H-reflex changes in adolescents with idiopathic scoliosis: a randomized clinical trial

Abstract

[Purpose] To detect H-reflex asymmetry and investigate the effect of direction sensitive exercise therapy protocol among patients with thoracolumbar and/or lumbar scoliosis. [Subjects and Methods] Fifty patients (10–17 years), Cobb’s angle 10–20 degrees with thoracolumbar and lumbar scoliosis participated in the study. Soleus H-reflex was tested on both sides during prone lying position and standing position. Patients were randomly assigned into two groups. Group I received direction sensitive exercise therapy while the participants in group II received traditional exercise. Exercises were applied three times per week for twelve successive weeks. [Results] There were significant differences indicating asymmetry in the H-reflex amplitude on concave side. Cobb’s angle significantly decreased and the H-reflex amplitude on concave side as well as H concave/convex ratios in both lying and standing significantly increased in both groups. Direction sensitive exercise therapy showed a more significant increase in the measured outcomes than traditional exercises therapy protocol. [Conclusion] H-reflex test was effective in discovering the asymmetry between concave and convex sides. Based on H-reflex test, direction-sensitive exercise therapy was more effective than traditional exercises in decreasing Cobb’s angle and increasing H-reflex values as well as H/H percent in concave side in patients with adolescent idiopathic scoliosis.

Effectiveness of scoliosis-specific exercises for adolescent idiopathic scoliosis compared with other non-surgical interventions: a systematic review and meta-analysis

“…One study [22] included in this review compared a strict bracing regimen with SSE, and reported that bracing was more effective than SSE in reducing curve progression, with lower mean spinal deformity measures at follow-up reported for bracing. This is supported by evidence from previous reviews [1,4,7,[30][31][32][33][34][35] of observational and controlled studies showing improvements in Cobb angle measurements with bracing. However, the results of the meta-analysis revealed a mean difference between groups of 2.7°, which is below the normally accepted MDC of 6° [25].…”

Comparison of Spatial Photogrammetry and Digital Radiology

“…If the curvature of the Cobb angle of 10° and above shows an increase by 5° and more within six months, it is progressive (Sarwark & Davis, 2018;Kanter et al 2018). Information regarding the length of the scoliosis arch, the degree of rotation, torsion and vertebral wedgedness is also of importance (Alayat et al, 2017;Le Berre et al 2017). It is also recommended to assess the correctability of scoliosis, tested in the plane of maximal deformation, and bone age (the Risser test) (Minkara et al 2018;Ng & Bettany-Saltikov, 2017) .…”