Postural Alterations Research Articles

Local high-frequency vibration therapy following eccentric exercises reduces muscle soreness perception and posture alterations in elite athletes.

Exercise-induced muscle damage produces painful sensations (delayed onset of muscle soreness, DOMS). DOMS causes compensatory postural adaptations, which in turn affect athletes' walking and running gait biomechanics. It is still debated whether the postural changes are due to impaired proprioception or pain perception. To disambiguate between these two contrasting hypotheses, we designed a study that tested post-exercise postural adjustments in two groups of athletes: a group who was administered a vibration therapy (VT), to attenuate pain perception, and a control group. Thirty professional futsal players were tested on five different occasions: baseline, eccentric exercises (EE) session day, 24, 48 and 72h after EE. Vibration therapy (120Hz) was applied on legs muscles for 15min in the experimental group, while no vibration was applied in the control group. The measurements included: isokinetic evaluation, stabilometric test, perceived soreness evaluation and serum levels of creatine kinase, and lactate dehydrogenase. 48h after EE, the control group showed changes in biomechanical parameters (antero-rotations of pelvis, p < 0.05). A substantial alteration in the hip kinematics was found, associated to a reduced contractile force (p < 0.01) and soreness perception. On the contrary, the VT group did not show any change in posture and pain perception. High-intensity VT decreases EE effects on muscle strength and DOMS. DOMS significantly changes athletes' posture; but postural changes disappear following a VT therapy that decreases pain perception. It is concluded that soreness perception is the main cause of postural changes and that its effects can be counteracted using VT therapy.

Frozen shoulder or shoulder stiffness from Parkinson disease?

To understand the role of camptocormia (increased kyphosis) and postural alteration in Parkinson's disease in the development of shoulder pathology, with a special concern for adhesive capsulitis and shoulder stiffness. A preliminary online search was carried out, with combination of keywords including "Parkinson," "Shoulder stiffness," "Frozen shoulder," "Adhesive capsulitis," "Postural alteration," "Camptocormia". The retrieved papers were screened by title and abstract and those considered relevant to the aim of the review were read in full text and included. Relevant information were extracted and reported into text. Due to a severe impairment of posture, patients affected by PD show an increased thoracic kyphosis (camptocormia) and decreased mobility of the trunk that can yield a humeroacromial impingement syndrome and capsulitis, resulting in inflammation of the bursa, shoulder pain and reduction of movement. Furthermore, kinematic of the shoulder is allowed by the combined movement of the humerus, the scapula, the clavicle, the thoracic wall and thoracic spine. The thoracic spine and wall mobility are severely impaired in the parkinsonian patient, thus limiting the shoulder motion. The postural alteration observed in PD is the primum movens for shoulder pathology, since anterior tilt of the scapula, which occurs with the increment of thoracic kyphosis, yields to a subacromial impingement. A closed loop is then created, as the rigidity of the shoulder causes further alteration in the posture, which worsens the impingement syndrome and so on.

Assessment of Mandibular Surface Area Changes in Bruxers Versus Controls on Panoramic Radiographic Images: A Case Control Study.

Background:Bruxism is the commonest of the many parafunctional activities of the masticatory system. Opinions on the causes of bruxism were numerous and widely varying. It can occur during sleep as well as wakefulness. Bruxism was for long considered a major cause of tooth wear. Other effects of bruxism may include tooth movement and tooth mobility, as well as changes in oral soft tissues and jaw bone. Since the exact etiology and manifestations are unclear, it was difficult to diagnose Bruxism. In this study, we evaluated the area change as measured from digital panoramic radiographs that can occur in the lower jaw bone in those with Bruxism and compared the results with non-bruxers.Aims and Objective:To determine the surface area changes of the mandible, condylar and coronoid processes in Bruxers from Panoramic radiographs and to compare and contrast the changes with age and gender matched controls.Materials and Methods:The study was conducted in the department of Oral Medicine and Radiology. The total sample size was 40. The sample was divided into two groups, Bruxers and non-bruxers with 20 subjects in each group. Healthy volunteers aged between 20- 30 years diagnosed with Bruxism and Healthy volunteers aged between 20- 30 years diagnosed without Bruxism were included in group II (Non-Bruxers). Bruxchecker was made use of in confirming the Bruxism in Group I. The Panoramic radiograph was used as the imaging modality for the study. The measurements were made with the help of software, Image J. All the measurements were tabulated and statistical analysis was made using ANOVA (Post hoc) followed by Dunnett’s test and unpaired t test.Results:A comparison of the mandibular surface area as a whole and also condylar and coronoid processes individually were carried out. Significant results were obtained in case of condylar and coronoid processes between the two groups. The surface area of condylar process of Group I was found to be lower than that of Group II. The surface area of the right coronoid process of group I was found to be less when compared to that of group II but the values of the left coronoid process of group I was found to be more when compared with group II. The surface area of the mandible showed no significant difference between the groups. There was significant difference between the genders in case of mandible, condyle and coronoid. The surface area of mandible and condylar process was found to be lower in female when compared to male. The surface area of coronoid process was found to be more in case of females when compared to that of males in Group I.The results of our study show that while the overall surface area of bruxers remain unaffected when compared to controls, the condylar and coronoid process show significant change. The hitherto belief that the primary brunt of bruxism is borne by the masseter would require a revisit since alteration in tonicity of the masseter would reflect in surface area change of the mandible as a whole. An increase in the surface area of the coronoid process in bruxers was observed in our study which could be attributed to altered activity of the temporalis, a muscle largely responsible for the posture of the mandible. This could imply that bruxers show alteration in temporalis activity which would explain several clinical manifestations such as headache, neck pain, shoulder pain and altered posture and so on which we have observed in the clinical practice of neuromuscular dentistry. Further studies examining the activity of the temporalis and masseter would further corroborate our findings and form the basis for future research in this arena.Conclusion:This original research was carried out to assess the surface area changes in mandible and condylar and coronoid processes of Bruxers and non-bruxers. The results showed significant changes in the surface area of condylar and coronoid process in Bruxers when compared to the controls. This is an area of study with paucity of available literature. This study would be a stepping stone for future studies in this arena.

Early-onset of symptoms and clinical course of Pompe disease associated with the c.-32–13 T > G variant

BackgroundIndividuals with late-onset Pompe disease (LOPD) and the common c.-32–13 T > G variant are widely thought to have milder, adult-onset disease. This belief, and the consequent low suspicion of clinical involvement in children, has led to delays in diagnosis and treatment initiation in patients with early onset of symptoms. Previous reports of LOPD in children do not include description of the early-onset phenotype. This description of signs and symptoms, some of which are subtle and less known, is important to facilitate prompt identification and appropriate treatment in symptomatic children. MethodsRetrospective chart review of a cohort of 84 LOPD patients with the c.-32–13 T > G variant was conducted to identify patients diagnosed clinically (as opposed to through newborn screening) who had clinically documented symptom-onset within the first two years of life. ResultsFour patients had early onset of symptoms, with age at onset ranging from 10 days to 20 months. Initial symptoms included delay in achievement of gross motor milestones, signs of proximal muscle weakness, swallow and feeding difficulties, and sleep apnea. Early and characteristic alterations in posture and movement were identified in all patients. Age at diagnosis ranged from 10 months to 26 months. Median age at enzyme replacement therapy (ERT) initiation was 23.5 months. Despite ERT, progression of musculoskeletal involvement and residual muscle weakness was evident in all patients, as evidenced by ptosis, myopathic facies, scoliosis, lumbar lordosis, scapular winging, and trunk and lower extremity weakness. Standardized functional assessments showed gross motor function below age level as measured by the Alberta Infant Motor Scales, the Peabody Developmental Motor Scales-2, the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, and the six-minute walk test. ConclusionsOnset of symptoms including delay in achievement of gross motor milestones, signs of proximal muscle weakness, swallow and feeding difficulties, and sleep apnea in the first two years of life is not uncommon in individuals with LOPD and the c.-32–13 T > G variant. Patients with early-onset disease appear to have a more, rapid and severe progression of disease with persistent residual muscle deficits which partially improve with higher doses of ERT. Careful evaluation for specific and characteristic patterns of posture and movement in patients with this variant is necessary to identify those who have early onset of disease. Increased awareness of the early-onset signs and symptoms may also enable early identification of disease onset in children who are diagnosed through newborn screening.

The Influence of Posture and Balance on Voice: A Review

The role of posture in vocal performance is recognized for many years. Speech therapists and singing teachers use this knowledge to correct bad postures to improve vocal quality with good results, although most of that knowledge is empirical.&#x0D; This review evaluates the influence of posture and balance on voice.&#x0D; Modification in posture secondary to exogenous stimulation can affect voice, while alterations to the voice production mechanism can cause modifications in posture.&#x0D; Vocal effort results in segmental alterations of posture, accompanied by global postural changes. Dysphonic individuals demonstrate a greater displacement of the centre of gravity forward, which results in postural instability, increasing muscular work to maintain the posture and balance. After vocal rehabilitation, dysphonic patients presented an improvement in posture parameters in static and dynamic posturography.&#x0D; Posturography evaluation of patients before and after vocal treatment may represent a clinically useful variable in evaluating the efficacy of vocal therapy.

Are the alterations in body posture related to decreased trunk muscle endurance in healthy young adults?

Trunk muscle endurance exercises are commonly used for correcting the postural alterations. However, there is no study investigating the relationship between postural alignment and trunk muscle endurance in healthy young adults. The aim of this study was to examine whether the three-dimensional (3D) body posture is related to trunk muscle endurance in healthy young adults. Forty-two healthy young adults enrolled in this study. For 3D evaluation of the body posture, an internet-based postural assessment system was used. Alterations in posture (head, ribcage, and pelvis) were evaluated by using the Posture Index which represents the total score of postural displacements. The higher Posture Index scores indicate more severe displacements in the posture. Trunk muscle endurance measurements included side bridge, trunk flexors and trunk extensors endurance tests. Spearman's rho was used to evaluate the associations between measured parameters. The median age of the participants were 22 (IQR: 21.0-23.0) years. The only significant correlation was detected between the side bridge endurance test and the total Posture Index score (rho =⁣-0.402, p= 0.008). These results indicated that the alterations of the body posture was significantly related to lower lateral trunk muscle endurance scores. These findings support the importance of trunk muscles, especially lateral trunk musculature to have a better body posture.

Low back pain and disability in military police: an epidemiological study

Abstract Introduction: The low back pain is a major public health problem in industrialized societies, commonly affecting the adult population. The occupation is considered as a risk factor, especially those functions that require physical effort, we have as example the job of the military police, who are exposed to several risk factors, both those who perform administrative activities, and those who perform the ostensive policing. Objective: The aim of this study was to evaluate the prevalence of low back pain among military police, as well the presence of disability and associated factors. Methods: This is an analytical cross-sectional study. Was evaluated the level of disability, pain before and after the work shift, flexibility, postural alterations and anthropometric measures. It was used the regression analysis, considering 95% CI and p &lt; 0.05. Were interviewed 97 military police with mean age of 39.30 (± 5.33), all males. Results: The complaint of low back pain was significantly larger after the work shift, and 82.5% reported difficulties in daily life activities due to low back pain. Conclusion: There is a high prevalence of low back pain and impairment in daily life activities because of military police. The data presented reinforce the need to consider low back pain as a public health problem that affects the whole population, especially the military police.

Frequent postural alterations in patients with different types of temporomandibular disorders

To describe postural alterations according to the type of temporomandibular disorder (TMD). Prior informed consent, 30 patients were included in the study, with a mean age of 27.4 years; 80% women, diagnosed with TMD based on Diagnostic Criteria (DC/ TTM) by a trained researcher in the clinic of the Faculty of Stomatology of the BUAP. Subsequently, a postural analysis (three views) was carried out at the facilities of the School of Physiotherapy of the BUAP using an acetate grid. The results were analyzed with descriptive statistics in the SPSS v20 program. 16.7% of the patients presented muscular TMD, 36.7% joint TMD, and the rest combined TMD. The most common postural alterations were: high shoulder: 93.3%, pelvic tilt: 86.7%, and forward head posture: 83.3%. On average, the patients had between 4 and 5 postural changes. 100% of the patients ha alterations in the side view, while 50% of the patients with TMD of combined origin had alterations in the three views, as well as 45.5% of the patients with TMD of joint origin, and 60% of the patients with TMD of muscular origin. TMD patients present postural changes, mainly forward head posture, pelvic tilt and high shoulder, with special involvement related to muscle and combined diagnosis.

Managing Gait, Balance, and Posture in Parkinson's Disease.

Postural instability and gait difficulties inexorably worsen with Parkinson's disease (PD) progression and become treatment resistant, with a severe impact on autonomy and quality of life. We review the main characteristics of balance instability, gait disabilities, and static postural alterations in advanced PD, and the available treatment strategies. It remains very difficult to satisfactorily alleviate gait and postural disturbances in advanced PD. Medical and surgical interventions often fail to provide satisfactory or durable alleviation of these axial symptoms, that may actually call for differential treatments. Exercise and adapted physical activity programs can contribute to improving the patients' condition. Gait, balance, and postural disabilities are often lumped together under the Postural Instability and Gait Difficulties umbrella term. This may lead to sub-optimal patients' management as data suggest that postural, balance, and gait problems might depend on distinct underlying mechanisms. We advocate for a multidisciplinary approach from the day of diagnosis.

Association between voice disorder and breathing alteration in children

ABSTRACT Objective: to analyze the association between voice disorder and aspects related to breathing mode in children, according to sex. Methods: 250 children, aged six to nine years, attending a public school in São Paulo city, were selected. The collection consisted of spontaneously audio recorded speech samples. The breathing mode was evaluated for lip resting posture and nasal flow. Three audiologists performed the perceptual evaluation of the voice quality, with the help of GIRBAS scale. The results were associated using the chi-square test (p = 0.05). Results: 50.4% females and 49.6% males. As for the overall grade (G), 12.8% had voice disorder with respect to voice quality. In the breathing mode, 36.8% presented alterations in lip posture and 71.2%, in nasal flow. The associations between voice disorder and gender (p = 0.96), lip posture (p = 0.38) and nasal flow (p = 0.18) and between alterations in the nasal flow and sex (p = 0.449) were not confirmed. The association between lip posture and sex revealed significant differences in favor of males (p = 0.003). Conclusion: there was no statistically significant difference associating voice disorders with breathing mode (lip posture and nasal flow) and gender.

Inverted Rearfoot posture in subjects with coexisting patellofemoral osteoarthritis in medial knee osteoarthritis: an exploratory study

BackgroundWhile abnormal rearfoot posture and its relationship to patellofemoral (PF) pain has been thoroughly discussed in the literature, its relationship to patellofemoral osteoarthritis (PFOA) has not been determined. This study aimed to examine whether rearfoot posture is associated with a higher prevalence of radiographic PFOA in a compartment-specific manner in patients with medial tibiofemoral osteoarthritis (TFOA).MethodsParticipants from orthopedic clinics (n = 68, age 56–90 years, 75.0% female), diagnosed with radiographic medial TFOA (Kellgren/Lawrence [K/L] grade ≥ 2) were included in this study. The presence of PFOA and static rearfoot posture were evaluated using a radiographic skyline view and a footprint automatic measurement apparatus, respectively. The relationship between rearfoot posture and PFOA was examined using analysis of covariance and propensity score-adjusted logistic regression analysis.ResultsOn average, patients with coexisting PFOA and medial TFOA (n = 39) had an inverted calcaneus 3.1° greater than those with isolated medial TFOA (n = 29). Increased calcaneus inverted angle was significantly associated with a higher probability of the presence of medial PFOA (odds ratio: 1.180, 95% confidence interval: [1.005, 1.439]; p = 0.043). Calcaneus inverted angle was not associated with higher odds of lateral PFOA presence based on the adjusted values.ConclusionsThe presence of an inverted rearfoot was associated with PFOA. Although these findings do not clearly indicate a biomechanical link between rearfoot posture and PFOA, this study shed light on the potential relationship between altered rearfoot posture and PFOA, as can be seen between rearfoot abnormality and PF pain.

A comparison of upper body and limb postures across technology and handheld device use in college students.

[Purpose] People using technology and handheld devices adopt postures of the upper limb and neck that could result in musculoskeletal pathology. Previous research has explored the postures assumed during isolated use of technology devices, such as a smartphone, however a comparison of posture assumed between multiple devices has not been completed. The purpose of this study was to compare the posture of the upper body and limb between handheld devices and technology. [Participants and Methods] Twenty one healthy college students completed this study. Pictures of participants were taken in a neutral posture and as they performed standard tasks with 3 devices (mobile phone, tablet, laptop). A mobile application calculated sagittal and coronal plane posture variables, which were compared between device conditions with an ANOVA and post-hoc tests. [Results] Head translation and angulation and shoulder angulation varied significantly between conditions in both planes. Shoulder translation varied significantly between conditions in the sagittal plane. Rib translation varied significantly between conditions in the coronal plane. Tablet use produced postures that were statistically different than the other devices. [Conclusion] Use of each device altered posture however, frequent, regular use of a tablet may produce greater deleterious effects than regular use of other handheld devices/technology.

Effects of Muscle Energy Technique versus Mobilization on Pain and Disability in Post-Partum Females with Sacroiliac Joint Dysfunction

Post Partum phase is the period immediately after delivery till 6 weeks. Low back pain due to sacroiliac Dysfunction is commonly experienced during this phase due to physiological changes which happen during pregnancy as well as biomechanical changes which leads to altered posture. Current study intended to compare the effects of 2 different manual therapy techniques i.e. Mobilization and Muscle Energy Technique (MET) on pain and disability in Post partum females diagnosed with Sacroiliac dysfunction. 30 subjects were randomly allocated into 2 groups, Group A(Mobilization) and Group B (Muscle Energy Technique) with 15 subjects allocated in each group using Simple Random Sampling. Readings were taken for Numeric Pain Rating Scale (NPRS) and Modified Oswestry Disability Index (MODI) on baseline and at the end of 4th week. Analysis of data collected was done by using SPSS Software version 16. Results showed that although both the groups (A&B) improved at the end of 4th week, the results of Group B were more significant compared to group A in terms of reducing pain (p= 0.03) and disability (0.036). Muscle Energy Technique was found to be more effective in females with post partum low back pain due to Sacroiliac dysfunction as measured by Numeric Pain Rating Scale and Modified Oswestry Disability. The results could be explained on the basis of neurophysiological and mechanical effects of MET on pain.

Assessing Infant Carriage Systems: Ground Reaction Force Implications for Gait of the Caregiver

ObjectiveTo assess the acute alterations of anterior infant carriage systems on the ground reaction force experienced during over-ground walking.BackgroundPrevious research has identified the alterations in posture and gait associated with an increased anterior load (external or internal); however, the forces applied to the system due to the altered posture during over-ground walking have not been established.MethodThirteen mixed gender participants completed 45 over-ground walking trials at a self-selected pace under three loaded conditions (unloaded, semi-structured carrier 9.9 kg, and structured carrier 9.9 kg). Each trial consisted of a 15-m walkway, centered around a piezoelectric force platform sampling at 1,200 Hz. Differences were assessed between loaded and unloaded conditions and across carriers using paired samples t tests and repeated measures ANOVA.ResultsAdditional load increased all ground reaction force parameters; however, the magnitude of force changes was influenced by carrier structure. The structured carrier displayed increased force magnitudes, a reduction in the time to vertical maximum heel contact, and an increased duration of the flat foot phase in walking gait.ConclusionEvidence suggests that the acute application of anterior infant carriers alters both kinetic and temporal measures of walking gait. Importantly, these changes appear to be governed not solely by the additional mass but also by the structure of the carrier.ApplicationThese findings indicate carrier structure should be considered by the wearer and may be used to inform policy in the recommendation of anterior infant carriage systems use by caregivers.

AVALIAÇÃO DA IMAGEM POSTURAL NA DOENÇA DE PARKINSON: UM ESTUDO DE DESENVOLVIMENTO

Introdução: Indivíduos com Doença de Parkinson (DP) geralmente apresentam alterações posturais decorrentes do componente de balanço (perda de reflexos posturais) e do componente postural de orientação, como postura flexora, camptocormia, síndrome de Pisa e antecollis. Objetivo: Desenvolver um instrumento para avaliar a percepção da imagem postural (IP) de pessoas com DP. Metodologia: Estudo de desenvolvimento, com natureza aplicada. Resultados: A escala desenvolvida denominou-se EAIP-DP (Escala de Avaliação da Imagem Postural- Doença de Parkinson). Foram consideradas 3 vistas: sagital, com doze desenhos da postura ereta até camptocormia; frontal, com doze desenhos da postura alinhada até a síndrome de Pisa; e sagital da cabeça, com seis desenhos da postura alinhada para retificação até antecollis. Os desenhos foram numerados de 1 a 6, onde 1 representou maior deformidade e 6, ausência de deformidade. A média dos valores das imagens variou de 1 a 6, considerando-se a percepção de deformidade como ausente, leve, média e grave. Conclusão: O instrumento desenvolvido nessa pesquisa, EAIP-DP, incluiu desenhos criados para representar progressivamente as alterações posturais específicas da DP, de modo a detectar o nível de percepção da IP relacionado às deformidades. Alteração da IP pode apresentar impacto sobre o equilíbrio, qualidade da marcha e do movimento corporal. Futuras pesquisas são necessárias para avaliar a validade e a confiabilidade da escala proposta.

Adjustment of the dynamic weight distribution as a sensitive parameter for diagnosis of postural alteration in a rodent model of vestibular deficit.

Vestibular disorders, by inducing significant posturo-locomotor and cognitive disorders, can significantly impair the most basic tasks of everyday life. Their precise diagnosis is essential to implement appropriate therapeutic countermeasures. Monitoring their evolution is also very important to validate or, on the contrary, to adapt the undertaken therapeutic actions. To date, the diagnosis methods of posturo-locomotor impairments are restricted to examinations that most often lack sensitivity and precision. In the present work we studied the alterations of the dynamic weight distribution in a rodent model of sudden and complete unilateral vestibular loss. We used a system of force sensors connected to a data analysis system to quantify in real time and in an automated way the weight bearing of the animal on the ground. We show here that sudden, unilateral, complete and permanent loss of the vestibular inputs causes a severe alteration of the dynamic ground weight distribution of vestibulo lesioned rodents. Characteristics of alterations in the dynamic weight distribution vary over time and follow the sequence of appearance and disappearance of the various symptoms that compose the vestibular syndrome. This study reveals for the first time that dynamic weight bearing is a very sensitive parameter for evaluating posturo-locomotor function impairment. Associated with more classical vestibular examinations, this paradigm can considerably enrich the methods for assessing and monitoring vestibular disorders. Systematic application of this type of evaluation to the dizzy or unstable patient could improve the detection of vestibular deficits and allow predicting better their impact on posture and walk. Thus it could also allow a better follow-up of the therapeutic approaches for rehabilitating gait and balance.

Efficacy of corrective exercise strategy in subjects with hyperkyphosis.

Age-related hyperkyphosis causes deleterious effects on health, physical function, and quality of life. Recently, health care providers recognized it as a major health concern. To identify the effect of corrective exercise strategy on hyperkyphosis and compare it with that of conventional exercise. Subjects were randomly categorized into two groups. Each group comprised 30 subjects. Group A received the corrective exercise strategy, and group B received conventional exercises for 8 weeks of the study duration (15 repetitions of each exercise for three sessions/day for a total duration of 45 min and 4 days/week. Pre- and post-interventional hyperkyphosis were analyzed according to posture number using the Posture Pro 8 postural analysis software. In addition, pectoralis minor flexibility was assessed using the ruler scale method in centimeters. Both groups showed highly significant postural alteration and changes in pectoralis minor muscle length (p< 0.001)CONCLUSIONS:The corrective exercise strategy seems to promote scapular stability and produce a more upright posture of the upper thoracic spine.

A method to quantify the "cone of economy".

A non-randomized, prospective, concurrent control cohort study. The purpose of this study is to develop and evaluate a method to quantify the dimensions of the cone of economy (COE) and the energy expenditure associated with maintaining a balanced posture within the COE, scoliosis patients and compare them to matched non-scoliotic controls in a group of adult degenerative. Balance is defined as the ability of the human body to maintain its center of mass (COM) within the base of support with minimal postural sway. The cone of economy refers to the stable region of upright standing posture. The underlying assumption is that deviating outside one's individual cone challenges the balance mechanisms. Adult degenerative scoliosis (ADS) patients exhibit a variety of postural changes within their COE, involving the spine, pelvis and lower extremities, in their effort to compensate for the altered posture. Ten ADS patients and ten non-scoliotic volunteers performed a series of functional balance tests. The dimensions of the COE and the energy expenditure related to maintaining balance within the COE were measured using a human motion video capture system and dynamic surface electromyography. ADS patients presented more COM sway in the sagittal (ADS: 1.59 cm vs. H: 0.61 cm; p = 0.049) and coronal (ADS: 2.84 cm vs. H: 1.72 cm; p = 0.046) directions in comparison to the non-scoliotic control. ADS patients presented with more COM (ADS: 33.30 cm vs. H: 19.13 cm; p = 0.039) and head (ADS: 31.06 cm vs. H: 19.13 cm; p = 0.013) displacements in comparison to the non-scoliotic controls. Scoliosis patients expended more muscle activity to maintain static standing, as manifest by increased muscle activity in their erector spinae (ADS: 37.16mV vs. H: 20.31mV; p=0.050), and gluteus maximus (ADS: 33.12mV vs. H: 12.09mV; p=0.001) muscles. We were able to develop and evaluate a method that quantifies the COE boundaries, COM displacement, and amount of sway within the COE along with the energy expenditure for a specific patient. This method of COE measurement will enable spine care practitioners to objectively evaluate their patients in an effort to determine the most appropriate treatment options, and in objectively documenting the effectiveness of their intervention.

Effects of high-heeled footwear on static and dynamic pelvis position and lumbar lordosis in experienced younger and middle-aged women

There is still conflicting evidence about the effect of high-heeled footwear on posture, especially if methodological confounders are taken into account. The purpose of this study was to investigate the effect of high-heeled footwear on lumbopelvic parameters in experienced younger and middle-aged women while standing and walking. Thirty-seven experienced younger (n=19:18–25 years) and middle-aged (n=18:26–56 years) women were included in this randomized crossover study. Using a non-invasive back shape reconstruction device (rasterstereography), static (pelvic tilt and lumbar lordosis angle) and dynamic (pelvic rotation, median lumbar lordosis angle and range of motion) parameters representing pelvis position and lumbar curvature were measured. In order to analyse standing and walking on a treadmill (0.83m/s), the effects of high-heels (7–11cm) were compared to standard control shoes. There were no effects on the lumbar lordosis angle or range of motion under static or dynamic conditions (p>0.05, d≤0.06). But there was a small effect for a reduced pelvic tilt (p=0.003, d=0.24) and a moderate effect for an increased transversal pelvic rotation (p=0.001, d=0.63) due to high heel shoed standing or walking, respectively. There were no significant age-group or interaction effects (p>0.05).Altered pelvic parameters may be interpreted as compensatory adaptations to high-heeled footwear rather than lumbar lordosis adaptations in experienced wearers. The impact of these findings on back complaints should be revisited carefully, because muscular overuse as well as postural load relieving may contribute to chronic consequences. Further research is necessary to examine clinically relevant outcomes corresponding to postural alterations.

Relação entre a mobilidade diafragmática e as curvaturas da coluna vertebral em pacientes com doença pulmonar obstrutiva crônica

RESUMO Na doença pulmonar obstrutiva crônica (DPOC), os pacientes podem apresentar redução da mobilidade diafragmática e uma série de compensações na coluna torácica, nas cinturas escapular e pélvica. No entanto, não está clara a relação da mobilidade diafragmática com alterações posturais na coluna vertebral e na pelve desses indivíduos. Objetivou-se verificar se existe relação entre a mobilidade diafragmática com as curvaturas da coluna vertebral de pacientes com DPOC e em indivíduos aparentemente saudáveis. Foram avaliados 22 pacientes com DPOC e 22 indivíduos aparentemente saudáveis. As avaliações foram: antropometria, espirometria, mobilidade diafragmática e avaliação postural. Foram analisadas quatro alterações posturais: lordose cervical, cifose torácica, lordose lombar, posição pélvica. Não houve diferença estatisticamente significativa entre os grupos, em relação às variáveis idade, massa corporal, estatura e IMC, confirmando que os grupos foram pareados. Não houve diferença estatisticamente significante em nenhuma das variáveis referentes às curvaturas da coluna vertebral e à posição da pelve entre os grupos estudados. No grupo DPOC houve correlação da mobilidade diafragmática com a cifose torácica (r=-0,543; p=0,009). Já em relação ao grupo de indivíduos aparentemente saudáveis, não houve correlação da mobilidade quanto os indivíduos aparentemente saudáveis apresentaram os mesmos ângulos de curvatura da coluna vertebral e a mesma posição da pelve. Contudo, os pacientes com DPOC apresentaram relação entre a mobilidade diafragmática e o ângulo da curvatura torácica.