Do imbalance situations stimulate a spinal straightening reflex in patient with adolescent idiopathic scoliosis?

Correlation between balance and Adolescent Idiopathic Scoliosis (AIS) is still unclear. To identify the most useful type of physical exercises to be proposed for conservative treatment, is interesting to explore better this field. Our aim was to evaluate the changes of scoliosis curves in a group AIS patients while submitted to an unbalancing situation. We considered in a pre-post trial 14 AIS patients (46 curves), 12 to 15 years old, with 19.3+/-9.9 degrees Cobb curves. Assessment has been made using GOALS (Global Optoelectronic Approach for Locomotion and Spine), a non-ionising instrument that allow a 3D reconstruction of the spine. We evaluated the patients twice in a standardised standing position: on the floor, and on a sway bench. On the sway bench there was a statistically (but not clinically) significant reduction of the curves. This was confirmed considering the average of the curves of each patient, but not when considering the worst curve. Looking at the curves, 13% worsened and 33% improved, versus 14% and 43% respectively looking at the patients. We did not find similar reactions in all patients, but in general a spinal straightening reflex while on a sway bench appears. In any case these variations are of low degree.

A systematic review of physical and rehabilitation medicine topics as developed by the Cochrane Collaboration.

The aim of this paper is to give an overview of the Cochrane Collaboration, its development over the years, and its usefulness for physical and rehabilitation medicine specialists. After introducing the Cochrane Collaboration, we systematically analyzed all titles of the reviews in each of the 50 review groups. For ''Rehabilitation,'' we included not only exercise and physical therapy, but also all of the educational and pharmacological interventions aimed at supporting rehabilitation. The search was performed using Issue 2, 2007 of the Cochrane Library. We retrieved 138 completed reviews that dealt with rehabilitation interventions performed by 20 review groups. No umbrella reviews could be found at present. The most prolific groups in the rehabilitation field were: musculoskeletal (28 reviews), stroke (20), back (18), and the movement disorder group (13). The most discussed intervention was exercise (37 reviews), dealing with physical medicine (20) and pharmacological intervention (11). Six other reviews dealt with multidisciplinary rehabilitation. Low back pain treatment and stroke were the most investigated topics. The Cochrane Collaboration serves today as a main step in increasing an evidence-based approach to medicine and rehabilitation. Europa Medicophysica is continuously increasing its importance and presence in the world of physical and rehabilitation medicine, and part of its mission is to increase and strengthen an evidence-based approach to this field. We will continue to look at the contents of the Cochrane database and regularly report on its updates concerning topics of interest for physical and rehabilitation medicine.