Abstract
Adolescent idiopathic scoliosis (AIS) is characterized by uneven shoulders, spinal curvature, and uneven hips, and asymmetry in paraspinal muscle activities is common in AIS. This pilot study was aimed at examining the use of a surface electromyography (sEMG) biofeedback posture training program in adolescents with mild scoliosis (Cobb′s angle < 30°) to attenuate asymmetry in paraspinal muscle activities and control the curve progression. Seven female adolescents (age, 12–14 years) with mild scoliosis (Cobb′s angle < 30°) were recruited. The participants received 30 tailor-made sessions of sEMG biofeedback posture training at a rate of one to two sessions per week for approximately 6 months. The activities of the paraspinal muscles (the trapezius, latissimus dorsi, thoracic erector spinae, and lumbar erector spinae) measured by sEMG during habitual sitting postures and spinal deformity evaluated by 3D ultrasound imaging were compared before and after training. The mean values of the root-mean-square sEMG ratio, an index of symmetry in paraspinal muscle activities of the muscle pairs between the concave and convex sides of the spinal curve, revealed significant asymmetry over the trapezius and lumbar erector spinae before the training (p <0.05). After the training, all seven adolescents achieved relatively more symmetrical paraspinal muscle activities over these two muscle pairs (p < 0.05). In two adolescents, the spinal curvature decreased by 5.7° and 5.6°, respectively, whereas the remaining adolescents showed a minimal curve progression with changes in the spinal curvature controlled under 5°. To conclude, sEMG biofeedback posture training can reduce asymmetry in paraspinal muscle activities and control curve progression in adolescents with mild scoliosis and can potentially be considered an alternative early intervention for muscle reeducation in this cohort.
Highlights
Longitudinal studies showed that trunk asymmetry and poor posture in prepubertal children may predict scoliosis [3] characterized by uneven shoulders, spinal curvature, and uneven hips
The results of one-sample t-test showed that the RMS surface electromyography (sEMG) ratios was significantly deviated from the ratio of 1 over the muscle pairs of the trapezius (M = 2:837, tð6Þ = 2:800, p < 0:05) and lumbar erector spinae (M = 0:629, tð6Þ = −3:894, p < 0:01), suggesting a relative asymmetry of the paraspinal muscle activities in these two muscle pairs among seven participants
A time × muscle pair repeated measure analysis of variance (ANOVA) was conducted to compare the relative symmetry in sEMG activities over the four paraspinal muscle pairs before and after the training
Summary
Poor torso posture is characterized by a prolonged deviation from a “neutral spine” [1]. Kwok et al [7] compared paraspinal muscle activities between female adolescents with and without mild scoliosis (i.e., spinal curve angle less than 20°) by sEMG during habitual standing and sitting postures and found that those with thoracic- or thoracolumbar-type scoliosis had higher average root-mean-square (RMS) sEMG values on the convex side of the affected muscle regions. They showed evident asymmetry in muscle activities between the left and right upper trapezius and latissimus dorsi in the habitual sitting posture [7].
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