The involvement of musculoskeletal system and its influence on postural stability in children and young adults with cystic fibrosis

Abstract

BackgroundCystic fibrosis (CF) affects the musculoskeletal system via a multifactorial pathway that includes vitamin D deficiency and involvement of respiratory muscles such as intercostals due to recurrent upper and lower respiratory tract infections. Eventual result is the deterioration of musculoskeletal health and posture in CF patients. Postural stability is directly affected by posture and can be compromised in every musculoskeletal problem. The aim of this study is to evaluate musculoskeletal system and postural stability in patients with CF.MethodsPatients with CF over six years of age and age and sex-matched control groups were included in the study. Cobb angle and thoracic kyphosis angles were measured on the spine radiographs. Both patients and control group were examined with pediatric gait, arms, legs and spine scale (pGALS). They also were evaluated with a NeuroCom Balance Master for their postural stability.ResultsFifty-one patients with CF and 94 healthy controls participated in the study. In results of the pGALS examination, CF group had significantly more pathological findings than the control group in lower extremity appearance and movement (p = 0.006 and p = 0.01) and spine appearance and movement (p = 0.001 and p = 0.022) domains. The tandem walking speed was significantly higher in controls with a mean of 24.45 ± 7.79 while it was 20.47 ± 6.95 in the CF group (p = 0.03). Various limits of stability parameters also showed significant differences. Medium correlations were found between musculoskeletal examination and postural stability parameters.ConclusionIn patients with CF, a systematic but simple musculoskeletal examination can detect pathologies, which are more frequent than the normal population. These pathologies show a medium correlation with the involvement of postural stability.

Prevalence and Impact of Rheumatologic Pain in Cystic Fibrosis Adult Patients

“…Interestingly in our study, patients with spinal and/or joint pain were significantly shorter (167 ± 7 vs. 172 ± 9 cm, p = 0.023) and more frequently colonized with Staphylococcus aureus (91% vs. 56%, p < 0.008). The comparison is difficult with other specific studies concerning musculoskeletal and arthropathy in CF (6,13,36,37). In Roehmel et al study involving 186 CF children and adults (mean age: 27 years), patients with CFA (defined as at least one symptom out of the following: joint pain, joint swelling, joint reddening or limitation of movement) were more likely to be older, female gender, and to have a higher rate of total IgG, chronic colonization with Aspergillus spp.…”

Compensation of Respiratory-Related Postural Perturbation Is Achieved by Maintenance of Head-to-Pelvis Alignment in Healthy Humans

“…Of note, the differences between BPXR lung volumes and reference lung volumes were more marked with age (namely in subjects with lower postural compensation capacity) and particularly so for maximal expiration (that threatens balance more than maximal inspiration, see above). This postulated mechanism (impact of limited postural compensation capabilities on vital capacity) could, beyond aging, be called on to explain part of the impact of thoracic deformities on lung volumes [e.g., scoliosis (Szopa and Domagalska-Szopa, 2017) or secondary spinal lesions (Kenis-Coskun et al, 2017)].…”

Aerobic exercise capacity, cough strength, posture, and depression in primary ciliary dyskinesia

“…40 Another study stated that children and young adults with CF had more frequent spinal and lower extremity deformities. 41 Lopes et al showed that children with persistent asthma had higher protraction of the head and shoulder. 42 Low body weight and bone mineralization, increased dyspnea and cough frequency, decreased peripheral muscle strength and pulmonary function, and shortening of the accessory respiratory muscles may contribute to postural abnormalities in patients with PCD.…”