Journal of Paramedical Sciences & Rehabilitation

Journal of Paramedical Sciences & Rehabilitation

Effect of Using Brace on Kinetics and Kinematics Variables of Lower Limbs and Trunk during Walking in Patients with Idiopathic Scoliosis

Document Type : Original Article

Authors
A Nadi 1
M.T Karimi 2
K Sharifmoradi 3
A Jafari Sarveolia 1
P Saljoughian 1
1 Department of Orthotics and Prosthetics, Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Orthotics and Prosthetics, Rehabilitation Faculty, Musculoskeletal Research Centre, Isfahan University of Medical Sciences, P.O.B. 81745-164, Isfahan
3 Department of physical education and sport science, human science faculty, university of kashan, kashan, Iran
10.22038/jpsr.2017.14003.1296
Abstract
Purpose:
Adolescent idiopathic scoliosis is a deformity of spinal column which is associated with the lateral curvature and rotation of the vertebras. Brace can decrease and prevent the progression of deformity, however, there is no information about the effect of brace on muscle fibers length in these patients. Therefore, the aim of this study was to assess the kinetics and kinematics variables of lower limbs and trunk during walking in patients with idiopathic scoliosis compared to healthy subjects.
Methods:
Five girls with adolescent idiopathic scoliosis (2 subjects have right and 3 subjects have left apex curve) with mean age, height and weight of 12.68±1.16 m, 1.53±0.08 kg and 35.6±6.1 m, respectively and 5 healthy girls with the same age and weight participated in this study. Qualysis motion analysis system and a Kistler force plate were used to record kinematic (joints range of motion) and kinetic (peak of muscle moment, joint contact forces and muscle length) data. Qualysis and Open-SIM software were used to extract the data. All data were analyzed using the SPSS 22 software at α=0.05.
Results:
The fiber length of external oblique muscle in scoliosis patients was shorter in right (α=0.02) and left (α=0.02) sides by 4 and 18 mm, respectively. The hip range of motion in frontal plane was lower in patients with idiopathic scoliosis by 6.5 deg (α=0.01). Pelvis rotation was also lower in horizontal plane by 9.8 deg compared to the normal group (α=0.04).
Conclusion:
There were no significant differences between kinetic, kinematic and joint contact forces in normal group and patients with idiopathic scoliosis and in convex and concave side of patients. Maybebrace could reduce pelvis and trunk range of motion, prevents the progression of curvature, and balances the forces applied on the joints and muscle fibers length in this patients. The rehabilitation interventions should be done in order to increase the fiber length of external oblique muscle both in convex and concave sides.
Keywords
Adolescent idiopathic scoliosis
kinetic
Kinematic
joint contact force
Subjects
  1. Rogala EJ, Drummond DS, Gurr J. Scoliosis: incidence and natural history. A prospective epidemiological study. The Journal of Bone & Joint Surgery 1978; 60(2): 173-6.
  2. Nachemson AL, Sahlstrand T. Etiologic Factors in Adolescent Idiopathic Scoliosis. Spine. 1977; 2(3): 176-84.
  3. Weinstein SL. Adolescent idiopathic scoliosis: prevalence and natural history. Instructional course lectures1988; 38: 115-28.
  4. Burwell R, Cole A, Cook T, Grivas T, Kiel A, Moulton A, et al. Pathogenesis of idiopathic scoliosis. The Nottingham concept. Acta Orthopaedica Belgica 1991; 58: 33-58.
  5. Reuber M, Schultz A, McNEILL T, SPENCER D. Trunk muscle myoelectric activities in idiopathic scoliosis. Spine 1983; 8(5): 447-56.
  6. Haderspeck K, Schultz A. Progression of idiopathic scoliosis: an analysis of muscle actions and body weight influences. Spine 1981; 6(5): 447-55.
  7. De Mauroy CJ, Lecante C, Barral F. " Brace Technology" Thematic Series-The Lyon approach to the conservative treatment of scoliosis. Scoliosis 2011; 6(1): 1-14.
  8. Grivas TB, Bountis A, Vrasami I, Bardakos NV. Brace technology thematic series: the dynamic derotation brace. Scoliosis2010; 5(1): 20.
  9. Moe JH. Indications for Milwaukee brace non-operative treatment in idiopathic scoliosis. Clinical orthopaedics and related research 1973; 93: 38-43.
  10. van Loon PJ, Roukens M, Kuit JD, Thunnissen FB. A new brace treatment similar for adolescent scoliosis and kyphosis based on restoration of thoracolumbar lordosis. Radiological and subjective clinical results after at least one year of treatment. Scoliosis 2012; 7(1): 19.
  11. Weiss H-R, Negrini S, Rigo M, Kotwicki T, Hawes MC, Grivas TB, et al. Indications for conservative management of scoliosis (SOSORT guidelines). Studies in health technology and informatics.2007;135:164-70.
  12. Fidler M, Jowett R, Troup J. Histochemical study of the function of multifidus in scoliosis. Scoliosis and Muscle 1974: 184-92.
  13. Fidler M, Jowett R. Muscle imbalance in the aetiology of scoliosis. Journal of Bone & Joint Surgery, British Volume 1976; 58(2): 200-1.
  14. Kennelly K, Stokes M. Pattern of Asymmetry of Paraspinal Muscle Size in Adolescent Idiopathic Scoliosis Examined by Real-Time Ultrasound Imaging: A Preliminary Study. Spine 1993; 18(7): 913-7.
  15. Roaf R. The basic anatomy of scoliosis. J Bone Joint Surg Br 1966; 48(4): 786-92.
  16. Blount WP. Non-operative treatment of scoliosis with the Milwaukee brace. Manitoba medical review 1965; 45(8): 478-80.
  17. Aulisa AG, Mastantuoni G, Laineri M, Falciglia F, Giordano M, Marzetti E, et al. Brace technology thematic series: the progressive action short brace (PASB). Scoliosis 2012; 7(1): 6.
  18. Aulisa L, Lupparelli S, Pola E, Aulisa A, Mastantuoni G, Pitta L. Biomechanics of the conservative treatment in idiopathic scoliotic curves in surgical" grey-area". Studies in health technology and informatics 2001; 91: 412-8.
  19. Mahaudens P, Banse X, Detrembleur C. Effects of short-term brace wearing on the pendulum-like mechanism of walking in healthy subjects. Gait & posture 2008; 28(4): 703-7.
  20. Wong M, Cheng C, Ng B, Lam T, Sin S, Lee-Shum L, et al. The effect of rigid versus flexible spinal orthosis on the gait pattern of patients with adolescent idiopathic scoliosis. Gait & posture 2008; 27(2): 189-95.
  21. Gelalis I, Ristanis S, Nikolopoulos A, Politis A, Rigas C, Xenakis T. Loading rate patterns in scoliotic children during gait: the impact of the schoolbag carriage and the importance of its position. European Spine Journal 2012; 21(10): 1936-41.
  22. Chockalingam N, Dangerfield PH, Rahmatalla A, Ahmed E-N, Cochrane T. Assessment of ground reaction force during scoliotic gait. European spine journal 2004; 13(8): 750-4.
  23. Chockalingam N, Rahmatalla A, Dangerfield P, Cochrane T, Ahmed e-N, Dove J. Kinematic differences in lower limb gait analysis of scoliotic subjects. Studies in health technology and informatics 2001; 91: 173-7.
  24. Kramers-de Quervain IA, Müller R, Stacoff A, Grob D, Stüssi E. Gait analysis in patients with idiopathic scoliosis. European Spine Journal 2004; 13(5): 449-56.
  25. Yang JH, Suh S-W, Sung PS, Park W-H. Asymmetrical gait in adolescents with idiopathic scoliosis. European Spine Journal 2013; 22(11): 2407-13.
  26. Schizas C, Kramers-de Quervain I, Stüssi E, Grob D. Gait asymmetries in patients with idiopathic scoliosisusing vertical forces measurement only. European Spine Journal 1998; 7(2): 95-8.
  27. Karimi M, Kavyani M. Scoliosis curve analysis with Milwaukee orthosis based on Open SIMM modeling. Journal of craniovertebral junction & spine 2015; 6(3): 125.
  28. Lindh M. Energy Expenditure During Walking In Patients With Scoliosis: The Effect of Surgical Correction. Spine 1978; 3(2): 122-34.
  29. Mahaudens P, Banse X, Mousny M, Raison M, Detrembleur C. Very short-term effect of brace wearing on gait in adolescent idiopathic scoliosis girls. European spine journal 2013; 22(11): 2399-406.
  30. Chockalingam N, Bandi S, Rahmatalla A, Dangerfield PH, Ahmed E-N. Assessment of the centre of pressure pattern and moments about S2 in scoliotic subjects during normal walking. Scoliosis. 2008;3(1):10
  31. Chen P-Q, Wang J-L, Tsuang Y-H, Liao T-L, Huang P-I, Hang Y-S. The postural stability control and gait pattern of idiopathic scoliosis adolescents. Clinical biomechanics 1998; 13(1): S52-S8.
  32. Beaulieu M, Toulotte C, Gatto L, Rivard C-H, Teasdale N, Simoneau M, et al. Postural imbalance in non-treated adolescent idiopathic scoliosis at different periods of progression. European Spine Journal 2009; 18(1): 38-44.
  33. Wiernicka M, Kotwicki T, Kaczmarek D, Lochynski D. Postural stability in girls with idiopathic scoliosis. Scoliosis 2010; 5(Suppl1): O36.
  34. Kaviani Brojeni M, Karimi MT, Ebrahimi A. The effects of Milwaukee orthosis on gait parameters in a Scoliotic subject. Journal of Research in Rehabilitation Sciences 2013;8(8): 1403-12.
  35. Kadaba M, Ramakrishnan H, Wootten M, Gainey J, Gorton G, Cochran G. Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait. Journal of Orthopaedic Research 1989; 7(6): 849-60.
  36. Delp SL, Anderson FC, Arnold AS, Loan P, Habib A, John CT, et al. OpenSim: open-source software to create and analyze dynamic simulations of movement. Biomedical Engineering, IEEE Transactions on 2007; 54(11): 1940-50.
  37. Mahaudens P, Mousny M. Gait in adolescentidiopathic scoliosis. Kinematics, electromyographic and energy cost analysis. Studies in health technology and informatics 2009; 158: 101-6.
  38. Mahaudens P, Banse X, Mousny M, Detrembleur C. Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis. European Spine Journal 2009; 18(4): 512-21.
  39. Leong J, Lu W, Luk K, Karlberg E. Kinematics of the chest cage and spine during breathing in healthy individuals and in patients with adolescent idiopathic scoliosis. Spine 1999;24(13):1310
  40. Mahaudens P, Thonnard J-L, Detrembleur C. Influence of structural pelvic disorders during standing and walking in adolescents with idiopathic scoliosis. The Spine Journal 2005; 5(4): 427-33.
  41. Nicolopoulos K, Burwell R, Webb J. Stature and its components in adolescent idiopathic scoliosis. Cephalo-caudal disproportion in the trunk of girls. Journal of Bone & Joint Surgery, British Volume 1985; 67(4): 594-601.
  42. Saji M, Upadhyay S, Leong J. Increased femoral neck-shaft angles in adolescent idiopathic scoliosis. Spine 1995; 20(3):303-11.
  43. Lenke LG, Engsberg JR, Ross SA, Reitenbach A, Blanke K, Bridwell KH. Prospective dynamic functional evaluation of gait and spinal balance following spinal fusion in adolescent idiopathic scoliosis. Spine. 2001 Jul 15;26(14):E330-7.
  44. Karimi MT, Kavyani M, Etemadifar MR. Gait analysis in adolescent idiopathic scoliosis walking with Boston brace. Scoliosis 2014; 9(Suppl 1): O24.
  45. Oatis C. Kynesiology: the mechanics and pathomechanics of human movement. Kynesiology: The Mechanics and Pathomechanics of Human Movement-Lippincott Williams& Wilkins. 2009-66, 97.
  46. Kim H, Lee C-K, Yeom JS, Lee JH, Cho JH, Shin SI, et al. Asymmetry of the cross-sectional area of paravertebral and psoas muscle in patients with degenerative scoliosis. European Spine Journal 2013; 22(6): 1332-8.
  47. Gaudreault N, Arsenault AB, Larivière C, DeSerres SJ, Rivard C-H. Assessment of the paraspinal muscles of subjects presenting an idiopathic scoliosis: an EMG pilot study. BMC musculoskeletal disorders. 2005;6(1):14.
  48. Papi E, Ugbolue UC, Solomonidis S, Rowe PJ. Comparative study of a newly cluster based method for gait analysis and plug-in gait protocol. Gait & Posture. 2014;39:S9-S10
  49. Hicks JL, Uchida TK, Seth A, Rajagopal A, Delp SL. Is my model good enough? Best practices for verification and validation of musculoskeletal models and simulations of movement. Journal of biomechanical engineering. 2015;137(2):020905.
Journal of Paramedical Sciences & Rehabilitation
Volume 6, Issue 3
Summer 2017
Pages 7-20