Thoracic changes and exercise capacity in patients with adolescent idiopathic scoliosis (original) (raw)
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Fisioterapia em Movimento, 2015
Introduction The adolescent idiopathic scoliosis (AIS) causes changes on the compliance of the chest. These changes may be associated with impaired lung function and reduced functional exercise capacity of these adolescents. We aimed to evaluate the correlation between functional exercise capacity, lung function and geometry of the chest at different stages of AIS.Materials and methods The study was carried out in a cross-sectional design which were evaluated 27 AIS patients at different stages of the disease. For chest wall evaluation, were created geometry angles/distances (A/D), which were quantified by Software Postural Assessment. The functional exercise capacity was assessed by a portable gas analyzer during the incremental shuttle walk test (ISWT). Besides that, manovacuometry and spirometry were also performed.Results Linear regressions showed that oxygen uptake (peak VO2) was correlated with distance travelled in the ISWT (R2 = 0.52), maximal respiratory pressures, cough pe...
Journal of International Medical Research
Objective This observational cohort study aimed to evaluate ventilatory function (VF) and functional exercise capacity (FEC) in mild adolescent idiopathic scoliosis (AIS). Methods Seventy-three adolescents with idiopathic scoliosis, aged approximately 10 to 17 years (mean age: 13.43 ± 1.27 years), with a Cobb angle less than 20° (mean: 16.44° ± 1.59°), met the inclusion criteria and were assigned to group A. Another 34 healthy adolescents with normal VF and FEC served as controls (group B). Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), maximum voluntary ventilation (MVV), and FEC (by the 6-minute walk test [6MWT]) were the main outcome measures. Results Post-study mean values of FVC, FEV1, FEV1/FVC, MVV, and the 6MWT were 2.42 ± 0.36 L and 3.26 ± 0.59 L, 2.14 ± 0.31 L and 3.03 ± 0.43 L, 88.13% ± 3.89% and 91.14% ± 4.67%, 76.96 ± 6.85 L/m and 107.61 ± 11.44 L/m, and 581.12 ± 12.25 m and 627.74 ± 15.27 m in groups A and B, respectively. Between-group compar...
Background: Idiopathic adolescent scoliosis (AIS) causes not only spinal deformities but rib cage abnormalities that lead to abnormal volumes and pulmonary capacity on pulmonary function testing (PFT). The objective of this study was to analyze the impact of a physical rehabilitation program on respiratory function in surgical patients with AIS. Methods: From October 2003 to October 2004, a total of 34 patients (age range, 10 to 18 years) presenting with AIS and a thoracic curvature between 45°and 88°were studied prospectively at a tertiary academic hospital. The patients underwent clinical and radiographic evaluations of the vertebral deformity, chest radiographs, PFT, evaluation of peak expiratory flow, and 6-min walk tests (6MWTs) before and after joining a physical rehabilitation program for 4 months. Results: An improvement in FVC, inspiratory capacity, FEV 1 , expiratory reserve volume, and performance assessed by 6MWT were observed after rehabilitation.
Cardiorespiratory Function of Patients with Adolescent Idiopathic Scoliosis
Coluna\/columna, 2021
Objective: Adolescent idiopathic scoliosis (AIS) is a spinal deformity that can cause cardiorespiratory dysfunction, contributing to decreases in tolerance for aerobic exercise (TAE) and in functionality. The objective is to assess the TAE and lung capacity of patients who underwent corrective AIS surgery in the pre- (PRE) and postoperative (POST) periods. Methods: Sixty individuals, PRE (n=30, age: 18.5±2.4 years) and POST (n=30, age: 24.5±4.5 years), participated in the study. The forced vital capacity (FVC), the forced expiratory volume in the first second (FEV1) and the FEV1/FVC ratio, as well as the maximum inspiratory and expiratory pressure were verified. The TAE was assessed by the distance travelled in the 6-minute walk test (6MWT), together with blood pressure, heart rate, respiratory rate and peripheral oxygen saturation measured at the beginning and at the end of the test. Results: A mild restrictive pattern in lung function and reduced expiratory muscle strength were ob...
Respiratory Function in Adolescent Girls with Mild and Moderate Idiopathic Scoliosis
Journal of Turkish Spinal Surgery, 2020
Objective: First, this study aimed to compare the respiratory function in adolescent girls with idiopathic scoliosis (AIS) who were not involved in any previous treatment and compare them with an age-matched control group in girls. Second, it investigated the relationship between respiratory function (RF) and curve magnitude and location of the curvature in patients. Materials and Methods: Thirty-five females with AIS, aged 10 to 17 years, and thirty-five age-matched healthy females were involved in the study. RF was measured using a handheld spirometer. Measurements included the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and the FEV1/FVC ratio. The AIS group was classified according to the location of the major Cobb angle (thoracic, lumbar, and thoracolumbar). Statistically, all results were compared between groups, and the RF was correlated with the major curve magnitude and the location of the curvature in patients with AIS. Results: The mean value of the major Cobb angle in degrees was 35.2°±6.5° (minimum-maximum: 22°-48°). Ten patients had thoracic, 16 had lumbar, and nine had thoracolumbar scoliosis. When compared with the results of the RF test, females with AIS had significantly lower values in all tests (p<0.05). There was no relationship between RF and the degree of the major Cobb angle. There was a significant negative correlation (p=0.033) between thoracic scoliosis and PEF values. Conclusion: Patients with AIS with the mild and moderate scoliosis had worse RF than healthy adolescents. Thoracic scoliosis was more negatively affected. Exercise programmes should consider strengthening respiratory muscles in patients with AIS, especially those with thoracic scoliosis.
Journal of International Medical Research, 2019
Objectives To assess pulmonary function and functional capacity in children and adolescents with mild or moderate idiopathic scoliosis who were included in a rehabilitation programme, and to observe some of their physical activity behaviours. Methods Forty children (aged 9–17 years) with mild or moderate idiopathic scoliosis (patients) and 40 sex- and age-matched healthy controls were included in the study. Physical activity behaviours (hours of time spent at a desk and at a computer, hours of competitive and non-competitive practice of exercise per week) were recorded. Patients were assessed before beginning rehabilitation and 12 weeks after an exercised-based programme by spirometry and functional capacity testing (6-minute walk test). Results All respiratory and functional capacity parameters were significantly increased after physical therapy compared with before beginning physical therapy in patients. However, there were still differences between patients and controls in all as...
European Spine Journal, 2022
Purpose Some teenagers with adolescent idiopathic scoliosis (AIS) display compromised lung function. However, the evidence regarding the relations between pulmonary impairments and various spinal deformity parameters in these patients remains unclear, which affects clinical management. This systematic review and meta-analysis aimed to summarize the associations between various lung function parameters and radiographic features in teenagers with AIS. Methods A search of PubMed, Embase, PEDro, SPORTDiscus, CINAHL, Cochrane Library, and PsycINFO (from inception to March 14, 2022) without language restriction. Original studies reporting the associations between lung function and spinal deformity in patients with AIS were selected. Independent reviewers extracted data and evaluated the methodological quality of the included studies according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pearson correlation and 95% confidence intervals were calculated using random-effects meta-analysis. Results Twenty-seven studies involving 3162 participants were included. Limited-quality evidence supported that several spinal parameters were significantly related to lung function parameters (e.g., absolute value and percent of the predicted forced vital capacity (FVC; %FVC), forced expiratory volume in one second (FEV 1 ; %FEV 1), and total lung capacity (TLC; %TLC)) in AIS patients. Specifically, meta-analyses showed that main thoracic Cobb angles in the coronal plane were significantly and negatively related to FVC (r = − 0.245), %FVC (r = − 0.302), FEV 1 (r = − 0.232), %FEV 1 (r = − 0.348), FEV 1 /FVC ratio (r = − 0.166), TLC (r = − 0.302), %TLC (r = − 0.183), and percent predicted vital capacity (r = − 0.272) (p < 0.001). Similarly, thoracic apical vertebral rotation was negatively associated with %FVC (r = − 0.215) and %TLC (r = − 0.126) (p < 0.05). Conversely, thoracic kyphosis angles were positively related to %FVC (r = 0.180) and %FEV 1 (r = 0.193) (p < 0.05). Conclusion Larger thoracic Cobb angles, greater apical vertebral rotation angle, or hypokyphosis were significantly associated with greater pulmonary impairments in patients with AIS, although the evidence was limited. From a clinical perspective, the results highlight the importance of minimizing the three-dimensional spinal deformity in preserving lung function in these patients. More research is warranted to confirm these results.
Spine Deformity, 2020
Study designA group of adult patients with idiopathic scoliosis, diagnosed before the age of ten, at a mean of 26.5 years after treatment with either brace or surgery during childhood and adolescence attended a clinical follow-up.ObjectivesTo evaluate the relation between thoracic mobility, rib-cage deformity, and pulmonary function.Summary of background dataLong-term studies of pulmonary function in relation to thoracic mobility after treatment in this patient group have not been published.MethodsA total of 106 patients, 57 braced and 49 operated patients, attended the follow-up. We examined thoracic mobility (range of motion of the thoracic spine, thorax expansion, and breathing movements) and rib-cage deformity (curve size and trunk deformity) as well as pulmonary function, especially total lung capacity (TLC). Respiratory muscle strength was evaluated in a subgroup.ResultsThoracic range of motion was significantly less among the surgically treated patients compared with both the...