REHABILITATION Functional testing of muscles in patients with pectus excavatum – indications for preoperative rehabilitation

Abstract

Introduction: Studies of people with pectus excavatum usually relate to physiological abnormalities caused by the deformity, as well as its impact on posture. Little is known about muscle length disorders associated with this defect. Aim of the study: Determining whether the presence of pectus excavatum is associated with changes in muscle length; developing guidelines for preoperative rehabilitation of pectus excavatum patients. Material and methods: 19 patients aged 13-19 years with diagnosed pectus excavatum were examined and qualified for the Nuss procedure at the Wielkopolska Centre of Pulmonology and Thoracosurgery in Poznań. The control group consisted of 30 healthy boys of similar age. Each patient underwent a total of 42 functional tests measuring the length of individual muscles. Results: A comparative analysis of the study and control groups in terms of muscle flexibility showed significant differences in the results of 8 tests of the 42 tests carried out (19.04%). These tests assessed the length of the pectoralis major (clavicular part, right and left), the internal rotators of both humeral joints, the iliopsoas muscle (left lower extremity) and the rectus femoris muscles (right and left), and the ischiocrural muscles (left lower extremity) -the muscles were shortened significantly more often in boys without pectus excavatum. Boys with this deformity had significantly lower body weight and a significantly lower BMI (body mass index) compared to boys in the control group. Conclusions: When planning a physiotherapy programme for pectus excavatum patients, an individualized approach should be used to achieve the best possible results.

The effect of surgical repair of the chest on postural stability among patients with pectus excavatum

“…It means that external and internal forces that affect the function of the respiratory muscles will also affect postural responses 13 . It has been previously shown that the flexibility of muscles such as the pectoralis major and the internal rotators of humeral joints is greater in PE patients 11 . So it may be an important factor leading to a decrease in PS among PE patients when compared to healthy controls 41 , 50 .…”

“…PE is often observed in children with muscular disorders, such as in children with Marfan syndrome, Ehlers-Danlos syndrome, osteogenesis imperfecta, or homocystinuria 3 , 5 . It is also known that patients with PE who are free of such diseases have greater flexibility of some muscles compared to healthy controls 11 . The muscles of the chest which are affected by PE are mainly respiratory muscles.…”

Features of Postural Body Stability in Children With Asymmetric Pectus Excavatum

“…Это влечёт ухудшение качества жизни пациентов, проявляющееся снижением выносливости при физической нагрузке, затрудненным дыханием, одышкой, болью в груди [5]. В настоящее время стали появляться свидетельства нарушения стабильности осанки у больных с воронкообразной деформацией грудной клетки [6]. Детальное изучение вертикального баланса у таких пациентов необходимо для лучшего понимания сложного механизма функционирования их органов и систем.…”