ACUTE EFFECTS OF SELF-CORRECTING MOVEMENT IN ADOLESCENTS WITH IDIOPATHIC SCOLIOSIS. ARE THERE ANY DIFFERENCES BETWEEN MALES AND FEMALES? OBSERVATIONAL STUDY

L. Marin^1,2,3, L. Pedrotti^4,5, M. Chiodaroli^2,6, M. Febbi^3,6, D. Silvestri³, F. Manzoni⁷, M. Vandoni¹, V. Carnevale Pellino^1,8

¹University of Pavia, Laboratory of Adapted Motor Activity (LAMA), Public Health, Experimental and Forensic Medicine, Pavia, Italy, ²Istituto di Cura Città di Pavia, University Hospital, Rehabilitation, Pavia, Italy, ³Asomi College of Sciences, Research, Malta, Malta, ⁴University of Pavia, Clinical Surgical Sciences, Diagnostic and Pediatrics, Pavia, Italy, ⁵Istituto di Cura Città di Pavia, University Hospital, Pediatric Orthopedics, Pavia, Italy, ⁶Laboratory for Rehabilitation, Medicine and Sport, Research, Rome, Italy, ⁷Protection Agency, Health Promotion Environmental Epidemiology Unit, Hygiene and Health Prevention, Pavia, Italy, ⁸University of Tor Vergata, Industrial Engineering, Rome, Italy

Background: Adolescent idiopathic scoliosis (AIS) is defined as a three-dimensional deformity of spine and trunk that is present in 2 to 4 percent of children between 10 and 16 years of age. The ratio of girls to boys with small curves of 10 degrees is equal but as the curve increases, the ratio changes up to 10 girls for a male for 30 degree curves; therefore, girls need treatment more commonly than boys. Therapeutic exercise based on the three-plane self-correcting movement (SCM) is primarily used for the treatment of AIS. Considering that AIS alters and reduces postural control and balance, it is useful to evaluate the acute effects of SCM on balance and spine alignment of adolescents (females and males) with AIS.

Purpose: To evaluate the acute effects of SCM on balance and spine alignment of adolescents with AIS and compare the results between females and males.

Methods: Thirtysix adolescents with AIS (23 females; Age=13.6±2.14) were recruited from the pediatric orthopedics clinic of the “City of Pavia” University Hospital (Pavia, Italy), and divided, by gender, into two groups: female (F), male (M). Both youth and parents signed an informed consent. No significant differences were found between the groups. All the participants knew how to perform the SCM. To evaluate the acute effects of SCM on balance and spine alignment we used a stabilometric platform (FreeMed, Sensormedica, Guidonia, Italy) combined with the Spine3D (Sensormedica), a non-invasive three-dimensional optoelectronic detection system that allows an accurate assessment of spine alignment (SA). Participants stood barefoot on the stabilometric platform, in a quiet erect stance, with the uncovered back facing the Spine 3D. Two tests were carried out using the two instruments simultaneously and keeping the feet position: before, in the spontaneously assumed position of each subject (SP) and in the position achieved with the SCM (SC). Eccentricity of the ellipse (EE), center of pressure medio-lateral (Sway X) and antero-posterior (Sway Y) directions, and SA were measured. The quantitative variables were calculated as mean±sd. The influences of gender on the outcomes were investigated through the ANCOVA. A pvalue≤0.05 was considered as significant.

Results: In SP, no significant differences were found between F and M: EE (0.44±0.30; 0.49±0.32), Sway X (9.46±3.96; 11.64±5.71), Sway Y (8.82±3.27; 6.99±2.59), SA (6.36±5.17; 4.77±3.02). In SC, balance and SA improved in both groups. F, compared to M, showed a worse balance but only the difference in EE was significant: EE (0.36±0.26; 0.22±0.19; p 0.028), Sway X (8.43±3.77; 8.66±2.76), Sway Y (9.29±2.74; 6.50±2.46), SA (4.01±2.89; 3.94±1.61).

Conclusions: Results highlight that, in acute, SCM can contribute to ameliorate balance and spine alignment of the adolescents with AIS. Girls seem to have more balance impairments than boys in maintaining the correction obtained by SCM.

Implications: Checking in real time the balance, especially in girls, and spine alignment could improve the effectiveness of the exercises.

Funding acknowledgements: No funding

Keywords:
Adolescent Idiopathic Scoliosis
Self-correction movement
Gender

Topics:
Musculoskeletal: spine
Paediatrics
Innovative technology: information management, big data and artificial intelligence

Did this work require ethics approval? Yes

Institution: Policlinico S. Matteo Foundation IRCCS

Committee: Ethics Committee Pavia,

Ethics number: Prot. Number 20210082530