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Asymmetrical thoracic-lumbar coordination during trunk rotation between adolescents with and without thoracic idiopathic scoliosis

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Abstract

Study design

Cross-sectional comparative study.

Purpose

To compare thoracic-lumbar kinematic changes and coordination based on coupling angles (CAs) in two different directions of trunk rotation between adolescents with idiopathic scoliosis (AIS) and control subjects.

Summary of background data

Altered three-dimensional (3D) deviations are often apparent in AIS groups during functional activities, such as gait. However, there is a lack of consistent evidence on coordinated motions during different directions of trunk rotation.

Methods

This study included 14 AIS and 17 age-matched control subjects who were all right limb dominant. A motion capture system was utilized to analyze the spinal segment motions. The outcome measures included range of motion (ROM) at the first thoracic (T1), seventh thoracic (T7), and first lumbar (L1) spinous processes as well as the sacral tubercle (S1). The CAs compared in-phase (rotation from right to left) and anti-phase (rotation from left to right) trunk rotations.

Results

Although there was no significant association with the spinal segments in the control group, the Cobb angle demonstrated significant positive correlations with anti-phase at T7 and L1 as well as in-phase at L1. Regarding the CAs, the groups demonstrated a significant interaction with both phases (F = 4.7, p = 0.04). The AIS group demonstrated positive correlations with ROM during in-phase at L1 and anti-phase at T7 and L1.

Conclusion

The coordination based on the CAs of the lumbar spine relative to the thoracic spine significantly decreased during left to right trunk rotation in the AIS group. These results indicated that the AIS group demonstrated directional dissociation toward the dominant side of lumbar rotation.

Level of evidence

III.

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References

  1. Cheng JC, Castelein RM, Chu WC et al (2015) Adolescent idiopathic scoliosis. Nat Rev Dis Primers 1:15030

    Article  PubMed  Google Scholar 

  2. Mendiratta A, Emerson RG (2009) Neurophysiologic intraoperative monitoring of scoliosis surgery. J Clin Neurophysiol 26:62–69

    Article  PubMed  Google Scholar 

  3. Vasiliadis ES, Evangelopoulos DS, Kaspiris A et al (2021) Sclerostin and Its Involvement in the Pathogenesis of Idiopathic Scoliosis. J Clin Med 10:5286

  4. Kotwicki T, Walczak A, Szulc A (2008) Trunk rotation and hip joint range of rotation in adolescent girls with idiopathic scoliosis: does the “dinner plate” turn asymmetrically ? Scoliosis 3:1

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bruyneel AV, Chavet P, Bollini G et al (2008) The influence of adolescent idiopathic scoliosis on the dynamic adaptive behaviour. Neurosci Lett 447:158–163

    Article  CAS  PubMed  Google Scholar 

  6. Pal GP (1991) Mechanism of production of scoliosis. A hypothesis. Spine (Phila Pa 1976) 16:288–292

    Article  CAS  Google Scholar 

  7. Schlager B, Krump F, Boettinger J et al (2018) Characteristic morphological patterns within adolescent idiopathic scoliosis may be explained by mechanical loading. Eur Spine J 27(9):2184–2191

    Article  PubMed  Google Scholar 

  8. Yang JH, Suh SW, Sung PS et al (2013) Asymmetrical gait in adolescents with idiopathic scoliosis. Eur Spine J 22:2407–2413

    Article  PubMed  PubMed Central  Google Scholar 

  9. Cheung J, Halbertsma JP, Veldhuizen AG et al (2005) A preliminary study on electromyographic analysis of the paraspinal musculature in idiopathic scoliosis. Eur Spine J 14:130–137

    Article  PubMed  Google Scholar 

  10. Cheung J, Veldhuizen AG, Halbertsma JP et al (2004) The relation between electromyography and growth velocity of the spine in the evaluation of curve progression in idiopathic scoliosis. Spine (Phila Pa 1976) 29:1011–1016

    Article  Google Scholar 

  11. Kramers-de Quervain IA, Muller R, Stacoff A et al (2004) Gait analysis in patients with idiopathic scoliosis. Eur Spine J 13:449–456

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bulthuis GJ, Veldhuizen AG, Nijenbanning G (2008) Clinical effect of continuous corrective force delivery in the non-operative treatment of idiopathic scoliosis: a prospective cohort study of the TriaC-brace. Eur Spine J 17:231–239

    Article  PubMed  Google Scholar 

  13. Castelein RM, Pasha S, Cheng JC et al (2020) Idiopathic scoliosis as a rotatory decompensation of the spine. J Bone Miner Res 35:1850–1857

    Article  PubMed  Google Scholar 

  14. Kim DS, Park SH, Goh TS et al (2020) A meta-analysis of gait in adolescent idiopathic scoliosis. J Clin Neurosci 81:196–200

    Article  PubMed  Google Scholar 

  15. Dunsky A (2019) The effect of balance and coordination exercises on quality of life in older adults: a mini-review. Front Aging Neurosci 11:318

    Article  PubMed  PubMed Central  Google Scholar 

  16. Bruijn SM, Meijer OG, van Dieen JH et al (2008) Coordination of leg swing, thorax rotations, and pelvis rotations during gait: the organisation of total body angular momentum. Gait Posture 27:455–462

    Article  PubMed  Google Scholar 

  17. Lamoth CJ, Meijer OG, Wuisman PI et al (2002) Pelvis-thorax coordination in the transverse plane during walking in persons with nonspecific low back pain. Spine (Phila Pa 1976) 27:E92-99

    Article  Google Scholar 

  18. Daryabor A, Arazpour M, Sharifi G et al (2017) Gait and energy consumption in adolescent idiopathic scoliosis: A literature review. Ann Phys Rehabil Med 60:107–116

    Article  PubMed  Google Scholar 

  19. Haber CK, Sacco M (2015) Scoliosis: lower limb asymmetries during the gait cycle. Arch Physiother 5:4

    Article  PubMed  PubMed Central  Google Scholar 

  20. Mahaudens P, Banse X, Mousny M et al (2009) Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis. Eur Spine J 18:512–521

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Park HJ, Sim T, Suh SW et al (2016) Analysis of coordination between thoracic and pelvic kinematic movements during gait in adolescents with idiopathic scoliosis. Eur Spine J 25:385–393

    Article  PubMed  Google Scholar 

  22. Yang YT, Yoshida Y, Hortobagyi T et al (2013) Interaction between thorax, lumbar, and pelvis movements in the transverse plane during gait at three velocities. J Appl Biomech 29:261–269

    Article  PubMed  Google Scholar 

  23. Park WH, Kim YH, Lee TR et al (2012) Factors affecting shoulder-pelvic integration during axial trunk rotation in subjects with recurrent low back pain. Eur Spine J 21:1316–1323

    Article  PubMed  PubMed Central  Google Scholar 

  24. Oldfield RC (1971) The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 9:97–113

    Article  CAS  PubMed  Google Scholar 

  25. Sung PS, Lee KJ, Park WH (2012) Coordination of trunk and pelvis in young and elderly individuals during axial trunk rotation. Gait Posture 36(2):330–331

    Article  PubMed  Google Scholar 

  26. Sung PS, Kim YH (2011) Kinematic analysis of symmetric axial trunk rotation on dominant hip. J Rehabil Res Dev 48:1029–1036

    Article  PubMed  Google Scholar 

  27. Sung PS (2014) A kinematic analysis for shoulder and pelvis coordination during axial trunk rotation in subjects with and without recurrent low back pain. Gait Posture 40:493–498

    Article  PubMed  Google Scholar 

  28. Spinelli BA, Wattananon P, Silfies S et al (2015) Using kinematics and a dynamical systems approach to enhance understanding of clinically observed aberrant movement patterns. Man Ther 20:221–226

    Article  PubMed  Google Scholar 

  29. Hamill J, Haddad JM, McDermott WJ (2000) Issues in quantifying variability from a dynamical systems perspective. J Appl Biomech 16:407–418

    Article  Google Scholar 

  30. Miller RH, Chang R, Baird JL et al (2010) Variability in kinematic coupling assessed by vector coding and continuous relative phase. J Biomech 43:2554–2560

    Article  PubMed  Google Scholar 

  31. Rodrigues P, Chang R, TenBroek T et al (2015) Evaluating the coupling between foot pronation and tibial internal rotation continuously using vector coding. J Appl Biomech 31:88–94

    Article  PubMed  Google Scholar 

  32. van den Hoorn W, Bruijn SM, Meijer OG et al (2012) Mechanical coupling between transverse plane pelvis and thorax rotations during gait is higher in people with low back pain. J Biomech 45:342–347

    Article  PubMed  Google Scholar 

  33. Wattananon P, Ebaugh D, Biely SA et al (2017) Kinematic characterization of clinically observed aberrant movement patterns in patients with non-specific low back pain: a cross-sectional study. BMC Musculoskelet Disord 18:455

    Article  PubMed  PubMed Central  Google Scholar 

  34. Heiderscheit BC, Hamill J, Van Emmerik R (2002) Variability of stride characteristics and joint coordination among individuals with unilateral patellofemoral pain. J Appl Biomech 18:110–121

    Article  Google Scholar 

  35. Portney LG, Watkins MP (2009) Foundations of clinical research applications to practice, 3rd edn. Pearson Education Inc., Upper Saddle River

    Google Scholar 

  36. Schlosser TP, van Stralen M, Brink RC et al (2014) Three-dimensional characterization of torsion and asymmetry of the intervertebral discs versus vertebral bodies in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 39:E1159-1166

    Article  Google Scholar 

  37. Gieysztor EZ, Sadowska L, Choinska AM et al (2018) Trunk rotation due to persistence of primitive reflexes in early school-age children. Adv Clin Exp Med 27:363–366

    Article  PubMed  Google Scholar 

  38. Sung PS, Spratt KF, Wilder DG (2004) A possible methodological flaw in comparing dominant and nondominant sided lumbar spine muscle responses without simultaneously considering hand dominance. Spine (Phila Pa 1976) 29:1914–1922

    Article  Google Scholar 

  39. Ma Q, Lin H, Wang L et al (2020) Correlation between spinal coronal balance and static baropodometry in children with adolescent idiopathic scoliosis. Gait Posture 75:93–97

    Article  PubMed  Google Scholar 

  40. Sung PS, Lee KJ, Park WH (2012) Coordination of trunk and pelvis in young and elderly individuals during axial trunk rotation. Gait Posture 36:330–331

    Article  PubMed  Google Scholar 

  41. Selles RW, Wagenaar RC, Smit TH et al (2001) Disorders in trunk rotation during walking in patients with low back pain: a dynamical systems approach. Clin Biomech (Bristol, Avon) 16:175–181

    Article  CAS  Google Scholar 

  42. Lee AL, Lu H (2014) Global-motion aftereffect does not depend on awareness of the adapting motion direction. Atten Percept Psychophys 76:766–779

    Article  PubMed  Google Scholar 

  43. Barton GJ, Hawken MB, Foster RJ et al (2013) The effects of virtual reality game training on trunk to pelvis coupling in a child with cerebral palsy. J Neuroeng Rehabil 10:15

    Article  PubMed  PubMed Central  Google Scholar 

  44. McIntire KL, Asher MA, Burton DC et al (2007) Trunk rotational strength asymmetry in adolescents with idiopathic scoliosis: an observational study. Scoliosis 2:9

    Article  PubMed  PubMed Central  Google Scholar 

  45. Neuman BJ, Baldus C, Zebala LP et al (2016) Patient factors that influence decision making: randomization versus observational nonoperative versus observational operative treatment for adult symptomatic lumbar scoliosis. Spine (Phila Pa 1976) 41:E349-358

    Article  Google Scholar 

  46. Yagi M, Ohne H, Konomi T et al (2017) Walking balance and compensatory gait mechanisms in surgically treated patients with adult spinal deformity. Spine J 17:409–417

    Article  PubMed  Google Scholar 

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Funding

No funding was received for this work.

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Authors and Affiliations

  1. Doctor of Physical Therapy Program, Indiana Wesleyan University, 4201 South Washington Street, Marion, IN, 46953, USA

    Paul S. Sung

  2. Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Medical College of Hallym University, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, Republic of Korea

    Moon Soo Park

Authors
  1. Paul S. Sung
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Contributions

PS: Substantial contributions to the conception or design of the work. Acquisition of data for work. PS/MP, Analysis of data for the work. Interpretation of data for the work. Drafting the work for important intellectual content. Critical revision of the work for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Paul S. Sung.

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Conflict of interest

No financial or personal conflicts of interest in relation to the submission of this paper, other people, or any organizations.

Ethical approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Institutional Review Board (IRB) at Korea University (0816A2 and 1225A3) approved this study. We thank Dr. WH Park and graduate students at Korea University for their critical analyses of the important intellectual content and interpretation of data.

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Sung, P.S., Park, M.S. Asymmetrical thoracic-lumbar coordination during trunk rotation between adolescents with and without thoracic idiopathic scoliosis. Spine Deform 10, 783–790 (2022). https://doi.org/10.1007/s43390-022-00483-y

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