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Abstract
ABSTRACT Objective: To verify the relation of muscular response to the vestibular stimulation of the erector spinae, specifically longissimus thoracis and iliocostalis lumborum, with the origin of scoliosis in a population of individuals with level V cerebral palsy of the Gross Motor Function Classification System (GMFCS). Methods: Cross-sectional study of 12 individuals aged between four and 14 years. The muscular activity of the longissimus thoracis and iliocostalis lumborum was recorded by electromyography in the presence of anteroposterior and lateral imbalances, comparing it with that obtained in sitting position without imbalances. Scoliosis was assessed by radiological study following Cobb method. Results: Statistically significant differences were found between correct responses of both muscles to anteroposterior imbalances and absence of right thoracolumbar scoliosis (p=0.005; p=0.028), left thoracic scoliosis (p=0.005; p=0.046) and right lumbar scoliosis (p=0.005; p=0.046). Conclusions: The symmetry of muscular responses to anteroposterior imbalances, both of longissimus thoracis and iliocostalis lumborum, seems to be one of the factors that prevent the development of spine deviations in this population. Level of evidence: IV. Type of Study: Case series
Highlights
Cerebral palsy (CP) describes a group of encephalopathies that occurs in childhood and, in many cases, causes secondary musculoskeletal changes
The muscular activity of the longissimus thoracis and iliocostalis lumborum was recorded by electromyography in the presence of anteroposterior and lateral imbalances, comparing it with that obtained in sitting position without imbalances
We found that 100% of the study population, all classified as Gross Motor Function Classification System (GMFCS) level V, had at least one curve greater than 10o as measured by the Cobb method, in line with the authors who associate scoliosis with cerebral palsy and the motor level.[5,6]
Summary
Cerebral palsy (CP) describes a group of encephalopathies that occurs in childhood and, in many cases, causes secondary musculoskeletal changes. Deviations of the spine are common, becoming structured (scoliosis) in 25% of individuals.[1]. Patterns of scoliosis have been described in relation to pelvic obliquity and hip dislocation[2] and postural asymmetry have been associated with scoliosis,[3] the mechanism that causes development and increase of the curvature over time is not completely understood. Some studies have associated both fetal postures and those maintained during the first years of life[4] with spinal deviations, noting the importance of asymmetries and postural preferences in the development and structuring of postural changes, but never explaining the underlying neurological mechanisms that produce them
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