Tibial nerve somato-sensory evoked potentials in idiopathic scoliosis.

Background. For many years the etiology of idiopathic scoliosis has been a topic of interest for researchers and clinicists. Material and methods. We examined somatosensory evoked potentials from the tibial nerves (tSSEP) in 120 children with idiopathic scoliosis, of whom 40 showed abnormal results and were retested by tSSEP one year later. The progressive nature of the scoliosis was evaluated on the basis of clinical and radiological examination. This group of 40 children was divided into two subgroups: Group I, consisting of 25 children with progressive scoliosis, and Group II, consisting of 15 children with non-progressive scoliosis. The groups were cross-referenced for one-curve scoliosis (21 children) and two-curve scoliosis (19 children). These children had been treated conservatively by asymmetrical three-plane trunk mobilization using the Dobosiewicz method. Results. Of the 40 children with abnormal results in the first tSSEP examination, 70% still had pathological recordings in the second examination. 65% of this group had progressive scoliosis, as compared to only 40.8% in the entire study population of 140 children. In the follow-up x-ray we found slight but statistically significant regressio of the Cobb angle and rotation. The radiological changes had no significant relation to changes in the tSSEPs. There was no statistically significant different in quantitative pathology on the tSSEPs between progressive and non-progressive scoliosis. Conclusions. These results may be an argument in favor of the hypothesis that idiopathic scoliosis results from a dysfunction of the sensory pathways.

Influence of asymmetric mobilisation of the trunk on the Cobb angle and rotation in idiopathic scoliosisin children and adolescents.

Background. The aim of the study was the radiological evaluation of the treatment of the idiopathic scoliosis utilising asymmetric trunk mobilisation in the strictly symmetric initial position. Material and methods. Presented study was based upon 136 cases (13 boys aged from 6 to 16 years and 123 girls aged from 6 to 18 years) treated due to the idiopathic scoliosis (from November 1999 to February 2001). Among 48 children suffering from double-major scoliosis 6 cases were infant scoliosis, 20 juvenile and 22 adolescent. Among 88 single scoliosis 6 were infant, 33 juvenile and 49 adolescent. Radiological examination was conducted always in the repeatable technical conditions. Radiograms were evaluated by the same physician. Radiological analysis of the scoliosis included value of the Cobb angle, angle of axial rotation. Results. In double-major scoliosis observed during one year period, in the thoracic segment Cobb angle decreased in 31,3%, increased in 39,5% and in 29,2% was unchanged. Axial rotation angle in 16,7% of cases decreased, in 35,4% increased and remained the same in 47,9%. In the lumbar segment Cobb angle decreased in 35,4%, increased in 39,6%, remained in 25%. Angle of axial rotation decreased in 23% of cases, increased in 29% and persisted in 48%. In single scoliosis Cobb angle decreased in 38,6%, increased in 35,3% and in 26,1% was unchanged. Axial rotation angle in 21,6% of cases decreased, in 29,5% increased and remained the same in 48,9%. Conclusion. Asymmetric mobilisation of the trunk in strictly symmetric initial positions is a method of choice in the conservative treatment of the idiopathic scoliosis.

Pathomechanic basics of conservative treatment of progressive idiopathic scoliosis according to Dobosiewicz method based upon radiologic evaluation.

Conservative treatment of idiopathic scoliosis, especially kinesitherapy, is not widely appreciated due to its suspected low effectiveness in relation to a surgical treatment. After long-year assessment of patomechanics of scoliosis in Department of Rehabilitation of Medical University of Silesia a conservative method of treatment, asymmetric trunk mobilization in strictly symmetric positions, was developed. This method enables to detain progression of scoliosis, or even decrease lateral curvature of a spine and angle of rotation assuming adequate cooperation of patient and its family.

Influence of method of asymmetric trunk mobilization on shaping of a physiological thoracic kyphosis in children and youth suffering from progressive idiopathic scoliosis.

Idiopathic scoliosis (IS), which is substantially a three-dimensional deformation of a spine, causes not only lateral curvature and axial rotation of vertebral column, but also lordotisation of vertebrae in structural curve extension. In an effect physiological thoracic kyphosis diminishes or even disappears. Method of asymmetric trunk mobilisation in strictly symmetric positions according to Dobosiewicz not only deteriorates progression of IS or even reduces lateral curvature, but also significantly rebuilds physiological thoracic kyphosis in cases of IS accompanied by straight back.

Exercise efficiency of girls with idiopathic scoliosis based on the ventilatory anaerobic threshold.

UNLABELLED: The aim of the study was to estimate the exercise efficiency in the group of girls with idiopathic scoliosis based on the ventilatory anaerobic threshold (VAT). MATERIAL AND METHOD: The investigation comprised 58 girls with idiopathic scoliosis, aged 10-16 years; 32 girls (55.20/0) with double major scolioSiS and 26 girls (44.8%) with single scoliosis. The girls were conservatively treated using Dobosiewicz method. The control group consisted of 31 healthy girls aged 10-16 years. The exercise test was performed using cycle ergometer. During the exercise the gas exchange parameters were recorded (minute expiratory ventilation, minute oxygen consumption, carbon dioxide production). On the basis of recorded parameters VAT has been computed, using V-slope method. RESULTS: The following VAT values were obtained in the group with scoliosis: 20.7+3.05 ml O2/min/kg b.m.; in control group: 21.9+3.50 ml O2/minlkg b.m. The differences between girls with idiopathic scoliosis and control group were not statistically significant. CONCLUSIONS: I. The exercise efficiency of girls with idiopathic scoliosis conservatively treated using Dobosiewicz method is normal. 2. Such high level of the exercise efficiency of the studied group probably was due to intensive 3-D respiratory exercises of these girls.

[Developmental age idiopathic osteoporosis--diagnostics and rehabilitation]. / Osteoporoza idiopatyczna wieku rozwojowego--diagnostyka i rehabilitacja.

Developmental age idiopathic osteoporosis is a rare metabolic disease, which pathomechanism is different from involutional osteoporosis. Its etiology still remains unknown. An onset of the disease is rapid, affecting previously healthy children of both sexes aged 3.5-15. A rapid loss of bone mass is especially remarkable. Clinical picture of the disease includes pain localised initially in feet, then in thoraco-lumbar section of the vertebral column, gradually progressive deformation of the longitudinal axes of limbs, gait pathology and progressive depletion of a lower limb muscle strength. The onset of the disease is non-specific. Diagnosis is possible on the basis of roentgen imaging depicting rarefaction of cancellous layer of the bone, numerous infractions of long bones and typical for osteoporotic deformation of vertebral shafts with reduction of their vertical dimension. Current research presents two-staged method of rehabilitation applied in developmental age osteoporosis. The main principle of treatment is based on increasing axial load of lower limbs in antigravitational position causing joint surfaces to be pushed together. Final stage of rehabilitation includes interval training on a moving track.