Effects of scapular stabilization exercises on posture and muscle imbalances in women with upper crossed syndrome: A randomized controlled trial

BACKGROUND: Scapular stabilization exercises can improve forward shoulder posture in young women. However, the effects of optimal exercise protocols on neck and shoulder postures, scapular muscle imbalance and thoracic kyphosis are still unclear. OBJECTIVES: To investigate the effects of scapular stabilization exercises on neck and shoulder postures, scapular muscle imbalance and thoracic kyphosis in young women with upper crossed syndrome. METHODS: Thirtyninewomenaged 1825 years with upper crossed syndrome were recruited. Participants were randomly allocated intotwo groups. The exercise group performed scapular stabilization exercises using elastic bands at 10 repetitionsset, 3 setsday, and 3 daysweek for 4 weeks. The control group did not perform any exercises during the experimental period. The cervical and shoulder angles were evaluated using the Kinovea program. A caliper, handheld dynamometer and flexi ruler were used to evaluate the length of the pectoralis minor, strength of the scapular stabilizer muscles and degree of the mid-thoracic curve, respectively. RESULTS: The exercise group showed significant differences (p< 0.05) in the increase in cervical and shoulder angle, length of the pectoralis minor, and strength of the scapular muscles, except in the degree of mid-thoracic curve compared to the control group. CONCLUSION: This study indicated that scapular stabilization exercises can improve forward head and shoulder posture, increase the flexibility of the pectoralis minor and strengthen the scapular muscles.

Distal Adding On In Lenke 2AR Adolescent Idiopathic Scoliosis:risk Factors Analysis and Clinical Assessment

Background: Risk factors and clinical outcome associated with distal adding on in Lenke 2AR adolescent idiopathic scoliosis (AIS) are not fully elucidated.Methods: Radiographic data of Lenke 2AR AIS patients treated by posterior pedicle screws in a single institution were retrospectively analyzed. Patients who developed distal adding on were compared with patients who did not. Clinical assessment were carried out by SF-36 and SRS-22 questionnaire. Risk factors of distal adding on were explored by binary logistic regression analysis.Results: A total of 88 patients completed an average of 2.9 (2-12.9) years of follow-up were included. 18 (20.5%) patients met the criterion of distal adding on while the rest of 70 cases did not at follow up.Clinical parameters were comparable before surgery and became lower at follow up in adding on group in dimensions of vitality (63.1±11.4Vs.67.5±11.8,P=0.026), mental health (73.9±9.2Vs.77.8±10.2,P=0.039), self-image (3.9±0.3Vs.4.2±0.3,P=0.021) and satisfaction (4.0±0.3Vs.4.5±0.4,P=0.035). The proportion of selection lowest instrumented vertebra (LIV) higher than last touching vertebra(LTV) was significantly higher in adding on group. (6/18vs 4/70, P=0.004) Binary logistic regression analysis revealed that preoperative main thoracic curve magnitude (OR=1.118,P=0.041), preoperative lumbar lordosis (OR=1.091,P=0.029), and the gap between LIV and LTV(OR=6.123,P=0.043) were independent risk factors associated with adding on.Conclusions: In Lenke 2AR AIS cases, the selection of LIV higher than LTV is closely correlated with the development of adding-on. Patients with minor main thoracic curve and lumbar lordosis are more likely to develop distal adding on. Adding on may cause discontent of patients .