Impact of Physical Flexibility Changes on Respiratory Function after Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis Surgery.

Introduction: Corrective scoliosis surgery in patients with adolescent idiopathic scoliosis (AIS) increases thoracic volume but does not improve respiratory function (RF). This study evaluates the effect of physical flexibility (PF) improvement after scoliosis surgery on RF. Methods: This study reviewed the records of 61 consecutive patients with AIS (56 female and 5 male; mean±standard deviation age: 14.8±2.2 years, range: 11-20 years) who had undergone posterior spinal fusion (PSF) of the thoracic curve. PF evaluated as finger-floor distance (FFD) was measured preoperatively and one year after surgery. After dividing the cohort into the PF improvement group and the PF nonimprovement group, RF changes at two years postoperative were statistically compared. Using logistic regression analysis, we evaluated the impact of a PF improvement on % forced vital capacity (%FVC) two years after surgery. Results: The rate of patients with increased FVC, %FVC, and forced expiratory volume 1.0 second two years after surgery was 79%, 51%, and 80%, respectively. The PF improvement group exhibited a significantly higher gain in %FVC versus the PF nonimprovement group (P=0.043). Moreover, PF improvement significantly prevented a %FVC decrease (odds ratio 8.43, 95% confidence interval 1.92-59.70; P<0.001), with an adjusted odds ratio of 11.86 (P<0.001). Conclusions: Patients with diminished PF after PSF for AIS may be less likely to achieve postoperative %FVC improvement. As increased postsurgical %FVC had a positive effect on physical function, treatment strategies that focus on maintaining and increasing PF are desirable from an RF viewpoint.

Systematic Review of Lumbar Elastic Tape on Trunk Mobility: A Debatable Issue.

OBJECTIVES: To systematically review the literature to analyze the effect of lumbar elastic tape application on trunk mobility, surpassing the minimal detectable change of the used outcome measurement tool, and to analyze the additional effect of applied tension and direction of elastic tape application in low back pain and participants without low back pain. DATA SOURCES: Four databases were used: PubMed, Web of Science, Physiotherapy Evidence Database (PEDro), and Google Scholar. STUDY SELECTION: The inclusion criteria were randomized and clinical controlled trials evaluating the effectiveness of lumbar elastic tape application on trunk mobility. DATA EXTRACTION: Two researchers executed the search and a third author was consulted to resolve disagreements. The methodological quality was scored using the PEDro scale, with studies scoring ≤5 being excluded. DATA SYNTHESIS: Eight out of 6799 studies were included; 5 studied individuals with low back pain, and 3 studied participants without low back pain. Two studies scored low on the PEDro scale and were excluded. None of the reported significant changes in trunk mobility due to elastic tape application exceeded the indicated minimal detectable change. No conclusions can be drawn from the direction and applied tension of elastic tape application. CONCLUSIONS: Based on the results of this systematic review, there is no evidence supporting the effect of lumbar elastic tape application. We recommend consensus in the use of more reliable and valid instruments in future studies.

Effects of increased functional residual capacity on finger-floor distance in healthy young adults.

[Purpose] To investigate the effect of increased functional residual capacity on the finger-floor distance and to assess spinal curvature in the sagittal plane using the Spinal Mouse in healthy young participants. [Participants and Methods] Thirty-nine healthy volunteers (age=21.2 ± 0.8 years) participated in this study. The finger-floor distance was used to measure trunk flexion and was recorded at the resting expiration level and at 2 different functional residual capacity levels: 1,000 and 2,000 ml air inhaled at the resting expiration level. Spinal curvature morphology was evaluated using the Spinal Mouse in the sagittal plane when flexion was completed under the 2 increased functional residual capacity and resting expiration level conditions during finger-floor distance measurement. Finger-floor distance and spinal curvature were assessed according to functional residual capacity using one-way repeated measures analysis of variance and post-hoc analysis. [Results] Significant effects and differences were found for the finger-floor distance under all conditions. No significant effect was found for spinal curvature. [Conclusion] An increase in functional residual capacity may decrease trunk flexion. This correlation might also be observed in patients with chronic obstructive pulmonary disease.

Minimum ten-year follow-up of spinal stenosis with degenerative spondylolisthesis treated with decompression and dynamic stabilization.

BACKGROUND: The Dynesys system remains the most widely implanted posterior non-fusion pedicle screw system. Various study designs used in investigations with good to excellent short- and mid-term results have been reported in the current literature. However, there is a lack of information concerning long-term outcomes following treatment for spinal stenosis with degenerative spondylolisthesis. METHODS: The aim of our study was twofold. Firstly, to assess whether the dynamic stabilization in situ with the Dynesys System without bone grafting provides enough stability to prevent progression of spondylolisthesis and secondarily to maintain significant clinical improvement in a long-term follow-up (FU). Therefore, the consecutive patients due to inclusion criterions underwent interlaminar decompression and stabilization with Dynesys instrumentation. Patients were evaluated clinically and radiologically after a minimum FU of 10 years. RESULTS: At FU, the mean low back pain (LBP) post-operatively and leg pain (LP) post-operatively on visual analog scale (VAS) and North American Spine Society (NASS) improved significantly (P<0.001) compared to preoperative examination. The mean value of NASS neurogenic symptoms (19.13% and 4.72%) and activity subscores were 23.13% and 10.74% respectively. In plain and functional radiographs the mean listhesis grade in neutral position was 11.11%, 11.8% in reclination and 11.63% in inclination. There were 17 and 8 patients with progressing degenerative osteochondrosis/listhesis at adjacent segments. CONCLUSIONS: Decompression and single and double level dynamic in situ stabilization with the Dynesys System demonstrate good clinical and radiological long-term results in elderly patients.

Comparison of immediate effects between two medical stretching techniques on Hamstrings flexibility.

[Purpose] The aim of this study was to compare immediate effects between new medical stretching (NMS) and conventional medical stretching (CMS) techniques on Hamstrings flexibility. [Subjects and Methods] Thirteen healthy adult males, with finger floor distance (FFD) less than zero centimeter, without known musculoskeletal and neurological impairment in spine or lower extremities, were included. The subjects were randomly allocated to two groups. The subjects were instructed to perform NMS and CMS (hold for 30 seconds once, twice for each side of lower extremity) for both sides (total two minutes, only one session for one day). The interval between the two techniques was one week. FFD was measured with digital standing trunk flexion meter at the pre-intervention and post-intervention of both techniques. [Results] The mean values of FFD improved at the post-interventions of both techniques. The tests of within subject effects indicated that the main effect of treatment was not significant but the main effect of time was significant and the interaction of treatment and time was also significant. [Conclusion] The results of this study indicated that both medical stretching techniques were effective on Hamstrings flexibility immediately after the intervention and NMS technique was more effective on improving flexibility.

Another Understanding for Effects of Physical Stimuli on Modification of Autonomic Nerve System by Two Kinds of Stimuli on Feet / 日本温泉気候物理医学会雑誌

<b>Background:</b> In one series of studies, we observed the effects of acupuncture treatment (AT) on the autonomic nerve system (ANS). We experimented from various view-points. At last, we discovered a specific pattern for modifying ANS status, which showed that functions of the parasympathetic nerve increased while those of the sympathetic nerve decreased. To further study systematic modification of ANS balance, we focused on the lower body (feet). Moreover, two kinds of stimuli, tapping and vibration, were applied while measuring the value of finger floor distance (FFD) and heart rate (HR). Finally, the effects on ANS were discussed.<BR><b>Methods:</b> Twenty healthy subjects participated in this study, and they were divided into two groups; the tapping group and the vibration group. The former received 50 taps on the feet, and the latter received vibrations for two minutes. In order to indicate ANS status the effects of these stimuli were evaluated by FFD values and a kinetic record of changes in HR.<BR><b>Results:</b> Both groups showed improvement in FFD values, which was the same as the results for AT via modification of ANS. However, changes in HR showed a different pattern from AT; in this study sympathetic nerve) dominantly showed an increase without a decrease in parasympathetic nerve.<BR><b>Discussion and Conclusions:</b> The reasons for differences in ANS modification may be found in the role, especially in an emergency, of the lower body. The lower body is heavy in skeletal muscles, which needs energy and blood to react during acute stress. The ANS, which controls blood distribution, may shift and concentrate system blood from the smooth muscles of the stomach (controlled by parasympathetic nerve) to the skeletal muscles of the legs and feet (controlled by sympathetic nerve). Thus, this study indicated that local stimuli of the foot induced systematic ANS modification.

Another Understanding for Effects of Physical Stimuli on Modification of Autonomic Nerve System by Two Kinds of Stimuli on Feet / 日本温泉気候物理医学会雑誌

Background: In one series of studies, we observed the effects of acupuncture treatment (AT) on the autonomic nerve system (ANS). We experimented from various view-points. At last, we discovered a specific pattern for modifying ANS status, which showed that functions of the parasympathetic nerve increased while those of the sympathetic nerve decreased. To further study systematic modification of ANS balance, we focused on the lower body (feet). Moreover, two kinds of stimuli, tapping and vibration, were applied while measuring the value of finger floor distance (FFD) and heart rate (HR). Finally, the effects on ANS were discussed. Methods: Twenty healthy subjects participated in this study, and they were divided into two groups; the tapping group and the vibration group. The former received 50 taps on the feet, and the latter received vibrations for two minutes. In order to indicate ANS status the effects of these stimuli were evaluated by FFD values and a kinetic record of changes in HR. Results: Both groups showed improvement in FFD values, which was the same as the results for AT via modification of ANS. However, changes in HR showed a different pattern from AT; in this study sympathetic nerve) dominantly showed an increase without a decrease in parasympathetic nerve. Discussion and Conclusions: The reasons for differences in ANS modification may be found in the role, especially in an emergency, of the lower body. The lower body is heavy in skeletal muscles, which needs energy and blood to react during acute stress. The ANS, which controls blood distribution, may shift and concentrate system blood from the smooth muscles of the stomach (controlled by parasympathetic nerve) to the skeletal muscles of the legs and feet (controlled by sympathetic nerve). Thus, this study indicated that local stimuli of the foot induced systematic ANS modification.