CHD7 gene polymorphisms in female patients with idiopathic scoliosis.

BACKGROUND: The CHD7 (chromosome domain helicase DNA binding protein 7) gene has been associated with familial idiopathic scoliosis (IS) in families of European descent. The CHD7 single-nucleotide polymorphisms have never been studied in Polish Caucasian IS patients. METHODS: The aim of this study was to investigate the relationship of CHD7 gene polymorphisms with susceptibility to or progression of IS in Polish Caucasian females. The study group comprised 211 females who underwent clinical, radiological and genetic examination. The study group was analyzed in three subgroups according to: (1) Cobb angle (Cobb angle ≤30° vs. Cobb angle ≥35°), (2) age of diagnosis (adolescent IS vs. early-onset IS) and (3) rate of progression (non-progressive vs. slowly progressive vs. rapidly progressive IS). The control group comprised 83 females with no scoliosis and with a negative family history who underwent clinical and genetic examination. In total six CHD7 gene polymorphisms were examined. Three polymorphisms (rs1017861, rs13248429, and rs4738813) were examined by RFLP (restriction fragment length polymorphism) analysis, and three were quantified by Sanger sequencing (rs78874766, rs4738824, and rs74797613). RESULTS: In rs13248429, rs78874766, and rs74797613 polymorphisms only the wild allele was present. The rs1017861 polymorphism demonstrated an association with IS susceptibility (p < 0.01). Two polymorphisms, rs1017861 and rs4738813, were associated with curve severity and progression rate (p < 0.05). None of the evaluated polymorphisms in CHD7 gene showed any association with the age of IS onset. CONCLUSIONS: The polymorphism rs1017861 in CHD7 gene showed an association with IS susceptibility. Two polymorphisms (rs1017861 and rs4738813) were associated with curve severity and progression rate. None of the evaluated polymorphisms in CHD7 gene showed any association with the age of IS onset. Further evaluation of CHD7 gene should be considered as IS modifying factor.

Low back pain in women before and after menopause.

Low back pain is a massive problem in modern population, both in social and economic terms. It affects large numbers of women, especially those aged 45-60. Going through a perimenopausal period is associated with many symptoms, including low back pain. This paper is a review of published research on the association between the perimenopausal age and low back pain. PubMed databases were investigated. After the search was narrowed to "menopausal status, back pain", 35 studies were found. Seven studies, which suited our area of research best, were thoroughly analyzed. All studies show increased pain when women enter this period of their life. There is no agreement among researchers regarding which stage of menopause is the most burdensome. Examples of possible treatments and physiotherapeutic methods targeting low back pain are also presented. Physiotherapeutic procedures used to treat low back pain include exercises in safe positions, balance exercises, manual therapy, massage and physical measures.

Scoliosis Research Society (SRS) Criteria and Society of Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) 2008 Guidelines in Non-Operative Treatment of Idiopathic Scoliosis.

According to the Scoliosis Research Society (SRS), idiopathic scoliosis (IS) is a curvature of more than 10° Cobb angle, affecting 2-3% of pediatric population. Idiopathic scoliosis accounts for 80% of all scoliosis cases. Non-operative principles in the therapy of idiopathic scoliosis, including Scoliosis Research Society (SRS) criteria and guidelines proposed by the experts of the Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORTS) were presented. The possibility to carry out quality of life assessments in a conservative procedure was also demonstrated. Based on the natural history of idiopathic scoliosis, SRS criteria, SOSORT 2008 experts' opinion and the knowledge of the possibilities of psychological assessment of conservative IS treatment, rules were proposed regarding nonsurgical IS therapy procedures, with special consideration being paid to the proper treatment start time (age, Risser test, biological maturity, Cobb angle), possibility of curvature progression, the importance of physiotherapy and psychological assessment. The knowledge of SRS criteria and SOSORT guidelines regarding the conservative treatment of IS are essential for proper treatment (the right time to start treatment), and supports establishment of interdisciplinary treatment teams, consisting of a physician, a physiotherapist, an orthopedic technician and a psychologist.

Regular School Sport versus Dedicated Physical Activities for Body Posture-A Prospective Controlled Study Assessing the Sagittal Plane in 7-10-Year-Old Children.

Body posture develops during the growing period and can be documented using trunk photography. The study aims to evaluate the body posture in children aged 7-10 years undergoing a dedicated physical activities program versus regular school sport. A total of 400 children, randomly chosen from a cohort of 9300 participating in a local scoliosis screening program, were evaluated twice at a one-year interval. A total of 167 children were involved in regular school sport (control group), while 233 received both school sport and a dedicated physical activities program (intervention group). Standardized photographic habitual body posture examination was performed at enrollment (T0) and one-year after (T1). Sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), chest inclination (CI), and head protraction (HP) were measured. At T0, the body posture parameters did not differ between groups. At T1 in the controls, all five parameters tended to deteriorate (insignificant): SS p = 0.758, LL p = 0.38, TK p = 0.328, CI p = 0.081, and HP p = 0.106. At T1 in the intervention group, the SS decreased (p = 0.001), the LL tended to decrease (p = 0.0602), and the TK, CI, and HP remained unaltered. At T1, the SS and LL parameter differed between groups statistically (p = 0.0002 and p = 0.0064, respectively) and clinically (2.52° and 2.58°, respectively). In 7-10-year-old children, participation in dedicated physical activities tends to improve their body posture compared to regular school sport.

Spirometry Examination of Adolescents with Thoracic Idiopathic Scoliosis: Is Correction for Height Loss Useful?

Loss of body height is observed in patients with idiopathic scoliosis (IS) due to spine curvatures. The study compared pulmonary parameters obtained from spirometry examination considering the measured versus the corrected body height. One hundred and twenty adolescents with Lenke type 1 or 3 IS who underwent preoperative spirometry examination and radiographic evaluation were enrolled. The mean thoracic Cobb angle was 68° ± 12.6, range 48-102°. The difference between the measured and the corrected body height increased with the greater Cobb angle. Using the corrected body height instead of the measured body height significantly changed the predicted values of pulmonary parameters and influenced the interpretation of the pulmonary testing results.

Polish Adaptation of the Italian Spine Youth Quality of Life Questionnaire.

The study aimed to carry on the process of the cultural adaptation of the Italian Spine Youth Quality of Life Questionnaire (ISYQOL) into Polish (ISYQOL-PL). The a priori hypothesis was: the ISYQOL-PL questionnaire is reliable and appropriate for adolescents with a spinal deformity. Fifty-six adolescents (mean age 13.8 ± 1.9) with idiopathic scoliosis (AIS) with a mean Cobb angle 29.1 (±9.7) and two with Scheuermann juvenile kyphosis (SJK) with a kyphosis angle 67.5 (±17.7) degrees were enrolled. All patients had been wearing a corrective TLSO brace for an average duration of 2.3 (±1.8) years. The Institutional Review Board approved the study. The cross-cultural adaptation of the ISYQOL-PL was performed following the guidelines set up by the International Quality of Life Assessment Project. The reliability was assessed using internal consistency (the Cronbach's alpha coefficient) and test-retest reliability (intraclass correlation coefficient ICC2.1, CI = 95%); moreover, floor and ceiling effects were calculated. The internal consistency was satisfactory (Cronbach's alpha coefficient 0.8). The test-retest revealed high reliability with the value of ICC2.1 for the entire group 0.90, CI (0.84 to 0.94). There was neither floor nor ceiling effect for the ISYQOL-PL overall score. The ISYQOL-PL is reliable and can be used in adolescents with spinal deformity.

The Measurement of Health-Related Quality of Life of Girls with Mild to Moderate Idiopathic Scoliosis-Comparison of ISYQOL versus SRS-22 Questionnaire.

This study aimed to compare the Italian Spine Youth Quality of Life Questionnaire (ISYQOL-PL) versus the Scoliosis Research Society-22 (SRS-22) questionnaire scores evaluating the validity of the concurrent and known-groups. Eighty-one girls (mean age 13.5 ± 1.8 years) with idiopathic scoliosis (IS) with a mean Cobb angle of 31.0 (±10.0) degrees were examined, all treated with a corrective TLSO brace for an average duration of 2.6 (±1.9) years. The patients' scores were compared as follows: (1) age: ≤13 years vs. >13 years); (2) scoliosis severity: mild (Cobb angle 10-30°) vs. moderate (Cobb angle > 30°); (3) single curve pattern vs. double curve pattern. Lin's concordance correlation coefficient was used to evaluate the strength of the association between ISYQOL-PL and SRS-22 scores. t-tests were applied to assess if the ISYQOL-PL measure and SRS-22 total score were significantly different in the different groups of patients. The concurrent validity analysis showed a moderate correlation (Lin pccc = 0.47). The ISYQOL-PL showed a significantly better quality of life in mild than moderate scoliosis. The severity of scoliosis but not the age or the curve pattern demonstrated a direct statistically significant effect on patients' quality of life only when evaluated using the ISYQOL-PL.

Postural Stability in Adolescent Girls with Progressive Idiopathic Scoliosis.

The aim of this work was to analyze postural stability of girls having progressive form of idiopathic scoliosis and undergoing specific period of the adolescent growth spurt. Twenty-seven girls, aged 13.4 ± 1.2 years, presenting structural idiopathic scoliosis, thoracic or thoracolumbar pattern, radiological Cobb angle 41.7 ± 17.4° (study group) and 37 healthy girls (control group) were included. The groups were sex, age, height, weight, and BMI matched. Postural stability examination was performed using two stabilometric platforms with visual control (eyes open) at three stages: (1) both legs' stance, (2) left leg stance, and (3) right leg stance. The Center of Pressure (COP) sway path length, the area and the displacement amplitude were compared. For the double stance, no difference in postural stability parameters between the groups was found. However, for the right leg stance, the total sway path length was longer (p = 0.04) and the mean amplitude of the lateral COP displacement was increased (p = 0.03) in the scoliotic group. In conclusion, for double stance, the adolescent girls with progressive form of idiopathic scoliosis revealed fair postural stability compared to control group. An impaired postural control was observed during right leg stance.

Non-structural misalignments of body posture in the sagittal plane.

BACKGROUND: The physiological sagittal spinal curvature represents a typical feature of good body posture in the sagittal plane. The cervical and the lumbar spine are curved anteriorly (lordosis), while the thoracic segment is curved posteriorly (kyphosis). The pelvis is inclined anteriorly, and the lower limbs' joints remain in a neutral position. However, there are many deviations from the optimal body alignment.The aim of this paper is to present the most common types of non-structural misalignments of the body posture in the sagittal plane. MAIN BODY OF THE ABSTRACT: The most common types of non-structural misalignments of body posture in the sagittal plane are as follows: (1) lordotic, (2) kyphotic, (3) flat-back, and (4) sway-back postures. Each one may influence both the skeletal and the muscular system leading to the functional disturbance and an increased strain of the supporting structures. Usually, the disturbances localized within the muscles are analyzed in respect to their shortening or lengthening. However, according to suggestions presented in the literature, when the muscles responsible for maintaining good body posture (the so-called stabilizers) are not being stimulated to resist against gravity for an extended period of time, e.g., during prolonged sitting, their stabilizing function is disturbed by the hypoactivity reaction resulting in muscular weakness. The deficit of the locomotor system stability triggers a compensatory mechanism-the stabilizing function is overtaken by the so-called mobilizing muscles. However, as a side effect, such compensation leads to the increased activity of mobilizers (hyperactivity) and decreased flexibility, which may finally lead to the pathological chain of reaction within the musculoskeletal system. CONCLUSIONS: There exist four principal types of non-structural body posture misalignments in the sagittal plane: lordotic posture, kyphotic posture, flat-back posture, and sway-back posture. Each of them can disturb the physiological loading of the musculoskeletal system in a specific way, which may lead to a functional disorder.When planning postural corrective exercises, not only the analysis of muscles in respect to their shortening and lengthening but also their hypoactivity and hyperactivity should be considered.

Retrospective analysis of idiopathic scoliosis medical records coming from one out-patient clinic for compatibility with Scoliosis Research Society criteria for brace treatment studies.

BACKGROUND: First author attempted to analyse medical records of patients with idiopathic scoliosis for compliance with the Scoliosis Research Society brace studies criteria. A retrospective analysis of medical records of 2705 girls treated from 1989 to 2002 was carried out. METHODS: Age, Cobb, Risser and menarchal status were analyzed for compliance with the Scoliosis Research Society brace studies criteria: a) age ≥10 years, b) Risser 0-2, c) 25-40° Cobb angle, d) no earlier treatment, e) patients before first menses or not more than one year from first menses. RESULTS: It has been found that 183 girls out of 2705 were ≥10 years old and in the range 25-40° Cobb angle. One hundred two out of 2705 patients revealed eligible for brace effectiveness study according to SRS 2005 criteria. 120 out of 2705 patients revealed eligible for brace brace effectiveness study according to SRS-SOSORT 2014 criteria. CONCLUSION: The excluded patients revealed too old or with too significant Cobb angles. This indicates the changing criteria for scoliosis brace treatment over the time. Direct comparison of current results of brace treatment with historical series of cases turns out to be very difficult.