Effect of Body Morphology on Standing Balance in Adolescent Idiopathic Scoliosis

Allard, Paul; Chavet, Pascale; Barbier, Franck; Gatto, Laura; Labelle, Hubert; Sadeghi, Heydar

doi:10.1097/01.phm.0000137344.95784.15

Cited by 59 publications

(72 citation statements)

References 28 publications

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“…These results observed in two orthogonal planes are confirmed by previous studies of gait and standing postures [12,17]. Ontogenic development of spinal deformity associated with the morphotype of SG and with the consequences of biomechanical aspect [1] may explain the variability of dynamic motor strategies. Orthogonal displacement reflects the influence of mechanical ontogenesis on adaptive behaviour.…”

Section: Discussionsupporting

confidence: 87%

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Dynamical asymmetries in idiopathic scoliosis during forward and lateral initiation step

et al. 2009

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Adolescent idiopathic scoliosis (AIS) is characterized by morphological trunk modifications acting on body mass distribution. Some specific biomechanical strategies during postural regulation have been reported. Given that spinal deformity is three-dimensional, some strategy analysis resulting from different stepping directions should lead to a better understanding of the dynamic adaptation of behaviour. The aim of this study is to identify dynamic strategies of AIS patients stepping in lateral and forward directions. Ten AIS patients with a right thoracic curve and 15 controlled volunteers have been tested. Ground reaction forces (GRF) have been recorded for rightlimb stepping and for left-limb stepping associated to forward and lateral directions. Force amplitudes, corresponding occurrences, impulses of stepping phases and an asymmetry index have been computed. Asymmetry and variability increased in the AIS group, compared to the control group, whatever the stepping direction is. Asymmetry for AIS patients systematically provides an increased left initiation GRF compared to a right initiation. Nevertheless, for both groups, lateral initiation shows the largest asymmetry index reported for a forward initiation. More precisely, adaptive dynamic strategies for the AIS group have been characterized by an asymmetry between right and left limbs for lateral and forward initiation. These results can be explained by the influence of scoliosis pathology on dynamic movements due to spinal deformity. A right thoracic curve leads to an extra weight on the limb, which needs to be moved; consequently, stepping initiation with the right limb was more challenging for patients than stepping with the left limb. For the AIS group, the observed variability can also depend on the ontogenesis of adaptive strategies. Lateral step initiation has to be considered as the most relevant paradigm to study scoliosis and may also serve as a clinical basis for treatment to analyse the dynamic postural control and asymmetry strategies of the scoliosis patient.

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Section: Discussionsupporting

confidence: 87%

“…Spinal deformity has no effect on trunk motion but influences movement between body segments (spine and limbs) [22]. AIS girls presented ectomorphic somatotype [1]. Ectomorphic somatotype and one-curvature scoliosis [15] were shown to be both postural instability sources.…”

Section: Introductionmentioning

confidence: 99%

Dynamical asymmetries in idiopathic scoliosis during forward and lateral initiation step

et al. 2009

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“…Subjects have a tendency to stand either on their right or left but as a group this effect is masked by the mean. Similar results were reported by Silferi et al [41], Allard et al [2] and Nault et al [32] in scoliotic subjects. Figures 2 and 3 illustrate the antero-posterior and medio-lateral COP RMS and range for the scoliotic and non-scoliotic girls.…”

Section: Resultssupporting

confidence: 81%

“…Nault et al [32] were the first to associate standing imbalance with body posture attitude in SCO girls under observation though Sawatzky et al [39] and Masso and Gorton [29] reported changes in standing body segment alignment following spinal instrumentation. The type of curves was also shown to influence static and dynamic postural control in SCO [18] as well as body morphology was associated with standing imbalance in SCO [2]. Balance impairments in SCO girls was reported by Sahlstrand et al [36] and later associated with a deficit on a cerebral level [19], vestibular imbalance [37,38] and proprioceptive disorders [5,22].…”

Section: Discussionmentioning

confidence: 92%

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Free moment contribution to quiet standing in able-bodied and scoliotic girls

et al. 2007

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Adolescent idiopathic scoliosis girls are known to display standing imbalance. In addition to a motor deficit problem, the axial torsion of the spine and trunk torsion could reflect an imbalance around the vertical axis. Unlike the excursion of the center of pressure (COP), the forces and moments were rarely addressed to characterize the quiet standing balance. Nonetheless, one dynamical parameter, called free moment (T V ), representing the vertical torque on the feet can reflect the oscillation around the vertical axis associated to the standing imbalance. The objectives of this study were to test if the free moment variability can be utilized to characterize standing balance in a group of able-bodied and non-treated scoliotic girls and to determine if it was associated with that of the COP among each group of subjects tested. Forty-six adolescent girls with half of them presenting an adolescent idiopathic scoliosis were tested during quiet standing balance.Standing balance was assessed with the subjects standing upright and bare feet on a force plate. RMS and range of COP excursions and free moment were calculated.The scoliotic group displayed higher variability in COP excursion by about 24% than the able-bodied girls. Similarly, the T V RMS (P = 0.00136) and range (P = 0.00197) were statistically higher by about 42% in the scoliotic group. The variability of T V was associated with that of the COP in both groups. In the medio-lateral direction, the significant correlations between the RMS and range of the free moment and those of the COP were about 0.7 for the able-bodied group and 0.5 for the medio-lateral COP range for the scoliotic group girls. Along the antero-posterior axis, the only statistically significant correlations were observed for the scoliotic group. The free moment variability about the COP measured during quiet standing can be suggestive of an asymmetry control of the trunk around the vertical axis during standing balance. Its variability was more pronounced in scoliotic girls and was associated with the antero-posterior COP variability reflecting both biomechanical and motor control deficits. Free moment calculation could be a supplement insight into the standing balance of scoliotic subjects. Keywords Scoliosis Á Standing balance Á Free moment Abbreviations APAntero-posterior direction COM The center of mass is a point equivalent of the total body mass resulting from the location of each body segment COP The center of pressure is the location of the net ground reaction force. ML Medio-lateral direction x where X m is the arithmetic mean of the variable X. X i is the ith value of the variable X measured at the instant i, and N is the number of X i values

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Association Between Components of Body Composition and Scoliosis: A Prospective Cohort Study Reporting Differences Identifiable Before the Onset of Scoliosis

Clark

Taylor

Harding

et al. 2014

Journal of Bone and Mineral Research

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There is an increasing body of research suggesting that low body weight is associated with scoliosis, but this is based on case-control studies, which are prone to bias. No studies have investigated the components of body weight: fat and lean mass. We have therefore carried out the first population-based prospective study of the association between fat and lean mass at age 10 years assessed by dual-energy X-ray absorptiometry (DXA), with presence of scoliosis at age 15 years using the Avon Longitudinal Study of Parents and Children (ALSPAC). All children with scoliosis at age 10 years were excluded. Of 5299 children at age 15 years, 312 (5.9%) had scoliosis. Our results show a negative association between body mass index (BMI)/body weight at age 10 years and scoliosis at age 15 years, with a 20% reduced risk of scoliosis per SD increase in BMI (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.70-0.92; p ¼ 0.001). This association with BMI/body weight reflects associations with both fat mass and lean mass. After adjustment for age, gender, leg length, and fat mass per SD increase in lean mass, there was a 20% reduced risk of scoliosis (OR, 0.80; 95% CI, 0.65-0.97) and per SD increase in fat mass there was a 13% reduced risk of scoliosis (OR, 0.87; 95% CI, 0.74-1.03). In terms of adipocyte function, an inverse association was seen between leptin at age 10 years and scoliosis (OR for scoliosis per SD increase in leptin of 0.78; 95% CI, 0.63-0.99), and a positive association between adiponectin at age 10 years and scoliosis (OR for scoliosis per SD increase in adiponectin of 1.44; 95% CI, 0.99-2.10). This is the first study to address the association between the individual components of body weight and scoliosis in a prospective cohort study, and shows altered body composition that is present before the onset of clinically detected scoliosis.

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Effect of Body Morphology on Standing Balance in Adolescent Idiopathic Scoliosis

Cited by 59 publications

References 28 publications

Dynamical asymmetries in idiopathic scoliosis during forward and lateral initiation step

Dynamical asymmetries in idiopathic scoliosis during forward and lateral initiation step

Free moment contribution to quiet standing in able-bodied and scoliotic girls

Association Between Components of Body Composition and Scoliosis: A Prospective Cohort Study Reporting Differences Identifiable Before the Onset of Scoliosis

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