Generalised Joint Hypermobility in Caucasian Girls with Idiopathic Scoliosis: Relation with Age, Curve Size, and Curve Pattern

The aim of the study was to assess the prevalence of generalised joint hypermobility (GJH) in 155 girls with idiopathic scoliosis (IS) (age 9–18 years, mean 13.8 ± 2.3). The control group included 201 healthy girls. The presence of GJH was assessed with Beighton (B) test. GJH was diagnosed in 23.2% of IS girls and in 13.4% of controls (P=0.02). The prevalence of GJH was significantly (P=0.01) lower in IS girls aged 16–18 years in comparison with younger individuals. There was no difference regarding GJH occurrence between girls with mild (11–24°), moderate (25–40°), and severe scoliosis (>40°) (P=0.78), between girls with single thoracic, single lumbar, and double curve scoliosis (P=0.59), and between girls with thoracic scoliosis length ≤7 and >7 vertebrae (P=0.25). No correlation between the number of points in B and the Cobb angle (P=0.93), as well as between the number of points in B and the number of the vertebrae within thoracic scoliosis (P=0.63), was noticed. GJH appeared more often in IS girls than in healthy controls. Its prevalence decreased with age. No relation between GJH prevalence and curve size, curve pattern, or scoliosis length was found

Limits of Normality and Symmetry in Standing Back Shape and Posture: 3D Mapping and Analysis of Young Adults

Abnormalities of posture are a common cause of pain and disability. Objective measurement systems for postural evaluation are not widely accessible in the UK especially on the National Health Service. Within physiotherapy practice one of the most common methods of assessing posture and/or back shape is by visual observation which is prone to error and lacks objectivity. The study has sought to produce normative values for back shape and posture indices in young asymptomatic adults. A convenience sample of 100 Teesside University (TU) students were recruited. This study used a 3‐D Digitizer. Data was analyzed using SPSS. The acromion and the inferior scapular angle in the dorsal frontal plane differed between the right and left shoulders of the back in females. The distance between the inferior angle of the scapula and the apical thoracic vertebrae also differed. No other statistically significant differences were found in distances between key landmarks. Overall young adults are very symmetrical. Frontal plane angles showed that overall healthy young adults have relatively straight spines. The left inferior angle of the scapula in females was found to be rotated anteriorly in comparison to the right shoulder. Results will provide a normative database for clinicians who routinely assess back posture

Joint hypermobility in children with idiopathic scoliosis: SOSORT award 2011 winner

<p>Abstract</p> <p>Background</p> <p>Generalized joint hypermobility (JHM) refers to increased joint mobility with simultaneous absence of any other systemic disease. JHM involves proprioception impairment, increased frequency of pain within joints and tendency to injure soft tissues while performing physical activities. Children with idiopathic scoliosis (IS) often undergo intensive physiotherapy requiring good physical capacities. Further, some physiotherapy methods apply techniques that increase joint mobility and thus may be contraindicated.</p> <p>The aim of this paper was to assess JHM prevalence in children with idiopathic scoliosis and to analyze the relationship between JHM prevalence and the clinical and radiological parameters of scoliosis. The methods of assessment of generalized joint hypermobility were also described.</p> <p>Materials and methods</p> <p>This case-control study included 70 subjects with IS, aged 9-18 years (mean 13.2 ± 2.2), Cobb angle range 10°-53° (mean 24.3 ± 11.7), 34 presenting single curve thoracic scoliosis and 36 double curve thoracic and lumbar scoliosis. The control group included 58 children and adolescents aged 9-18 years (mean 12.6 ± 2.1) selected at random. The presence of JHM was determined using Beighton scale complemented with the questionnaire by Hakim and Grahame. The relationship between JHM and the following variables was evaluated: curve severity, axial rotation of the apical vertebra, number of curvatures (single versus double), number of vertebrae within the curvature (long versus short curves), treatment type (physiotherapy versus bracing) and age.</p> <p>Statistical analysis was performed with Statistica 8.1 (StatSoft, USA). The Kolmogorov-Smirnov test, U Mann-Whitney test, Chi²test, Pearson and Spermann correlation rank were conducted. The value <it>p </it>= 0.05 was adopted as the level of significance.</p> <p>Results</p> <p>JHM was diagnosed in more than half of the subjects with idiopathic scoliosis (51.4%), whilst in the control group it was diagnosed in only 19% of cases (<it>p </it>= 0.00015). A significantly higher JHM prevalence was observed in both girls (<it>p </it>= 0.0054) and boys (<it>p </it>= 0.017) with IS in comparison with the corresponding controls. No significant relation was found between JHM prevalence and scoliosis angular value (<it>p </it>= 0.35), apical vertebra rotation (<it>p </it>= 0.86), the number of vertebrae within curvature (<it>p </it>= 0.8), the type of applied treatment (<it>p </it>= 0.55) and the age of subjects (<it>p </it>= 0.79). JHM prevalence was found to be higher in children with single curve scoliosis than in children with double curve scoliosis (<it>p </it>= 0.03).</p> <p>Conclusions</p> <p>JHM occurs more frequently in children with IS than in healthy sex and age matched controls. No relation of JHM with radiological parameters, treatment type and age was found. Systematically searched in IS children, JHM should be taken into account when physiotherapy is planned.</p