Skip to main content
Log in

Electromyogram and kinematic analysis of lateral bending in idiopathic scoliosis patients

  • Published:
Medical and Biological Engineering and Computing Aims and scope Submit manuscript

Abstract

In adolescent idiopathic scoliosis (AIS), surgical planning currently relies on spinal flexibility evaluation using lateral bending radiographs. The aim was to evaluate the feasibility of non-invasive dynamic analysis of trunk kinematics and muscle activity in patients with AIS before surgical correction. During various lateral trunk bending tasks, erector spinae (18 sites) and abdominal (four sites) muscle activity was sampled using surface electrodes in ten AIS patients and in ten controls. Simultaneously, the spatial displacements of infrared emitting diodes located on the trunk were sampled. Parameters considered were the heterolateral-to-homolateral root-mean-square EMG ratios R at each site and total lateral bending and thoracic and lumbar curvature angle courses. Main alterations concerned apical muscle activity during left bending tasks. ANOVA results showed a significant effect of side (p=2.1×10−9), EMG recording site (p=1.9×10−16), pathology (p=3.9×10−16) and task (p=2.2×10−11) on R ratios. The R ratio at T10 and L1 for a simple lateral bending task during left bending averaged 4.8 (SD 4.3) and 3.0 (SD 3.1) in AIS patients, and 2.3 (SD 2.8) and 1.3 (SD 0.4) in controls (p=6.4×10−4 and 2.5×10−3, LSD post hoc). This preliminary study allowed the development of a functional, noninvasive, non-irradiating dynamic tool for pre-operative evaluation in AIS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Aronsson, D. D., Stokes, I. A., Ronchetti, P. J., andRichards, B. S. (1996): ‘Surgical correction of vertebral axial rotation in adolescent idiopathic scoliosis: prediction by lateral bending films’,J. Spinal Disord.,9, pp. 214–219

    Google Scholar 

  • Alexander, M. A., andSeason, E. H. (1978): ‘Idiopathic scoliosis: an electromyographic study’,Arch. Phys. Med. Rehabil.,59, pp. 314–315

    Google Scholar 

  • Avikainen, V. J., Rezasoltani, A., andKauhanen, H. A. (1999): ‘Asymmetry of paraspinal EMG-time characteristics in idiopathic scoliosis’,J. Spinal Disord,12, pp. 61–67

    Google Scholar 

  • Behensky, H., Krismer, M., andBauer, R. (1998): ‘Comparison of spinal mobility after Harrington and CD instrumentation’,J. Spinal Disord,11, pp. 155–162

    Google Scholar 

  • Bylund, P., Jansson, E., Dahlberg, E., andEriksson, E. (1987): ‘Muscle fiber types in thoracic erector spinae muscles. Fiber types in idiopathic and other forms of scoliosis’,Clin. Orthop.,214, pp. 222–228

    Google Scholar 

  • Chan, Y. L., Cheng, J. C., Guo, X., King, A. D., Griffith, J. F., andMetreweli, C. (1999): ‘MRI evaluation of multifidus muscles in adolescent idiopathic scoliosis’,Pediatr. Radiol.,29, pp. 360–363

    Google Scholar 

  • Cheung, K. M., andLuk, K. D. (1997): ‘Prediction of correction of scoliosis with use of the fulcrum bending radiograph’,J. Bone Joint Surg.,79-A, pp. 1144–1150

    Google Scholar 

  • Coussement, A., Faure, C., andCoussement, N. (1980): ‘Repères et mesures en radiodiagnostic’, 3rd edn (Expansion Scientifique Française, Paris, 1980)

    Google Scholar 

  • Donovan, W. H., Dwyer, A. P., andBedbrook, G. M. (1980): ‘Electromyographic activity in paraspinal musculature in patients with idiopathic scoliosis before and after Harrington instrumentation’,Arch. Phys. Med. Rehabil.,61, pp. 413–417

    Google Scholar 

  • Ford, D. M., Bagnall, K. M., McFadden, K. D., Greenhill, B. J., andRaso, V. J. (1984): ‘Paraspinal muscle imbalance in adolescent idiopathic scoliosis’,Spine,9, pp. 373–376

    Google Scholar 

  • Gram, M. C., andHasan, Z. (1999): ‘The spinal curve in standing and sitting postures in children with idiopathic scoliosis’,Spine,24, pp. 169–177

    Google Scholar 

  • Guth, V., Abbink, F., Gotze, H. G., andHeinrichs, W. (1978): ‘Ganguntersuchung an Patienten mit idiopathischen Skoliosen und der Einfluss des Milwaukee-Korsetts auf das Gangbild’,Z. Orthop. Ihre Grenzgeb.,116, pp. 631–640

    Google Scholar 

  • Hopf, C., Scheidecker, M., Steffan, K., Bodem, F., andEysel, P. (1998): ‘Gait analysis in idiopathic scoliosis before and after surgery: a comparison of the pre-and postoperative muscle activation pattern’,Eur. Spine J.,7, pp. 6–11

    Article  Google Scholar 

  • Hopf, C. (2000): ‘Kriterien zur Behandlung idiopathischer Skoliosen zwischen 40 degrees und 50 degrees. Operative vs. konservative Therapie’,Orthopäde,29, pp. 500–506

    Article  Google Scholar 

  • Hsu, J. D., Slager, U. T., Swank, S. M., andRobinson, M. H. (1988): ‘Idiopathic scoliosis a clinical, morphometric and histopathological correlation’,J. Pediatr. Orthop.,8, pp. 147–152

    Google Scholar 

  • Kennelly, K. P., andStokes, M. J. (1993): ‘Pattern of asymmetry of paraspinal muscle size in adolescent idiopathic scoliosis examined by real-time ultrasound imaging. A preliminary study’,Spine,18, pp. 913–917

    Google Scholar 

  • Khosla, S., Tredwell, S. J., Day, B., Shinn, S. L., andOvalle, W. K. (1980): ‘An ultrastructural study of multifidus muscle in progressive idiopathic scoliosis. Changes resulting from a sarcolemmal defect at the myotendinous junction’,J. Neurol. Sci.,46, pp. 13–31

    Article  Google Scholar 

  • Kleinman, R. G., Csongradi, J. J., Rinksy, L. A., andBleck, E. E. (1982): ‘The radiographic assessment of spinal flexibility in scoliosis: a study of the efficacy of the prone push film’,Clin. Orthop.,162, pp. 47–53

    Google Scholar 

  • Lenke, L. G., Betz, R. R., Bridwell, K. H., Clements, D. H., Harms, J., Lowe, T. G., andShufflebarger, H. L. (1998): ‘Intraobserver and interobserver reliability of the classification of thoracic adolescent idiopathic scoliosis’,J. Bone Joint Surg.,80-A, pp. 1097–1106

    Google Scholar 

  • Lowe, T. G., Edgar, M., Margulies, J. Y., Miller, N. H., Raso, V. J., Reinker, K. A., andRivard, C. H. (2000): ‘Etiology of idiopathic scoliosis: current trends in research’,J. Bone Joint Surg.,82-A, pp. 1157–1168

    Google Scholar 

  • Mannion, A. F., Meier, M., Grob, D., andMuntener, M. (1998): ‘Paraspinal muscle fibre type alterations associated with scoliosis: an old problem revisited with new evidence’,Eur. Spine J.,7, pp. 289–293

    Article  Google Scholar 

  • Mason, D. B., Schindler, A., andKing, N. (1998): ‘Estimation of the lumbar curve magnitude with correction of the right thoracic curve in idiopathic scoliosis’,J. Pediatr. Orthop.,18, pp. 602–605

    Google Scholar 

  • Meier, M. P., Klein, M. P., Krebs, D., Grob, D., andMuntener, M. (1997): ‘Fiber transformations in multifidus muscle of young patients with idiopathic scoliosis’,Spine,22, pp. 2357–2364

    Article  Google Scholar 

  • Mooney, V., Gulick, J., andPozos, R. (2000): ‘A preliminary report on the effect of measured strength training in adolescent idiopathic scoliosis’,J. Spinal Disord.,13, pp. 102–107

    Google Scholar 

  • Odermatt, D., Mathieu, P. A., Beauséjour, M., Aubin, C. É., andLabelle, H. (2002). ‘Electromyographic study of adolescent idiopathic scoliosis patients treated wit the Boston brace’,Submitted to Spine

  • Reuber, M., Schultz, A., McNeill, T., andSpencer, D. (1983): ‘Trunk muscle myoelectric activities in idiopathic scoliosis’,Spine,8, pp. 447–456

    Google Scholar 

  • Robinson, C. M., andMcMaster, M. J. (1996): ‘Juvenile idiopathic scoliosis Curve patterns and prognosis in one hundred and nine patients’,J Bone Joint Surg.,78-A, pp. 1140–1148

    Google Scholar 

  • Sahgal, V., Shah, A., Flanagan, N., Schaffer, M., Kane, W., Subramani, V., andSingh, H. (1983): ‘Morphologic and morphometric studies of muscle in idiopathic scoliosis’,Acta Orthop. Scand.,54, pp. 242–251

    Google Scholar 

  • Smith, R. M., andEmans, J. S. (1992): ‘Sitting balance in spinal deformity’,Spine,17, pp. 1103–1109

    Google Scholar 

  • Tachdjian, M. O. (1990): ‘Pediatric Orthopedics’, 2nd edn, Vol. 3, (Saunders, Philadelphia, 1990)

    Google Scholar 

  • Vaughan, J. J., Winter, R. B., andLonstein, J. E. (1996): ‘Comparison of the use of supine bending and traction radiographs in the selection of the fusion area in adolescent idiopathic scoliosis’,Spine,21, pp. 2469–2473

    Article  Google Scholar 

  • Vedantam, R., Lenke, L. G., Bridwell, K. H., andLinville, D. L. (2000): ‘Comparison of push-prone and lateral-bending radiographs for predicting postoperative coronal alignment in thoracolumbar and lumbar scoliotic curves’,Spine,25, pp. 76–81

    Google Scholar 

  • Yekutiel, M., Robin, G. C., andYarom, R. (1981): ‘Proprioceptive function in children wit adolescent idiopathic scoliosis’,Spine,6, pp. 560–566

    Google Scholar 

  • Zetterberg, C., Aniansson, A., andGrimby, G. (1983): ‘Morphology of the paravertebral muscles in adolescent idiopathic scoliosis’,Spine,8, pp. 457–462

    Google Scholar 

  • Zetterberg, C., Bjork, R., Ortengren, R., andAndersson, G. B. (1984): ‘Electromyography of the paravertebral muscles in idiopathic scoliosis. Measurements of amplitude and spectral changes under load’,Acta. Orthop. Scand.,55, pp. 304–309

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to V. Feipel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Feipel, V., Aubin, C.E., Ciolofan, O. et al. Electromyogram and kinematic analysis of lateral bending in idiopathic scoliosis patients. Med. Biol. Eng. Comput. 40, 497–505 (2002). https://doi.org/10.1007/BF02345446

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02345446

Keywords

Navigation