Camptocormia in a young man with anti-GAD-seropositive stiff-person syndrome.

Stiff-person syndrome (SPS) usually manifests as an autoimmune neuromuscular disorder characterised by pronounced and advancing rigidity, primarily affecting the trunk and proximal muscles. There are various clinical subtypes like classic SPS (truncal stiffness, generalised rigidity and muscle spasms), partial SPS (stiff-limb syndrome) and uncommon forms including progressive encephalomyelitis with rigidity and myoclonus. Camptocormia, defined as forward flexion of the spine in the upright position that disappears in the supine position, without fixed deformity, has been described only in two cases as an initial presentation of Anti glutamic acid decarboxylase (GAD) autoimmunity. We encountered a young male presenting with a progressive forward-leaning posture and involuntary rhythmic movements in the lower limb. Diagnostic workup included MRI, blood routines, autoimmune screening, genetic testing, lumbar puncture and electromyography. Elevated serum anti-GAD antibody levels, inflammatory CSF and certain other clinical features supported the diagnosis of SPS. Treatment involved benzodiazepines, muscle relaxants and immunotherapy with intravenous immunoglobulin. This case underscores the importance of considering immune-mediated causes, such as SPS, in patients presenting with camptocormia.

Severidade da disfunção temporomandibular e sua relação com a postura corporal / Gravedad de la disfunción temporomandibular y su relación con la postura corporal / Severity of temporomandibular dysfunction and its relationship with body posture

RESUMO O objetivo deste estudo foi identificar se existe correlação entre a severidade da disfunção temporomandibular (DTM) e postura corporal, bem como evidenciar as diferenças existentes na postura corporal nos diferentes graus de severidade. Foram avaliadas 71 mulheres de 18 a 35 anos quanto à severidade da DTM e à postura corporal, sendo divididas em grupo sem DTM e grupo com DTM. Foram utilizados o questionário Mandibular Function Impairment Questionnaire e o software Digital Image-Based Postural Assessment de avaliação postural por fotogrametria. Foi realizada análise estatística com ANOVA de um fator e teste de correlação Tau B de Kendall (α<0,05). Os grupos com e sem DTM apresentaram diferenças estatísticas, com tamanho de efeito grande (ŋ2>0,528), para: lordose cervical, pulsão e inclinação da pelve. Quanto à correlação da postura com a severidade da DTM, índices fracos, mas significativos, foram encontrados: ângulo da lordose cervical (τ=0,250), ângulo da cifose dorsal (τ=0,192), ângulo de inclinação pélvica (τ=−0,222) e medida de pulsão da pelve (τ=0,283). Esses resultados indicam que a lordose cervical e a pulsão da pelve se apresentam em aumento da lordose e da pulsão conforme o acréscimo da severidade da DTM, enquanto o ângulo de inclinação se apresenta em menor grau, tendendo à retroversão. Apesar das correlações fracas, os resultados evidenciam alguma relação da postura corporal com a DTM.

RESUMEN El objetivo de este estudio fue identificar si existe una correlación entre la gravedad de la disfunción temporomandibular (DTM) y la postura corporal, así como mostrar las diferencias en la postura corporal en diferentes grados de gravedad. Se evaluó la la postura corporal de 71 mujeres de 18 a 35 años, divididas en dos grupos: sin DTM y con DTM. Se utilizó el cuestionario Mandibular Function Impairment Questionnaire y el software Digital Image-Based Postural Assessment de evaluación postural por fotogrametría. Se realizó análisis estadístico con Anova de un factor y prueba de correlación Tau B de Kendall (α<0,05). Los grupos con y sin DTM presentaron diferencias estadísticas, con tamaño de efecto grande (ŋ2>0,528) para: lordosis cervical, pulsión e inclinación de la pelvis. En cuanto a la correlación de la postura con la gravedad de la DTM, índices débiles pero significativos fueron encontrados: ángulo de la lordosis cervical (τ=0,250), ángulo de la cifosis dorsal (τ=0,192), ángulo de inclinación pélvica (τ=−0,222) y medida de pulsión de la pelvis (τ=0,283). Estos resultados indican que la lordosis cervical y la pulsión de la pelvis aumentan según la gravedad de la DTM, mientras que el ángulo de inclinación se presenta en menor grado, tendiendo a la retroversión. A pesar de las correlaciones débiles, los resultados evidencian cierta relación de la postura corporal con la DTM.

ABSTRACT This study aimed to identify if there is a correlation between temporomandibular dysfunction (TMD) severity and body posture, as well as to show the differences in body posture in different degrees of severity. Seventy-one women aged 18-35 years were assessed for TMD severity and body posture and were divided into: Group without TMD and Group with TMD. We used the Mandibular Function Impairment Questionnaire and the Digital Image-Based Postural Assessment software for postural evaluation by photogrammetry. Statistical analysis was performed with one-way ANOVA and Kendall's Tau B correlation test (α<0.05). The groups with and without TMD presented statistical differences, with large effect size (ŋ2>0.528), for: cervical lordosis, drive and pelvic tilt. Regarding the correlation of posture with TMD severity, weak but significant indexes were found: cervical lordosis angle (τ=0.250), dorsal kyphosis angle (τ=0.192), pelvic tilt angle (τ=−0.222) and pelvic drive measurement (τ=0.283). These results indicate that cervical lordosis and pelvic drive are increased according to the severity of the TMD, while the pelvic tilt angle decreases, tending to a retroversion. Despite the weak correlations, the results show some relationship between body posture and TMD.

Spinal deformities after selective dorsal rhizotomy / Deformidades da coluna vertebral após rizotomia dorsal seletiva / Deformidades espinales luego de rizotomía dorsal selectiva

ABSTRACT Objective: Selective dorsal rhizotomy (SDR) used for spasticity treatment could worsen or develop spinal deformities. Our goal is to describe spinal deformities seen in patients with cerebral palsy (CP) after being treated by SDR. Methods: Retrospective study of patients operated on (SDR) between January/1999 and June/2012. Inclusion criteria: spinal Rx before SDR surgery, spinography, and assessment at follow-up. We evaluated several factors emphasizing level and type of SDR approach, spinal deformity and its treatment, final Risser, and follow-up duration. Results: We found 7 patients (6 males): mean age at SDR 7.56 years (4.08-11.16). Mean follow-up: 6.64 years (2.16-13), final age: 14.32 years (7.5-19). No patient had previous deformity. GMFCS: 2 patients level IV, 2 level III, 3 level II. Initial walking status: 2 community walkers, 2 household walkers, 2 functional walkers, 1 not ambulant, at the follow-up, 3 patients improved, and 4 kept their status. We found 4 TL/L laminotomies, 2 L/LS laminectomies, and 1 thoracic laminectomy. Six spinal deformities were observed: 2 sagittal, 3 mixed, and 1 scoliosis. There was no association among the type of deformity, final gait status, topographic type, GMFCS, age, or SDR approach. Three patients had surgery indication for spinal deformity at skeletal maturity, while those patients with smaller deformities were still immature (Risser 0 to 2/3) although with progressive curves. Conclusions: After SDR, patients should be periodically evaluated until they reach Risser 5. The development of a deformity does not compromise functional results but adds morbidity because it may require surgical treatment.

RESUMO Objetivo: A rizotomia dorsal seletiva (SDR) para tratamento da espasticidade pode piorar ou desenvolver deformidades da coluna vertebral. Nosso objetivo é descrever as deformidades da coluna observadas em pacientes com paralisia cerebral (PC) depois de serem submetidos à SDR. Métodos: Avaliação retrospectiva de pacientes operados (SDR), entre janeiro/1999 e junho/2012. Critérios de inclusão: Radiografias vertebrais prévias, espinografia e avaliação no acompanhamento. Foram avaliados vários fatores com ênfase no nível e tipo de abordagem da SDR, deformidade da coluna vertebral e seu tratamento, Risser final e tempo de acompanhamento. Resultados: Encontramos 7 pacientes (6 do sexo masculino): média de idade à SDR 7,56 anos (4,08-11,16). Acompanhamento médio: 6,64 anos (2,16-13); idade final: 14,32 anos (7,5-19). Nenhum paciente tinha deformidade anterior. GMFCS: 2 pacientes com nível IV, 2 com nível III, 3 com nível II. Estado deambulatório inicial: 2 deambuladores comunitários, 2 deambuladores domiciliares, 2 deambuladores funcionais, 1 Não deambulador; no acompanhamento, 3 melhoraram e 4 mantiveram seu estado. Foram encontradas 4 laminotomias TL/L, 2 laminectomias L/LS, 1 torácica. Foram detectadas 6 deformidades da coluna: 2 sagitais, 3 mistas e 1 escoliose. Não houve nenhuma associação entre o tipo de deformidade e o estado de deambulação final, tipo topográfico, GMFCS, idade nem abordagem da SDR. Três pacientes tinham indicação de cirurgia à maturidade esquelética, mas as deformidades menores eram ainda imaturas (Risser 0 a 2/3), apesar das curvas evolutivas. Conclusões: A coluna deve-se ser avaliada periodicamente depois da SDR até Risser 5. O desenvolvimento de uma deformidade não afeta o resultado funcional, mas sim acrescenta morbidade, pois pode exigir tratamento cirúrgico.

RESUMEN Objetivo: La rizotomía dorsal selectiva (SDR) para el tratamiento de la espasticidad podría empeorar o desarrollar deformidades espinales. Nuestro objetivo es describir deformidades espinales observadas en pacientes con parálisis cerebral (PC) luego de someterse a SDR. Métodos: Evaluación retrospectiva de pacientes operados (SDR) entre enero/1999 y junio/2012. Criterios de inclusión: Rx raquídeas previas, espinograma y evaluación al seguimiento. Se evaluaron diversos factores con énfasis en nivel y tipo de abordaje de SDR, deformidad espinal y su tratamiento, Risser final y tiempo de seguimiento. Resultados: Encontramos 7 pacientes (6 varones): edad promedio a la SDR 7,56 años (4,08 - 11,16). Seguimiento promedio: 6,64 años (2,16 - 13); edad final: 14,32 años (7,5 - 19). Ninguno tenía deformidad previa. GMFCS: 2 pacientes nivel IV, 2 nivel III, 3 nivel II. Estado ambulatorio inicial: 2 Deambuladores Comunitarios, 2 Domiciliarios, 2 Funcionales, 1 No Deambulador; al seguimiento 3 mejoraron y 4 lo mantuvieron. Hubo 4 laminotomías TL/L, 2 laminectomías L/LS y 1 torácica. Se detectaron 6 deformidades espinales: 2 sagitales, 3 mixtas y 1 escoliosis. No hubo asociación entre tipo de deformidad y estado ambulatorio final, tipo topográfico, GMFCS, edad ni abordaje para la SDR. Tres pacientes tuvieron indicación de cirugía; pero estos llegaron a la madurez esquelética, mientras que los de deformidades menores aún son inmaduros (Risser 0 a 2/3) aunque con curvas evolutivas. Conclusiones: Se debe evaluar periódicamente la columna después de SDR hasta Risser 5. La aparición de una deformidad no afecta el resultado funcional pero sí agrega morbilidad pues puede requerir tratamiento quirúrgico.

Minimally invasive percutaneous nephrolithotomy guided by ultrasonography to treat upper urinary tract calculi complicated with severe spinal deformity

ABSTRACT Objective: To report our experience of minimally invasive percutaneous nephrolithotomy(MPCNL) in managing upper urinary tract calculi complicated with severe spinal deformity. Materials and Methods: Between August 2001 to December 2012, 16 upper urinary calculi in 13 patients with severe spinal deformity were treated by MPCNL. Preoperative investigation of the respiratory function, evaluation of anatomy by intravenous urography (IVU) and CT scan, and preoperative kidney ultrasonagraphy with simulation of the percutaneous puncture were performed in all patients. The percutaneous puncture was guided by ultrasonography. Results: A total of 19 MPCNL procedures were performed in 16 kidneys, with an average 1.2 procedures in each kidney. Three kidneys needed two sessions of MPCNL, and 2 kidneys needed combined treatment with retrograde flexible ureterscopic lithotripsy. All procedures were successfully completed with no major complications during or after surgery. The mean (range) operative duration was 67 (20-150) min and the mean postoperative haemoglobin drop was 1.0 (0.2-3.1) g/dL. Complete stone-free status was achieved in 14 kidneys. At a mean follow-up of 48(3-86) months, recurrence of small lower calyx stone was detected in one patient. Recurrent UTI was documented by urine culture in two patients and managed with sensitive antibiotics. Conclusion: PCNL for patients with severe spinal deformities is challenging. Ultrasonography-assisted puncture can allow safe and successfully establishment of PCN tract through a narrow safety margin of puncture and avoid the injury to the adjacent organs. However, the operation should be performed in tertiary centers with significant expertise in managing complex urolithiasis.

Relação entre a excursão do músculo diafragma e as curvaturas da coluna vertebral em crianças respiradoras bucais / The relationship between excursion of the diaphragm and curvatures of the spinal column in mouth breathing children

OBJETIVO: Verificar a relação entre a excursão do músculo diafragma e as curvaturas da coluna vertebral em crianças respiradoras bucais. MÉTODOS: Foram avaliadas 52 crianças de 5 a 12 anos de idade, de ambos os sexos. Por meio de avaliação otorrinolaringológica, foram divididas em dois grupos: respiradores bucais e respiradores nasais. Todos os participantes foram submetidos a exame de videofluoroscopia do músculo diafragma e a avaliação postural. A excursão do diafragma foi analisada pelo programa Adobe Photoshop®, e a avaliação postural através de fotografias em norma lateral esquerda, sendo analisadas pelo Software de Avaliação Postural. RESULTADOS: Os grupos estudados apresentaram diferença estatisticamente significante quanto ao comportamento das curvaturas da coluna vertebral (lordose cervical: p = 0,003; lordose lombar: p = 0,001; cifose torácica: p = 0,002; posição da pelve: p = 0,001) e da excursão do músculo diafragma (diafragma lado direito: p = 0,001; diafragma lado esquerdo: p = 0,001). O grupo respirador bucal apresentou diminuição da lordose cervical, aumento da cifose torácica, aumento da lordose lombar e anteversão da posição da pelve. A distância excursionada pelo músculo diafragma em crianças respiradoras bucais é menor que em crianças respiradoras nasais. Não houve significância estatística ao relacionar o comportamento das curvaturas da coluna vertebral com a excursão do músculo diafragma. CONCLUSÃO: Não há relação entre as curvaturas da coluna vertebral com a excursão do músculo diafragma nos grupos estudados.

OBJECTIVE: To investigate the relationship between excursion of the diaphragm muscle and spinal curvatures in mouth breathing children. METHODS: A total of 52 children of both sexes, aged from 5 to 12 years, were studied. After otorhinolaryngological assessment, the children were divided into two groups: mouth breathers and nose breathers. All of the children underwent videofluoroscopic examination of the diaphragm muscle and postural assessment. Diaphragm excursion was analyzed using Adobe Photoshop® software, and postural assessment was recorded using photographs in left lateral view, which were then analyzed using SAPO postural assessment software. RESULTS: The groups studied exhibited statistically significant differences in terms of spinal curvatures (cervical lordosis: p = 0.003; lumbar lordosis: p = 0.001; thoracic kyphosis: p = 0.002; position of the pelvis: p = 0.001) and diaphragm excursion (right side diaphragm: p = 0.001; left side diaphragm: p = 0.001). The mouth breathing group exhibited reduced cervical lordosis, increased thoracic kyphosis, increased lumbar lordosis and the position of the pelvis was tilted forward. The distance traveled outwards by the diaphragm muscles of mouth breathing children was shorter than that traveled by the muscles of nose breathing children. The relationship between the behavior of spinal curvatures and diaphragm excursion had no statistical significance. CONCLUSION: There was no relationship between spinal curvatures and diaphragm excursion in the groups studied here.

Cribado de la escoliosis en una población escolar de 8 a 12 años de la provincia de Granada / Screening of scoliosis in a school population of 8 to 12 yearsin the province of Granada (Spain)

La escoliosis es una enfermedad que altera la columna vertebral de forma tridimensional; puede producirse en cualquier etapa de la vida, aunque la mayoría de las veces surge a partir de los 10 años de edad. Es tarea de los estamentos encargados cuidar de los escolares (médicos, fisioterapeutas y docentes) detectar esta deformidad del raquis. Son varios los objetivos planteados en este estudio. En primer lugar, detectar la alteración raquídea (escoliosis) en la población escolar de 8 a 12 años de la provincia de Granada; en segundo, establecer las relaciones entre los grupos de edad y sexo en la población con escoliosis de la provincia de Granada y, por último, determinar si la aparición de dicha alteración tiene mayor incidencia en determinadas zonas geográficas de Granada y su provincia. Por tanto, se realiza un estudio de carácter descriptivo y transversal de la población escolar (n=2.956) de la provincia de Granada analizándose las manifestaciones clínicas positivas mediante el método del test de Adams de los individuos con escoliosis. Un 16 % (n=472) de escolares presentó escoliosis, de los cuales el 57,6 % (n=272) eran varones; la distribución de niños y niñas de 8 a 12 años es bastante homogénea y no se aprecian diferencias significativas (p=0,62). Por zonas destaca una mayor incidencia de escoliosis en la zona 5 (Alpujarra-Valle de Lecrín). Se llega a la conclusión de que en la escoliosis no se aprecian diferencias significativas en función de los grupos de edad (8 a 12 años), que existe una tendencia mayor hacia el sexo varón y que se aprecian diferencias en cuanto a las siete zonas de estudio definidas por componentes laborales, ambientales, genéticos y de consanguinidad (AU)

The scoliosis is a disease that affects the three-dimensional shape of the spine, which may occur at any stage of life but mainly arises from 10 years of age, and it is everyone's job (doctors, physiotherapists and teachers) responsible for managing the schoolchild to detect this spinal deformity. Therefore, we included a number of objectives in our study; first to detect the spinal disorder (scoliosis) in the school population from 8 to 12 years of Granada province; to establish the relationships between age groups and gender in people with scoliosis in the province of Granada; and finally to determine whether the occurrence of such changes have a greater impact on certain geographical areas in Granada province. Thus, this is a descriptive and cross-sectional study of a school population (n=2,956) in the province of Granada analyzed the positive clinical signs using the Adams Test on individuals with scoliosis. Of the 16 % (n=472) of schoolchildren who had scoliosis, 57.6 % (n=272) were male. The distribution of children from 8 to 12 years is fairly homogeneous with no differences seen (p=0.62) and highlight areas of higher incidence of scoliosis in zone 5 (Alpujarra-Valle of Lecrín). We conclude that there are no significant differences in scoliosis as regards age group (8 to 12 years), but there is an increasing trend towards the male gender. Differences can also be observed in the seven areas of study defined by work, environmental, genetic and consanguinity factors (AU)

Factores predictivos de desarrollo de malformaciones raquídeas en el síndrome de Down / Predictive factors for the development of vertebral deformities in Down´s syndrome

Introducción: Son muchos los estudios publicados sobre patología raquídea en personas con síndrome de Down (SD), pero la mayoría se centran en las anomalías atloaxoideas de columna cervical. En cambio, no hay mucha información referente a otras malformaciones como la escoliosis, la cifosis o la lordosis, tal vez porque parece una patología poco frecuente y de poca repercusión física o vital. El objetivo de nuestro estudio era determinar la prevalencia de estas malformaciones raquídeas en un grupo de personas con SD y buscar los factores predictivos que puedan orientar sobre su desarrollo. Pacientes y métodos: Se estudió a un total de 60 personas con SD, 26 mujeres (43,33%) y 34 hombres (56,67%), con una media de edad de 39,8 ± 10,19 años, una media de peso de 65,4 ± 13,55 kg y una media de altura de 1,51 ± 0,4 m. En todas ellas estudiamos las distintas alteraciones de la estática raquídea siguiendo un protocolo establecido de estudio en los tres planos del espacio. Estudiamos sus datos antropométricos y también valoramos la presencia de otras alteraciones que, por su frecuencia, creíamos que podrían guardar relación con las malformaciones raquídeas estudiadas: patologías tiroidea, cardiaca y visual y otros tipos de alteraciones del aparato locomotor, como inestabilidad atloaxoidea, hiperlaxitud ligamentosa y deformidad de extremidades inferiores. Resultados: Un total de 49 personas (81,67%) tenían alguna malformación raquídea, 21 (35%) tenían escoliosis,escoliosis, 19 (31,67%), cifosis y 30 (50%), hiperlordosis lumbar. Quince personas (25%) tenían a la vez dos o más de estas malformaciones. Entre los factores predictivos no se halló ninguna relación con el sexo y la talla, pero sí con la edad: la prevalencia de lordosis lumbar era mayor en las personas de menos edad (p < 0,01), mientras que en las de más edad predominaba la cifosis dorsal (p < 0,001). Cruzando las malformaciones raquídeas con otros trastornos, vimos que quienes tenían algún tipo de patología visual corrían más riesgo de sufrir escoliosis (p < 0,0009), al igual que los que padecían otros tipos de malformaciones esqueléticas (p < 0,02). Conclusiones: La prevalencia de malformaciones raquídeas en el grupo de personas con SD estudiado es muy alta. Con la edad van cambiando las curvaturas: entre los más jóvenes predomina la hiperlordosis lumbar y entre los mayores, la cifosis dorsal. Los que tienen trastornos visuales y otras malformaciones esqueléticas corren más riesgo de sufrir escoliosis. Es opinión de los autores que en este grupo de la población es muy importante prevenir o reducir la aparición de desviaciones raquídeas (AU)

Background. There are many studies on spine pathology in people with Down Syndrome (DS), the majority of these focusing on atlantoaxial anomalies of the cervical column. There is, in contrast, much less information about other malformations such as scoliosis, kyphosis and lordosis, perhaps due to the fact that they are much less frequent pathologies with few physical and life-threatening repercussions. The aim of our study was to determine the prevalence of these spinerelated malformations in a group of patients with DS and to look for factors that might predict the course of their development. Patients and methods. Ee studied a total of 60 people with DS, 26 women (43.33%) and 34 men (56.67%) with an average age of 39.8 ± 10.19 years, weight average of 65.4 ± 13.55 kg, and height average of 1.51 ± 0.4 metres. In all cases, we studied the different alterations of the spine followed by well-established three-dimensional study protocol. We studied anthropometric data for these patients and also evaluated the other alterations which, due to their frequency, were thought that could be potentially related to other spine-induced malformations: thyroidal pathologies, heart and sight related problems and alterations affecting the locomotive apparatus such as atlantoaxial instability, hyperlaxitud of the ligaments and deformation of the lower limbs. Results. Forty-nine (81.67%) of the patients had some spine-related malformations, 21 (35%) had malformations related with scoliosis, 19 (31.67%) with kyphosis, 30 (50%) with lumbar hyperlordosis, and 15 (25%) suffered from 2 or more of these malformations. Sex and height did not seem to be a predictive factors, but age seemed related to lumbar lordosis, with this condition being more prevalent in younger patients (p < 0.01), while dorsal kyphosis was more prevalent in older patients (p < 0.001). On crossing spine-related malformations with other disorders, we noted that patients who suffered some form of visual pathology had a higher risk of suffering from scoliosis (p < 0.0009) and also other types of skeletal malformation (p < 0.02). Conclusions. The number of patients with spine-related malformations was very high in the DS study group. With time, the curvatures change: in young people bone curvature predominantly affects the lumbar hyperlordosis, while in older patients it affects the dorsal kyphosis. Patients with visual disorders and other malformations of the skeleton have a greater risk of suffering scoliosis. We think that in this population group it is very important to prevent or to reduce the column deviations (AU)

Relación entre la curvatura de las vértebras cervicales, la posición de la cabeza y las diferentes maloclusiones / Relation between the curvature of the cervical vertebrae, the head position and the different maloclussions

El propósito de esta revisión bibliográfica es valorar la posible relación entre la posición natural de la cabeza (PNC), la curvatura de las vértebras cervicales y las diferentes maloclusines (MO). Se incluyen en los objetivos de estudio la búsqueda de los factores cráneo-cervico-posturales que pueden influir a la hora de instaurar una MO, o viceversa, qué MO influyen en la curvatura de las vértebras cervicales y, en consecuencia, con la postura de la cabeza y del resto del cuerpo. La posible relación de los diferentes tipos de maloclusiones y la variación en la curvatura de las vértebras cervicales la podemos constatar, en cada sujeto, orientando la cabeza y la columna cervical propia de su sistema postural en el mismo plano (PNC), el plano sagital, ya que es una posición altamente reproducible con una sistemática de error tan mínimo que puede ser considerado despreciable (AU)

The intention of this bibliographical review is to evaluate the possible relation between the natural head position (NHP), the curvature of the cervical vertebrae and the different maloclussions (MO). The aim of this research is to find the cranium-cervical-factors tat can influence at the time of restoring a MO, or vice versa, what cervical vertebrae and, consequently, with the position of the head and the rest of the body. We can state the possible relation of the different types of maloclussions and the variation in the curvature of the cervical vertebrae, in each patient, by orientating the head and the cervical column of its own postural system in the same plane; the sagittal plane, since it is a highly reproducible position, with a systematics of such a minimum error that it can be considered despicable (AU)

Alterações posturais em crianças asmáticas / Degree of pelvic inclination and the level of lumbar lordosis in asthmatic children

Avaliar o grau de inclinação pélvica e o índice de lordose lombar em crianças asmáticas, comparando os valores encontrados com um grupo controle e relacionando-os com a gravidade da asma. Métodos: a amostra foi composta por 36 crianças, sendo 10 asmáticas e 26 não-asmáticas, na faixa etária de 6 a 11 anos de idade. Foram mensurados o grau de inclinação pélvica e o índice de lordose lombar por meio do pal meter e da régua flexível, respectivamente, em ambos os grupos, duas vezes pelo mesmo examinador. Resultados: os grupos foram homogêneos em relação ao sexo, idade, peso e altura. A análise dos resultados obtidos mostrou que não houve diferença significante no índice de lordose lombar e no grau de inclinação pélvica entre os dois grupos estudados e, no grupo dos asmáticos, não houve diferenças de resultados de acordo com a gravidade da doença. Conclusões: os reultados deste estudo, realizado com metodologia simples e recursos não dispendiosos, evidenciaram que a s crianças asmáticas não apresentam alterações posturais significantes associadas à gravidade da doença e quando comparadas às crianças do grupo controle.