Alteration in shoulder kinematics and associated muscle activity in people with idiopathic scoliosis.

STUDY DESIGN: A cross-sectional control-matched study in adolescents with idiopathic scoliosis (IS). OBJECTIVE: To evaluate whether subjects with IS had shoulder dysfunction and associated impairment in shoulder kinematics and muscular activation. SUMMARY OF BACKGROUND DATA: Evidence indicates that shoulder kinematics are related to shoulder pain and dysfunction. Despite the degree of morbidity associated with altered shoulder kinematics likely to occur in subjects with IS, no report has been published to address this hypothesis. METHODS: In this investigation, shoulder kinematics (scapular tipping, scapular upward rotation, and scapulohumeral rhythm) and associated muscular activities [upper trapezius (UT), lower trapezius (LT), serrantus anterior (SA), and middle deltoid (MD)] were evaluated with a 3-dimensional electromagnetic tracking device and electromyography during arm elevations in 13 female subjects with IS and 13 age-gender-dominant hand-matched controls. Additionally, self-reported Flexilevel Scale of Shoulder Function (FLEX-SF) was evaluated between the 2 groups. RESULTS: Subjects with IS demonstrated lower FLEX-SF scores than the controls (P = 0.01). For the convex side, more anterior tilt of the scapula in resting position was identified (P = 0.006). For the concave side, more scapular upward rotation in resting position was identified (P = 0.01). For the EMG amplitude, higher LT contraction activity on the convex side and lower LT and SA contraction activity on the concave side were established (P = 0.007 and less than 0.01, respectively). A moderate positive association was found between scapular posterior tipping during movement and FLEX-SF functional score (R = 0.51). A moderate negative association was found between LT muscular activity and FLEX-SF functional score (R = -0.54). CONCLUSION: Given the progressive nature of IS and kinematic linkage among the thoracic spine, scapula, and arm, inadequate posterior tipping movement and high LT muscular activity on the convex side of IS are important to consider in rehabilitation programs for subjects with IS.

The effectiveness of a functional training programme for patients with chronic low back pain--a pilot study.

INTRODUCTION: To investigate the effect of an individualised functional training programme for patients with low back pain (LBP). METHODS: A randomised, controlled trial with single-blind design was conducted. Patients with non-specific LBP for at least 3 months were recruited and randomised into training and control groups. Both groups maintained their current treatment, and the training group participated in an additional programme for 100 h. Measures were performed initially and after completing the programme, and included rating determining impairment associated with pain, Oswestry disability index (ODI) and functional capacity evaluation (FCE). RESULTS: Thirteen in the training group completed the training and measurements, and 12 in the control group completed their measurements. Twelve items in FCE had significant improvement in training group, but only one in control group. Severity of pain (11.8 +/- 3.6-5.6 +/- 3.6), activity limitation from pain (3.2 +/- 1.5-1.5 +/- 1.1) and emotional disturbance by pain (4.3 +/- 1.7-2.2 +/- 1.4) significantly decreased in the training group, no significant change in the control group. The ODI demonstrated a significant reduction (p = 0.044) in the training group (22 +/- 9-16 +/- 9), but not in the control group. CONCLUSION: An individualised functional training programme benefits chronic LBP patients.