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Objective:To quantify any correlation between the severity of spinal curvature of an adolescent with idiopathic scoliosis and their cardiopulmonary exercise endurance.Methods:The cardiopulmonary exercise test (CPET) results and the full-length spinal X-rays in a standing position of 64 adolescents with idiopathic scoliosis were reviewed retrospectively. Independent t-tests were used to compare the two datasets obtained from those with left or right thoracic scoliosis. The correlation between the Cobb angle and cardiopulmonary exercise endurance was analyzed using Pearson correlation coefficients, multiple factor linear regression and two-stage linear regression.Results:After adjusting for gender, age, height and weight, the multiple linear regression analysis showed that the Cobb angle was significantly negatively correlated with maximum tidal volume (β=-0.013) and significantly positively correlated with the rate of respiration (β=0.421). The relationship between the Cobb angle and cardiopulmonary exercise endurance was non-linear. With a Cobb angle > 34°, a 1° increase reduces cardiopulmonary exercise endurance by a factor of 1.4 on average. At smaller Cobb angles the corresponding increase is about 0.87 times.Conclusions:The Cobb angle is a negative predictor of ventilation during exercise among adolescents with idiopathic scoliosis. The more severe a patient′s spinal curvature, the lower the cardiopulmonary exercise endurance is likely to be.
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Objective:To visualize the research hot spots and frontiers of non-surgical treatments for idiopathic scoliosis (IS) based on CiteSpace.Methods:The Web of Science Core Database and China National Knowledge Infrastructure from 1990 to 2020 were searched for studies of non-surgical treatments of idiopathic scoliosis. The time, distributions of nations, institutions, academic disciplines and keywords of literature were analyzed. With CiteSpace 5.7.R4 and Excel 2017, the visualized knowledge graphs and the data tables were generated.Results:A total of 822 studies including 548 articles in English and 274 articles in Chinese were retrieved, including 378 articles published during 2015—2020. The top three nations with higher number of published articles were USA (114 studies), Canada (77 studies) and China (68 studies). Studies covered 33 disciplines, including rehabilitation, engineering and orthopedics, and the betweenness centrality of rehabilitation medicine was the highest (0.59). The non-surgical treatment research was focused on adolescents (187 studies) and brace treatment (116 studies). From 1990 to 2014, the non-surgical treatment of IS mainly focused on the brace treatment (70.4%,69/98) in domestic studies. After 2014, comprehensive treatments such as exercise therapy and manual therapy gradually became the research trend in this field (61.3%,92/150). Research hotspots included different forms of brace treatment (betweenness centrality: 0.31), exercise (6 studies), manual therapy (3 studies), guide of medicine (2 studies), acupuncture therapy (2 studies) of non-surgical treatments. Among top 30 research institutions for domestic publication of Chinese literature, there were 22 tertiary hospitals, 1 secondary hospital, 5 schools, 1 comprehensive rehabilitation service organization, and 1 community health service center.Conclusion:The research content of non-surgical treatment for idiopathic scoliosis tends to be diversified, comprehensive treatment of exercise therapy, brace therapy, and manual therapy are currently the main research hotspots.
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Objective To identify the surface electromyographic (sEMG) characteristics of bilateral stemocleidomastoid muscles in infants with congenital muscular torticollis (CMT) after rehabilitation.Methods One hundred and twenty two infants were enrolled from Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 2013 and December 2015,including 63 cases receiving rehabilitation (treatment group) and 59 cases without rehabilitation (control group).The sEMG parameters of bilateral sternocleidomastoid muscles in cervical neutral,left and right rotation and stretching posture in the supine position were retrospectively collected before and after treatment/follow-up;and the root mean square (RMS) was analyzed.Results Before treatment,the RMS values of the affected side in cervical neutral position,cervical rotation and stretching posture were significantly lower than those of the unaffected side in both groups(t=15.758 and 11.950,4.871 and 4.746,4.142 and 4.318,P＜0.01).In the follow-up for control group,the RMS values of the affected side in cervical neutral position,cervical rotation and stretching posture were significantly lower than those of the unaffected side (t=10.692,2.198 and 3.239;P＜0.01,=0.03 and ＜0.01).In the treatment group there were no significant differences in the RMS values in cervical neutral position,cervical rotation and stretching posture between affected side and unaffected side after treatment(t=1.647,1.090 and 0.136,P=0.10,0.28 and 0.89).Conclusion Rehabilitation reduces the difference of the RMS values between the affected and unaffected sternocleidomastoid muscles in infants with CMT.
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Objective To explore the effect of scoliosis-specific exercises ( SSE) on patients with mild ado-lescent idiopathic scoliosis ( AIS) . Methods Thirty patients with mild AIS were assigned to a control group ( n=10) or an SSE group ( n=20) . The control group received routine health education, while the SSE group completed a 60-minute set of SSE 2 to 3 times a week for 12 weeks. The angle of trunk rotation ( ATR) , maximum Cobb angle and angle of vertebral rotation (AVR) were recorded. Bone strength parameters including the speed of sound (SOS), Z-score and percentile distal radius were measured. Surface electromyography ( sEMG) was performed for the erector spinae muscle. In addition, forced vital capacity ( FVC) and forced expiratory volume in one second ( FEV1) were measured and compared with the predicted values ( FVC/pred% and FEV1pred%) . A falling index ( FI) and quality of life ( QOL) were measured. Results Compared with before the treatment, the average maximum Cobb angle in the control group increased significantly after the lessons, but there was no significant difference in any of the other measures, including QOL. For the control group the activation rate of the concave side of the apex level erector spi-nae was significantly lower than on the convex side both before and after the lessons. The SSE group showed no sig-nificant improvement in their average ATR, maximum Cobb angle, AVR or FI results, but their average SOS, Z-score and percentile of the distal radius, FVC, FEV1 and motor function improved significantly after the treat-ment. Before the treatment the activation rate of their concave side was also lower than on the convex side, but after the treatment there was no significant difference between them on average. Conclusion Early SSE can prevent further deformation, promote bone strength, improve lung function reduce the difference in the motor control of the bilateral erector spinae muscles among patients with mild AIS. It can promote a better quality of life and is worth ap-plying in clinical practice.
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@#Objective To determine the concept of functional evaluation for children with congenital heart disease in the views of International Classification of Functioning, Disability and Health (Children and Youth Version) (ICF-CY). Methods Clinical researches on children and adolescents with congenital heart disease nearly a decade were recalled from MEDLINE/PubMed and EMBASE. The concepts extracted were linked with ICF-CY. Results 224 researches were recalled. The oncepts linked with ICF-CY in 12 first categories, 28 second categories, of which 17 items were of body function, 2 of body structure, 6 of activities and participation, and 3 of environmental factors.Conclusion ICF-CY is a useful framework for functional assessment for children with congenital heart disease. It is important to make the measurement uniformity for comparability of the researches.