Spinal posture in different DanceSport dance styles compared with track and field athletes.

Background and objective: In DanceSport, athletes train for many years to develop a very specific posture. Presently there are few data as to whether these adaptations are habitual or cause permanent anatomical changes to the spine. The aim of the current study was to evaluate lumbar lordosis and thoracic kyphosis of the international level DanceSport dancers using track and field athletes as controls. Materials and methods: Thirty competitive DanceSport couples (15 men aged 23.4 6.6 years; 15 women aged 22.5 6.4 years) and 29 track and field athletes (16 mean aged 27 4.4 years and 13 women aged 22 4.1 years) volunteered. Twelve couples were Standard, 7 Latin American and 11 were Ten Dance couples. Thoracic kyphosis and lumbar lordosis angle were assessed in lateral view using a Vertebral Fracture Assessment scan. Results: DanceSport athletes had smaller S-shaped vertebral curvatures compared to track and field athletes. Male (5.7 4.78) and female dancers (8.7 5.98) had significantly smaller lumbar lordosis angle compared to their track and field counterparts (22.3 9.98 for men; 20.3 5.98 for women).Femaledancers(25.3 8.08)alsodemonstratedsignificantly smallerthoracickyphosis angle than female track and field (32.1 8.98) participants. It was further revealed that female Latin American dancers had significantly smaller lumbar lordosis values (3.7 3.18) compared with female Standard (10.7 6.18) and Ten Dance dancers (9.7 5.58). Conclusions: The results of the present study suggest that smaller S-shaped vertebral curvatures of DanceSport athletes compared with track and field athletes are permanent changes rather than habitual

Characterizing the shape of the lumbar spine using an active shape model: reliability and precision of the method

Copyright © 2008 Lippincott, Williams & WilkinsThis is a non-final version of an article published in final form in Spine Vol. 33 (7), pp. 807-813 (2008)Study Design. Analysis of positional magnetic resonance images of normal volunteers. Objective. To compare the reliability and precision of an active shape model to that of conventional lordosis measurements. Summary of Background Data. Characterization of lumbar lordosis commonly relies on measurement of angles; these have been found to have errors of around 10[degrees]. Methods. T2 weighted sagittal images of the lumbar spines of 24 male volunteers in the standing posture were acquired using a positional magnetic resonance scanner. An active shape model of the vertebral bodies from S1 to L1 was created. Lumbar lordosis was also determined by measuring the angles of the superior endplates. All measurements were performed twice by one observer and once by a second observer. Results. The shape model identified 2 modes of variation to describe the shape of the lumbar spine (mode 1 described curvature and mode 2 described evenness of curvature). Significant correlations were found between mode 1 and total lordosis (R = 0.97, P < 0.001) and between mode 2 and mean absolute deviation of segmental lordosis (R = 0.80, P < 0.001). Intra- and interobserver reliability was higher for the shape model (intraclass correlation coefficients, 0.98-1.00) than for the lordosis angle measurements (intraclass correlation coefficients, 0.68-0.99). The relative error of the shape model (mode 1 = 4%; mode 2 = 9%) was lower than the conventional measurements (total lordosis = 10%). Conclusion. The shape of the lumbar spine in the sagittal plane can be comprehensively characterized using a shape model. The results are more reliable and precise than measurements of lordosis calculated from endplate angles

Scoliosis treatment using a combination of manipulative and rehabilitative therapy: a retrospective case series

BACKGROUND: The combination of spinal manipulation and various physiotherapeutic procedures used to correct the curvatures associated with scoliosis have been largely unsuccessful. Typically, the goals of these procedures are often to relax, strengthen, or stretch musculotendinous and/or ligamentous structures. In this study, we investigate the possible benefits of combining spinal manipulation, positional traction, and neuromuscular reeducation in the treatment of idiopathic scoliosis. METHODS: A total of 22 patient files were selected to participate in the protocol. Of these, 19 met the study criterion required for analysis of treatment benefits. Anteroposterior radiographs were taken of each subject prior to treatment intervention and 4–6 weeks following the intervention. A Cobb angle was drawn and analyzed on each radiograph, so pre and post comparisons could be made. RESULTS: After 4–6 weeks of treatment, the treatment group averaged a 17° reduction in their Cobb angle measurements. None of the patients' Cobb angles increased. A total of 3 subjects were dismissed from the study for noncompliance relating to home care instructions, leaving 19 subjects to be evaluated post-intervention. CONCLUSIONS: The combined use of spinal manipulation and postural therapy appeared to significantly reduce the severity of the Cobb angle in all 19 subjects. These results warrant further testing of this protocol

Improvement of lower extremity electrodiagnostic findings following a trial of spinal manipulation and motion-based therapy

BACKGROUND: Lumbar disc herniation is a problem frequently encountered in manual medicine. While manual therapy has shown reasonable success in symptomatic management of these cases, little information is known how manual therapy may affect the structure and function of the lumbar disc itself. In cases where lumbar disc herniation is accompanied by radicular symptoms, electrodiagnostic testing has been used to provide objective clinical information on nerve function. This report examines the treatment rendered for a patient with lower extremity neurological deficit, as diagnosed on electrodiagnostic testing. Patient was treated using spinal manipulation and exercises performed on a Pettibon Wobble Chair™, using electrodiagnostic testing as the primary outcome assessment. CASE PRESENTATION: An elderly male patient presented to a private spine clinic with right-sided foot drop. He had been prescribed an ankle-foot orthosis for this condition. All sensory, motor, and reflex findings in the right leg and foot were absent. This was validated on prior electromyography and nerve conduction velocity testing, performed by a board certified neurologist. Patient was treated using spinal manipulation twice-weekly and wobble chair exercises three times daily for 90 days total. Following this treatment, the patient was referred for follow-up electrodiagnostic studies. Significant improvements were made in these studies as well as self-rated daily function. CONCLUSION: Motion-based therapies, as part of a comprehensive rehabilitation program, may contribute to the restoration of daily function and the reversal of neurological insult as detected by electrodiagnostic testing. Electrodiagnostic testing may be a useful clinical tool to evaluate the progress of chiropractic patients with lumbar disc herniation and radicular pain syndromes

Long-term outcome after anterior cervical discectomy without fusion

To retrospectively study the long-term outcome of patients after anterior cervical discectomy without fusion (ACD) compared to results published on the long-term outcome after ACD with fusion (ACDF). We reviewed the charts of all patients receiving ACD surgery between 1985 and 2000 to analyze the direct post-operative results as well as complications of the surgery. Moreover, 102 patients, randomly selected, were interviewed with the neck disability index to study possible persisting complaints up to 18 years after ACD surgery. A total of 551 Patients were identified. Two months post-operative follow up at the outpatient clinic revealed that 90.1% of patients were satisfied with the result of ACD surgery. At the time of the survey, this percentage had dropped to 67.6%. In addition, 20.6% and 11.8% had obtained moderate to severe complaints, respectively, in daily-life activities. Complaints were mainly localized in the neck region and occasionally provoked radiating pain in the arm. On the short term, ACD leads to a satisfied outcome. Over the longer term, patients report increasing complaints. The increase in complaints at the time of the survey may be the result of ongoing degenerative effects. Compared to published data on ACDF, there is no superiority of any fusion technique compared to ACD alone

Review of methods used by chiropractors to determine the site for applying manipulation

Background: With the development of increasing evidence for the use of manipulation in the management of musculoskeletal conditions, there is growing interest in identifying the appropriate indications for care. Recently, attempts have been made to develop clinical prediction rules, however the validity of these clinical prediction rules remains unclear and their impact on care delivery has yet to be established. The current study was designed to evaluate the literature on the validity and reliability of the more common methods used by doctors of chiropractic to inform the choice of the site at which to apply spinal manipulation. Methods: Structured searches were conducted in Medline, PubMed, CINAHL and ICL, supported by hand searches of archives, to identify studies of the diagnostic reliability and validity of common methods used to identify the site of treatment application. To be included, studies were to present original data from studies of human subjects and be designed to address the region or location of care delivery. Only English language manuscripts from peer-reviewed journals were included. The quality of evidence was ranked using QUADAS for validity and QAREL for reliability, as appropriate. Data were extracted and synthesized, and were evaluated in terms of strength of evidence and the degree to which the evidence was favourable for clinical use of the method under investigation. Results: A total of 2594 titles were screened from which 201 articles met all inclusion criteria. The spectrum of manuscript quality was quite broad, as was the degree to which the evidence favoured clinical application of the diagnostic methods reviewed. The most convincing favourable evidence was for methods which confirmed or provoked pain at a specific spinal segmental level or region. There was also high quality evidence supporting the use, with limitations, of static and motion palpation, and measures of leg length inequality. Evidence of mixed quality supported the use, with limitations, of postural evaluation. The evidence was unclear on the applicability of measures of stiffness and the use of spinal x-rays. The evidence was of mixed quality, but unfavourable for the use of manual muscle testing, skin conductance, surface electromyography and skin temperature measurement. Conclusions: A considerable range of methods is in use for determining where in the spine to administer spinal manipulation. The currently published evidence falls across a spectrum ranging from strongly favourable to strongly unfavourable in regard to using these methods. In general, the stronger and more favourable evidence is for those procedures which take a direct measure of the presumptive site of care– methods involving pain provocation upon palpation or localized tissue examination. Procedures which involve some indirect assessment for identifying the manipulable lesion of the spine–such as skin conductance or thermography–tend not to be supported by the available evidence.https://doi.org/10.1186/2045-709X-21-3