- and interday reliability of spine rasterstereographic system Formetric 4D with and without reflective markers. Twenty-six healthy volunteers (M group) had two markers placed in correspondence of vertebra prominens and intergluteal cleft, and 24 volunteers (NM group) were assessed without markers. All participants were analyzed two times in the same day and one time on a separate day. Trunk length, kyphotic angle, lordotic angle, pelvic inclination, kyphotic and lordotic apex, right and left lateral deviation,flèche cervicaleandlombaire, trunk imbalance, pelvic tilt, inflection point, rotation correction, right and left surface rotation, pelvic torsion, and trunk torsion were measured. Intraclass correlation coefficient (ICC) and Cronbach Alpha (Cα) were calculated. In M group, for intra-, interday, and overall evaluations, the higher reliability coefficients were 0.971, 0.963, and 0.958 (ICC) and 0.987, 0.983, and 0.985 (Cα) for trunk length, kyphotic angle, and lordotic apex, respectively; while in NM group, they were 0.978, 0.982, and 0.972 and 0.989, 0.991, and 0.991 for trunk length. In M group, the lower values were 0.598, 0.515, and 0.534 (ICC) and 0.742, 0.682, and 0.784 (Cα) for trunk and pelvic torsion and in NM group 0.561, 0.537, and 0.461 and 0.731, 0.695, and 0.729 for left lateral deviation. The reliability of most parameters was excellent.