Postural Alterations Research Articles

The effect of direct vertebral rotation on the spine parameters (coronal and sagittal) in adolescent idiopathic scoliosis.

Idiopathic scoliosis is accompanied by postural alterations, instability of gait, and functional disabilities. The objective was to verify radiographic parameters (coronal and sagittal) of adolescents with idiopathic scoliosis (AIS) pre- and post-surgery with direct vertebral rotation (DVR), associated with type 1 osteotomies in all segments (except the most proximal) and type 2 in the periapical vertebrae of the curves. A prospective study design was employed in which 41 AIS were evaluated and compared pre- and post-surgery. Scoliosis was confirmed by a spine X-ray exam (Cobb angle). Eight radiographic parameters were measured: Cobb angles (thoracic proximal and distal), segmental kyphosis, total kyphosis, lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt. The Cobb angle averaged 51.3∘± 14.9∘. Post-surgery, there were significant reductions for the following spine measurement parameters: Cobb angle thoracic proximal (p= 0.003); Cobb angle thoracic distal (p= 0.001); Cobb angle lumbar (p= 0.001); kyphosis (T5-T12, p= 0.012); and kyphosis (T1-T12, p= 0.002). These reductions showed the effectiveness of surgical correction to reduce Cobb angles and improve thoracic kyphosis. The values obtained for lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt were not significantly different pre- and post-surgery. The surgical technique of DVR in AIS proved to be effective in the coronal and sagittal parameters directed at Cobb angles and thoracic kyphosis in order to favor the rehabilitation process.

Association of Foot Posture with Lumbar Lordosis Angle in Teachers

Context: Anatomical alteration in the alignment of the foot leads to changes in proximal joints that in turn cause mechanical variations in the spine. Changes in the lower kinematic chain can have functional consequences in the form of low back pain and may be seen in professions requiring long-standing. This is often an unexplored, under-evaluated component of low back pain and hence proves its need. Aim: To study the relationship between ankle-foot complex and lumbar spine, and also to determine the association between Foot Posture and Lumbar Lordosis angle in teachers. Settings and Design: Data for the observational study were collected from school and college teachers of Belagavi city. Materials and Methods: Foot posture of 200 teachers in the age group of 20–50 years was assessed using Chippaux Index and Foot Posture Index-6 (FPI-6). Lumbar curvature was measured using Flexi curve ruler and angle was calculated. Functional limitation was assessed using Low Back Pain Rating Scale and Modified Oswestry Low Back Pain Disability Questionnaire. Statistical Analysis Used: Spearman's rank correlation and t-test were used for analysis. Results: Statistically significant association was noted between FPI-6, lumbar angle, Low back pain scores, and Modified Oswestry score with P = 0.0001. Gender comparison of the outcome measures did not reveal any significant relationship. Conclusion: Alteration in foot posture leads to changes in lumbar lordosis angle, which in turn may cause low back pain.

Assessment of dynamic postural alterations during walking in patients with adult spinal deformity

Assessment of dynamic postural alterations during walking in patients with adult spinal deformity

Alterações ortopédicas em crianças eutróficas e obesas

No Brasil, a obesidade é um dos mais alarmantes problemas nutricionais na infância e vida adulta. O objetivo deste trabalho foi caracterizar a postura dos membros inferiores de crianças de 6 a 9 anos, comparando os resultados das crianças eutróficas com as obesas. Inicialmente as medidas de peso e altura foram feitas para determinação do índice de massa corporal; a avaliação postural foi realizada com fotografias digitais e com o auxílio do programa Corel Draw 10. Nos joelhos valgos, foram observadas as distâncias intermaleolares, e calculado o ângulo Q, para determinação dos alunos com alterações de valgismo do joelho. A avaliação dos pés planos foi realizada através da sua impressão no pedígrafo e posteriormente, realizado o cálculo do índice de Schipaux-Smirak para a determinação destas alterações. As análises estatísticas foram realizadas utilizando o software Stata, através dos testes de qui-quadrado, exato de Fischer, Kruskal-Wallis, considerando um nível de significância de p<0,05. Foram avaliadas 708 crianças, sendo 46,8% do sexo masculino e 53,2% feminino. Destas, 77,4% estavam eutróficas, 17% com sobrepeso e 5,7% obesas. A idade média das crianças foi de 7,7 ± 1,0. O índice de massa corporal médio foi de 17,0 ± 2,9. Foi identificado diferença significativa entre os grupos nas variáveis relacionadas aos pés planos e a idade da criança. Conclui-se que a obesidade infantil deve ser combatida para evitar complicações futuras, inclusive ortopédicas. Não se sabe ao certo quando a formação do arco plantar acontece, mas a obesidade quando não favorece o rebaixamento deste arco, atrasa seu desenvolvimento.

Influence of Dental Malocclusion on Body Posture and Foot Posture in Children: A Cross-Sectional Study.

The number of studies that investigate the correlations between the temporomandibular system and body posture, postural control, or the distribution of plantar pressure has recently been increasing. However, most of the existing information is not conclusive. Therefore, the study objective was to evaluate if the features of dental malocclusion are correlated with body posture alterations at the lower limb level. This is a multicentre cross-sectional study with 289 children (8–14 years). Angle’s molar relation was analysed at the dental level. The postural control and the plantar pressure distribution were recorded via a force platform. Correlation and inferential analysis between the Angle class and the foot’s biomechanics were tested. The centre of gravity is anteriorised in Angle’s Class II in both the molar class (p ≤ 0.001) and the canine class (p ≤ 0.001). Likewise, a relationship was observed between the contact surface and Angle’s classes, being higher in class III than in II (p ≤ 0.001). The plantigrade phase is shortened in Angle’s Class III. A relationship was found between Angle’s Class II and a forward movement of the centre of gravity. No relationship was found between the Foot Posture Index and the truncated scaphoid height and the dental classification. An evident relationship between the gait typology and dental malocclusion was not found.

Postural and craniocervical dysfunctions and their relationship to the voice of women with cervical pain

Introduction: Altered body alignment may contribute to the onset of muscle hypertension in the cervical region. Alterations in the cervical region can generate several complications, including pain and hypertension during phonation. Objective: To relate the postural with functional alterations of the craniocervical region and the voice of women complaining of musculoskeletal pain in the cervical region. Methods: Case study with ten women complaining of cervical pain. Assessments: Craniocervical Dysfunction Index, photogrammetry, maximum vowel phonation time of the vowel /a/, and sound pressure level. Results: Craniocervical Dysfunction Index: 100% dysfunction. Maximum phonation time /a/: 100% decreased. There was a moderate significant positive correlation between these variables. Photogrammetry: all participants presented alterations in the calculated alignments. Sound pressure level: 90% altered. Conclusion: There were postural and functional dysfunctions in the craniocervical region and vocal alteration, suggesting that vocal imbalances are more related to functional than postural alterations of the craniocervical region.

Accuracy and reliability of a low-cost methodology to assess 3D body posture based on commercial cameras and Excel templates

Analysing posture in 3D generally requires expensive equipment and complex software, not accessible to most healthcare centres. The aim was to evaluate a 3D postural analysis methodology based on commercial cameras, a portable calibration device and Excel, a popular spreadsheet software. The accuracy and reliability of the methodology were studied using a 3D optical motion capture system with submillimetre accuracy as reference. 99 length and 99 angular anthropometrics parameters of 9 subjects were measured and Lin’s concordance correlation coefficient (Lin’s CCC), magnitudes of errors and Bland Altman graphs were computed. The measurement errors were of approximately 2 mm and of 1–2 deg, and the methodology was reliable (Lin’s CCCs above 0.99). The suggested low-cost methodology could be used for applied 3D postural studies, analysing asymmetries, postural alterations or population-based anthropometric parameters, where usually submillimetre accuracy is not required and therefore can be useful for medical centres with a limited budget.

The effects of nasal breathing due to pediatric allergic rhinitis on dentofacial growth and its dental considerations

Allergic rhinitis is a specific IgE mediated inflammatory disease of the nasal mucosa, characterized by symptoms such as rhinorrhea, nasal congestion, nasal obstruction, nasal and eye itching, and sneezing. The prevalence of allergic rhinitis varies according to country, age, and surveying methods, but it seems to increase worldwide, also in Korea. Prolonged mouth breathing caused by allergic rhinitis can produce muscular and postural alterations, causing alterations on the morphology, position, growth direction of the jaws, and malocclusion. Also, mouth breathing leads to dryness of the mouth, causing various oral diseases; gingivitis, halitosis, inflammation of tonsil, increased risk of dental caries and dental erosion. In dental clinic, using rapid maxillary expansion to persistent allergic rhinitis patients with narrow maxilla can enlarge maxillary dental arch and nasal cavity anatomy, improving nasal breathing and reducing nasal cavity resistance. However, it is desirable to use along with otolaryngologic treatment. Dentists should be aware of the characteristics of allergic rhinitis and its effects on patients, and consider when planning dental treatment.

Neck pain among smartphone users: an imminent public health issue during the pandemic time

Neck pain among smartphone users: an imminent public health issue during the pandemic time

Genetic and environmental effects on lumbar posture, flexibility and motion control in healthy adults

BackgroundAlthough alterations in posture, flexibility, and motion control of the lumbar spine are associated with low back pain, the underlying interplay between genetic and environmental influences on these traits remains unclear. The aim of this study is to investigate the extent to which genetics and the environment influence lumbar lordosis, flexibility, and motion control. DesignThe present cross-sectional and observational study employed the classic twin design with structural equation models. MethodsAn inertial measurement unit with a wireless movement analysis system, the ViMove (DorsaVi, Melbourne, Australia) was used to measure lumbar lordosis, flexibility, and motion control during range of motion and functional tests. Intraclass correlation was used to determine twin resemblance for the traits. Heritability (genetic influence on trait variation) of lumbar lordosis, flexibility and motion control was estimated from 52 healthy twins, 34 monozygotic and 18 dizygotic using age and sex adjusted univariate genetic models. ResultsA strong heritability estimate was found in lumbar lordosis (77%, 95% confidence interval [CI]: 38%–91%) in standing, followed by lumbar flexibility (67%, 95% CI: 32%–85%) in the sagittal plane. No significant intraclass correlations were found in monozygotic twin pairs for lumbar motion control or in dizygotic twin pairs during the hurdle step and in-line lunge test. ConclusionGenetic factors appear to have a substantial influence on lumbar lordosis and lumbar sagittal flexibility. Lumbar motion control may be more influenced by environmental factors.

P16. Spinopelvic deformities and postural malalignment affect gait patterns in ASD patients

BACKGROUND CONTEXT Adults with spinal deformity (ASD) are known to have postural malalignment affecting their quality of life. Classical evaluation and follow-up are usually based on full-body static radiographs and health related quality of life questionnaires. Despite being an essential daily life activity, a formal gait assessment is lacking in clinical practice. Moreover, gait alterations and their relationships with static deformities in ASD still remain to be elucidated PURPOSE To investigate gait alterations in subjects with ASD and their static radiographic determinants. STUDY DESIGN/SETTING Prospective Single Center. PATIENT SAMPLE A total of 52 Adult Spinal Deformity patients, and 63 control subjects. OUTCOME MEASURES Full body image, 3D gait analysis. METHODS A total of 52 Adult Spinal Deformity (ASD) patients age and weight-matched to 63 controls underwent full-body 3D gait analysis with extraction of 3D lower limb and trunk kinematics. All subjects underwent full-body biplanar X-rays with subsequent calculation of classical 3D postural parameters. Kinematics and postural parameters were compared between ASD and controls. Determinants of gait alterations among postural radiographic parameters were explored in ASD. RESULTS ASD subjects had significantly increased SVA (33.6±59 vs -4.6±20mm), CAM-HA (12±62 vs -21±26mm), PT (19±13 vs 11±6°), frontal Cobb (25±21 vs 4±6°) compared to controls (all p CONCLUSIONS Subjects with ASD are known to have spinal malalignment causing postural alterations such as forward bending of the trunk; they also recruit compensatory mechanisms in the pelvis and lower limbs by increasing radiographic pelvic tilt and knee flexion. This study showed that static compensations in the lower limbs persist during gait where ASD patient exhibit a flexed attitude at the trunk, hips and knees, a reduced hip mobility and loss of lordosis. ASD walked at a slower pace with an elevation of their single support time that might contribute to their stability while walking. These dynamic discrepancies were shown to be strongly related to skeletal radiological alterations, specifically the increased forward shift of the head and trunk, the pelvic retroversion and the lack of lumbar lordosis. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Subjects with temporomandibular joint disc displacement and body posture assessment via rasterstereography: a pilot case-control study.

The possible relationship between temporomandibular disorders (TMDs) and body posture is still controversial. Rasterstereography has been introduced as a radiation-free, reliable and non-invasive method to analyze three-dimensional spinal posture. The aim of this case-control study is to evaluate, through rasterstereography, body posture parameters in a group of patients with reducible unilateral dislocation of the articular disc, compared to healthy volunteers. Rasterstereographic recordings obtained were compared between the two groups with a paired t-student test. Furthermore, the relationship between Rasterstereographic recordings and clinical data in the TMD group were analyzed by means of multiple regression analysis. Only lateral deviation was statistically significant different between the two groups (rms VPDM Control group 40% > TMD group, p=0.02; 43% control group VPDM max > TMD group, p<0.02). In the TMD group, a significant relationship (p<0.05) was found out between lateral and rotational deviations of the column and muscular pain, therefore suggesting a possible overactivity of the masticatory muscles, especially of lateral pterygoids' bilaterally and the left masseter. Patients with reducible unilateral disc displacement showed limited postural alterations compared to healthy volunteers, only lateral deviations (VPDM rms and VPDM-max) were statistically significant (Π<0.05) between the two groups.

Disability and gait disturbances in older adults: a systematic review

Background: there are different alterations that produce changes in the progress of the elderly which, cause effects on the march producing a physical deterioration and establishing a relative fear of having falls. There is a high percentage, of about 93% of the geriatric population, of pathologies and alterations in the feet, percentage that is increasing with the progressive increase of the age. Because of these changes and the increase in the number of postural alterations, there is a progressive decrease in walking speed. The main objective of our review was to analyze the different technical aids that are used by older adults, including as an aid to wander footwear.&#x0D; Methods. A Narrative review was carried out, whose search was conducted for studies published in different languages, by examining the Pubmed; Enfispo, CINAHL; and Google Scholar databases. The inclusion criteria were studies related to alterations of the walking of older adults who use technical aids to improve walking, in patients over 60 and studies published in English or Spanish.&#x0D; Results: Of the potential 861 articles identified, 13 studies were included in the review for qualitative synthesis after the analysis. The imbalances have to be monitored and studied by professionals to be able to change technical assistance if necessary and that the patient does no suffer a worsening in your ambulation and quality of life.&#x0D; Conclusions: Due to the varied gait alterations, the treatment of these should be multidisciplinary. The importance of the Podiatrist's work in maintaining a walking and walking as physiologically as possible.&#x0D; Keywords: older adults, technical aids, disability.

Association between sitting posture on school furniture and spinal changes in adolescents.

To investigate the association between sitting posture during the use of school furniture and changes in the spine in adolescents. A cross-sectional study was conducted with 240 students. The sitting position on school furniture was collected five times (3, 6, 9, 12, and 15min). Postural alteration of the spine was identified by direct observation in front of a symmetograph. Screening for scoliosis was obtained by Adams test. The presence of the factor away from the table presented higher percentages at times 3, 6, 9, and 15min (24.2, 25, 29.2, and 26.7%, respectively). At 12min, the highest frequency was the presence of poorly positioned lower limbs (25.8%). Associations were observed between poor sitting posture with changes in head anteriorization and retroversion of the pelvis among women and with thoracic hyperkyphosis in men. The findings suggest that there are sex-dependent associations between poor sitting posture during use of school furniture and spinal alterations in adolescents.

Prevalence of temporomandibular disorder and its relation with plantar pressures in university students of health-related courses

Background: The temporomandibular disorders (TMD) are changes that occur at the structures that compose the temporomandibular joint. Changes in the temporomandibular complex provoke adaptations throughout the muscular system, which generate postural alterations, modifying the body biomechanics and interfering with their body alignment. Objective: To verify the prevalence of TMD in university students, and to analyze the plantar pressures of subjects with and without TMD. Methods: This research was approved by the Ethics Committee with number: 2.407.595. The 68 students of physiotherapy and dentistry courses were evaluated through the “Research Diagnostic Criteria for Temporomandibular Disorders” and through baropodometry. Plantar pressures of students were compared using the Mann-Whitney test. Results: 71% of the university students presented some type of TMD. Most subjects with TMD presented their pressure center located in the hindfoot contralateral to the disorder. Conclusion: There was no significant difference (p≥0.05) between the plantar pressures of the students with and without TMD.

ANÁLISIS DE LAS ALTERACIONES POSTURALES OCASIONADAS POR LA PRÁCTICA DEL SURF

Introducción: El surf es un deporte que se ha popularizado y ampliado alrededor del mundo, de ahí la importancia de conocer las alteraciones que se pueden producir por su práctica.&#x0D; Métodos: Se elaboró una revisión sistemática de estudios no experimentales de corte transversal en las bases de datos como: PubMed, Scopus, Annual Reviews, Sport Discus y PEDro, siguiendo los parámetros de la estructura PRISMA.&#x0D; Resultados: A partir del análisis de los estudios incluidos se muestran cambios en la postura por la práctica del Surf y se encontró que los deportistas del surf amateurs (recreativos) tienen mayor incidencia en desviaciones posturales versus profesionales. Con relación a las alteraciones posturales la zona más afectada del cuerpo es la región lumbar y entre las alteraciones más comunes de la región superior se encuentran las desviaciones del hombro anterior y lateral.&#x0D; Conclusión: Se concluye que la práctica del surf crea modificaciones que alteran la postura debido al gesto propio del deporte y que están condicionadas con base al tiempo de práctica y nivel del practicante.

Efeitos do exercício físico na alteração postural e funcionalidade de idosos: cuidados ao longeviver saudável

Estudo de abordagem intervencionista, objetivou avaliar os efeitos do exercício físico na alteração postural e condição funcional de seis idosas participantes de um núcleo interdisciplinar de pesquisa e extensão, incluídas por apresentar alterações posturais, problemas reumatológicos, Hipertensão Arterial Sistêmica (HAS) e/ou Diabetes Mellitus tipo 2 (DM2). Adotou-se o Instrumento de avaliação Postural (IAP); Simetográfo; Escala de Avaliação Analógica (EVA), entrevista semiestruturada e um protocolo cinesioterapêutico, adaptado à investigação, implementado em três sessões semanais, de sessenta minutos cada em dias alternados, em um total de 25 sessões. Dos resultados: IAP à vista anterior, houve redução de 66% para 33% na rotação de cabeça a E; melhora em alinhamento das cristas ilíacas de 50% para 66%; redução de rotação externa de quadril de 84% para 66%; melhora em geno valgo de joelhos de 33% para 16%. À vista lateral: redução da projeção da cabeça para frente de 66% para 33%; redução de ombros protusos de 66% para 33%. A redução da dor à EVA foi significativa para cinco das seis participantes e, HAS e DM2 com redução expressiva em 100%. Conclui-se que a abordagem cuidativa proximal contribuiu à melhoria da saúde das participantes, potencializou a adesão às atividades físicas regulares no núcleo e se reverteu em mais aquisição de benefícios ao processo de viver humano saudável ao longeviver.

Evaluation of upper extremity function and its relation to curve pattern in female adolescents with idiopathic scoliosis: a pilot study.

Cross-sectional and clinical measurement. To evaluate upper extremity function and its relation to the curve pattern in idiopathic scoliosis. Postural alterations and trunk distortions-caused by three-dimensional deformity itself in idiopathic scoliosis-may lead to functional changes in the upper extremity of subjects. Handgrip, pulp and lateral pinch strengths, hand dexterity, hand reaction time, coordination of upper extremity, upper extremity performance, throwing accuracy, and self-reported upper extremity disability were evaluated in 96 subjects. These subjects were divided into 3 groups: 47 with main thoracic curve pattern scoliosis (Lenke type 1), 31 with thoracolumbar/lumbar curve pattern scoliosis (Lenke type 5), and 18 unaffected (healthy control). Comparisons were performed between these three groups. The thoracic scoliosis group showed a significant decrease in concave lateral pinch strength, concave hand dexterity of turning, coordination of the upper extremities, and concave hand reaction time than the thoracolumbar/lumbar scoliosis group (p < 0.05). Bilateral handgrip strengths decreased in thoracic scoliosis group when compared to healthy controls. Healthy individuals demonstrated greater throwing accuracy than individuals with scoliosis. Upper extremity function was found to be affected based on the curve pattern. Individuals with main thoracic curves are likely to have deteriorated upper extremity function, especially for hand-specific motor skills, on the concave side, when compared to lumbar curves and healthy controls. Level III.

Identification of New Biomarkers of Posturo-Locomotor Instability in a Rodent Model of Vestibular Pathology.

The vestibular system plays a crucial role in maintaining postural balance. Unilateral vestibular lesions result in a typical syndrome characterized by postural imbalance, altered locomotor patterns and gaze stabilization, as well as cognitive and neurovegetative disorders. One of the main difficulties encountered in the development of new anti-vertigo drugs is the lack of sensitivity in the evaluation of this syndrome. Qualitative assessments of the vestibular syndrome have been developed, but methods of conducting quantitative evaluations are critically lacking. Recently, assessments with a dynamic weight-bearing device (DWB®, Bioseb) revealed postural alterations in rats subjected to unilateral vestibular neurectomy (UVN). Our team is evaluating a new version of this device capable of quantifying additional parameters of postural and locomotor equilibrium. The objective of this study was to use this device to assess these new posturo-locomotor parameters in a rat model of a vestibular pathology. The biomarkers measured by this device are as follows: the barycenter, the support surface and the weight distribution of the rats when they were moving or stationary. Before UVN, the rats showed a symmetric distribution of their weight along the lateral axis. In the acute phase after UVN on the left side, the rats distributed more weight on the right side than on the left side and then distributed more weight on the left side. These results corroborate those presented in our previous study. The support surface of the rats increased between 1 day and 30 days after UVN, and the barycenter distribution reflected the weight distribution. In addition, our results show smaller changes in the weight distributions when the animals are moving compared with when they are stationary in the acute phase after UVN. This study provides new information on the static and dynamic postural balance patterns observed after unilateral vestibular loss in rats. These data are relevant because they objectively quantify the posturo-locomotor component of vestibular syndrome as well as the compensatory strategies used after vestibular loss. These results may guide the development of rehabilitation protocols for vestibular patients and the validation of pharmacological compounds favoring the restoration of equilibrium.

Compensation of stochastic time-continuous perturbations during walking in healthy young adults: An analysis of the structure of gait variability

BackgroundDuring everyday locomotion, we cope with various internal or external perturbations (e.g. uneven surface). Uncertainty exists on how unpredictable external perturbations increase noise within the motor system and if they are compensated by employing covariation of the limb joints or rather due to decreased sensitivity of an altered posture. Research questionDo continuous stochastic perturbations affect the structure of gait variability in young and healthy adults? MethodsIn a cross-over study, gait kinematics of 21 healthy young sports students were registered during treadmill walking with and without continuous stochastic perturbations. Using the TNC method, the following aspects were analyzed: (a) the sensitivity of body posture to perturbations (‘tolerance’) decreasing gait variability, (b) the unstructured motor ‘noise’ increasing gait variability and (c) the amount of ‘covariation’ of the limb joints. ResultsCompared to normal walking, gait variability was significantly increased (p < .001) during walking with perturbations. The negative effect of noise was partly compensated by improved ‘covariation’ of leg joints (p < .001). The aspect ‘tolerance’ had a small effect on increasing gait variability during stance phase (p < .001) and decreasing gait variability during swing phase (p < .001). SignificanceIncreased motor noise due to external perturbations is partly compensated by improved covariation of the limb joints. However, the effect of an altered posture slightly affects gait variability. Further studies should focus on different populations (e.g. older participants) to see if they use the same mechanism (improved covariation) to compensate for stochastic perturbations.