Evaluation of the Stress Level of Children with Idiopathic Scoliosis in relation to the Method of Treatment and Parameters of the Deformity

Stress level due to existing body deformity as well as to the treatment with a corrective brace is one of factors influencing the quality of life of children with idiopathic scoliosis undergoing non-surgical management. The purpose of the study was to evaluate the stress level among children suffering from idiopathic scoliosis in relation to the method of treatment and the parameters of the deformity. Seventy-three patients with idiopathic scoliosis participated in the study. Fifty-two children were treated by means of physiotherapy, while 21 patients were treated with both Cheneau corrective brace and physiotherapy. To assess the stress level related to the deformity itself and to the method of treatment with corrective brace, the two Bad Sobernheim Stress Questionnaires (BSSQs) were applied, the BSSQ Deformity and the BSSQ Brace, respectively

The examination of the musculoskeletal system based only on the evaluation of pelvic-hip complex muscle and trunk flexibility may lead to failure to screen children for generalized joint hypermobility.

ObjectiveThe aim of the study was to evaluate whether the clinical assessment of the pelvic-hip complex muscle and trunk flexibility is sufficient for diagnosing generalized joint hypermobility (GJH).DesignA cross-sectional study.SettingCenter of Body Posture in Olsztyn, North East Poland.ParticipantsThe study included 136 females and 113 males aged 10-13 years.Main outcome measuresIn order to assess muscle flexibility, the straight leg raise (SLR) test (for hamstring) and modified Thomas test for one- (O-JHF) and two-joint (T-JHF) hip flexors were performed. To evaluate trunk flexibility the fingertip-to-floor (FTF) and lateral trunk flexion (LTF) tests were used. The GJH occurrence was assessed with the use of nine-point Beighton scale (threshold value ≥5 points for females, ≥4 for males). The analysis was carried out separately for females and males.ResultsThere were no significant differences between females with versus without GJH, and males with versus without GJH regarding SLR (p = 0.86, p = 0.19 for females and males, respectively), O-JHF (p = 0.89, p = 0.35 for females and males, respectively), T-JHF (p = 0.77, p = 0.4 for females and males, respectively), FTF (p = 0.19, p = 0.84 for females and males, respectively) and LTF (p = 0.58, p = 0.35 for females and males, respectively) tests results.ConclusionsClinical examination of the pelvic-hip complex muscles and trunk flexibility by use of SLR, O-JHF, T-JHF, FTF and LTF revealed to be insufficient in diagnosing GJH in children aged 10-13 years. Thus, the Beighton scale should be considered a standard element of physiotherapeutic examination of the musculoskeletal system in children and youth

The Influence of Self-Stretching Based on Postisometrical Relaxation, Static Stretching Combined with Stabilizing Exercises, and Stabilizing Exercises Only on the Flexibility of One-Joint and Two-Joint Hip Flexors

Background and Objective. The limitations of muscle flexibility are a common dysfunction of the musculoskeletal system. Therefore, various therapeutic techniques are used in rehabilitation programs to increase their flexibility. The aim of this prospective, randomized, single-blind study was to evaluate the changes in the flexibility of hip flexors in children who participated in a 6-week therapeutic program consisting of one physiotherapy session per week with a physiotherapist and daily home exercises. Material and Methods. A total of 94 children aged 10–13 years were randomly assigned to 3 experimental groups: postisometrical relaxation group (PIR group), static stretching combined with stabilizing exercise group (SE/SS group), and stabilizing exercise group (SS group). To assess the flexibility of one- and two-joint hip flexors, the modified Thomas test was used. The examination was conducted by blinded observers. Results. A significant improvement in the flexibility of one-joint hip flexors was documented in all 3 groups (P<0.01). The flexibility of two-joint hip flexors increased significantly only in the SS/SE group (P<0.05). After the program, the highest range of motion of the hip extension (test for one-joint hip flexors) was recorded in the SS/SE group (20.6°±4.5°), and it was significantly greater than in the SE group (16.6°±4.0°, P<0.05). There were no significant differences in the knee flexion (test for two-joint hip flexors) among all 3 groups (P>0.05). Conclusions. The 6-week therapeutic program regardless of the technique applied (postisometrical muscle relaxation, static stretching with stabilizing exercises, and stabilizing exercises only) resulted in the increased flexibility of one-joint hip flexors. Only static stretching combined with stabilizing exercises led to a significant increase in the flexibility of two-joint hip flexors

Comparison of age, height, weight, BMI as well as hamstring, one- and two-joint hip flexors flexibility, fingertip-to-floor and lateral trunk flexion test results between non-hypermobile females (NH females group) and females with generalized joint hypermobility (GJH females group).

<p>Abbreviations: SLR—straight leg raise test; O-JHF—one-joint hip flexors test; T-JHF—two-joint hip flexors test; FTF—fingertip-to-floor test; LTF—lateral trunk flexion test.</p><p>† Values are in mean (SD) and by independent t-test;</p><p>* Values are in median (QR) and by Mann-Whitney U test. Statistically significant differences are in bold;</p><p>LSD—least significant difference detected by statistical analysis with 0.8 power of the test.</p><p>Comparison of age, height, weight, BMI as well as hamstring, one- and two-joint hip flexors flexibility, fingertip-to-floor and lateral trunk flexion test results between non-hypermobile females (NH females group) and females with generalized joint hypermobility (GJH females group).</p

Parameters of the study group (females, n = 136 and males, n = 113).

<p>Abbreviations: F—females; M—males; SD—standard deviation; QR—Quartile Range.</p><p>Parameters of the study group (females, n = 136 and males, n = 113).</p

The results of the pelvic-hip complex muscles and trunk flexibility tests in males (n = 113).

<p>Abbreviations: SD—standard deviation; QR—Quartile Range; SLR—straight leg raise test; O-JHF—one-joint hip flexors test; T-JHF—two-joint hip flexors test; FTF—fingertip-to-floor test; LTF—lateral trunk flexion test.</p><p>The results of the pelvic-hip complex muscles and trunk flexibility tests in males (n = 113).</p

The tests used in the study: A—straight leg raise test, B—modified Thomas test for one-joint hip flexors, C—modified Thomas test for two-joint hip flexors, D—fingertip-to-floor test, E—lateral trunk flexion test.

<p>The tests used in the study: A—straight leg raise test, B—modified Thomas test for one-joint hip flexors, C—modified Thomas test for two-joint hip flexors, D—fingertip-to-floor test, E—lateral trunk flexion test.</p

Differences between Exam2 and Exam1 for all parameters.

<p>Abbreviations: PIR group – post-isometric relaxation group; SS group – static stretch with stabilizing exercises group; SE group – stabilizing exercises group; SLR – straight leg raise test; PA – popliteal angle test; FTF – finger-to-floor distance in trunk flexion test.</p