Muscle assessment in healthy teenagers, Comparison with teenagers with low back pain.

OBJECTIVES: To describe muscle parameters in healthy teenagers and compare them to teenagers with chronic low back pain. METHODS: A comparative study of 276 control teenagers and 51 teenagers with chronic low back pain (CLBP), benefiting from a specific treatment, 14.5 years average age. The control group is made up of teenagers without back pain and teenagers who reported some back pain when we asked them, but without specific treatment. The results to four static tests assessing trunk flexors, trunk extensors, hip extensors and quadriceps endurance are statistically compared. In the control group, associations between different clinical measures and possible back pain are looked for. RESULTS: The two groups are homogeneous, concerning age, weight, standing height, sitting height and BMI (p>0,05). Low back pain is more common in girls, either in the control group (n=48; 69% of girls) or in the group with CLBP (n=51; 78%). CLBP is associated with a poor endurance strength of the trunk extensors (median: 2 min 31 s in the control group to 1 min 45 s in the CLBP), with hip extensors weakness (median: 2 min 20s in the control group to 1 min 24s in the CLBP), and with quadriceps weakness (median: 2 min 39 s in the control group to 1 min 20s in the CLBP), (p=0.000). No significant difference was found between trunk flexors endurance in the two groups (median: 2 min 11s in the control group to 2 min 13s in the CLBP). In the control group, 48 teenagers reported back pain "often", "very often" or "all the time"; no links were found between pain and muscle flexibility, measured with finger-floor distance, heel-cheek distance, and popliteal angle. Only the sitting height was found statistically higher (p=0.003) in the control teenagers who reported back pain (87 cm) related to the ones who have no pain (85 cm). Sport influences global strength in lower limbs and changes the ratio of quadriceps to hip extensors, in favour of quadriceps. Neither pain nor the ratio of trunk flexors to trunk extensors are modified by sport. There is a linear relation between Shirado's and Sorensen's logarithmic values: it is consequently possible to predict the Shirado value when we have the Sorensen one. Trunk extensors, hip extensors and quadriceps endurance is lower in the CLBP group, 14.5 years of age.

[Evaluation of the efficacy of a carbon brace ("Corset monocoque carbone respectant la respiration" [CMCR]) preserving lung capacity to treat idiopathic scoliosis in children and adolescents: a retrospective study of 115 patients]. / Evaluation du résultat d'un corset monocoque carbone respectant la respiration (CMCR) dans la scoliose idiopathique chez l'enfant et l'adolescent: étude rétrospective sur 115 patients.

OBJECTIVES: The purpose of this retrospective study was to investigate whether treatment with a carbon brace (CMCR) stops the progression of idiopathic scoliosis in children and adolescents affected by combined or thoraco-lumbar scoliosis. METHOD: We compared clinical features (hump and vital capacity) and radiolographic data (Cobb angle, sacral slope, lumbar lordosis and thoracic kyphosis) at brace set-up and removal in 115 children and adolescents with combined or thoraco-lumbar scoliosis. The impact of the brace was evaluated in 2 subgroups: patients who started the treatment at Risser stages 0, 1 or 2 and those who started the treatment at Risser stages 3 or 4. With 95 patients, a questionnaire was used to evaluate the physical and psychological tolerance of the brace and technical difficulties during treatment with the orthosis. RESULTS: At brace set-up, the immediate angular correction was about 50% compared to the pre-brace angle; the reduction of the vital capacity was weak. After brace removal, radiographic data showed significant improvement in thoraco-lumbar scoliosis and in the lumbar curve of patients with combined scoliosis, although the thoracic curvature of the combined scoliosis was unchanged. No significant efficiency on the hump was observed. CONCLUSION: The CMCR brace can stop the progression of moderate combined or thoraco-lumbar scoliosis in growing children and adolescents, with little consequence to vital capacity, but seems to have no efficacy on the hump. This type of orthosis provides a better outcome in terms of thoracic mobility and vital capacity. The CMCR brace is indicated for children and growing teenagers with flexible, progressive scoliosis. This "mobile" brace definitely has its place in the current therapeutic arsenal.