Journal of Clinical Medicine

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10 pages, 3694 KiB

Open AccessArticle

Clinical and Radiographic Results in Thoracic Hyperkyphosis Surgical Treatment Considering the Optimal Distal Fusion Area

by Laura Scaramuzzo, Fabrizio Giudici, Calogero Velluto, Giuseppe Barone, Maria Concetta Meluzio, Antonino Zagra and Luca Proietti

J. Clin. Med. 2024, 13(22), 6799; https://doi.org/10.3390/jcm13226799 - 12 Nov 2024

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Abstract

Introduction: The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of patients who underwent posterior correction and fusion for thoracic hyperkyphosis, with a focus on determining the optimal distal fusion level. Methods: From 2006 to 2012, 26 patients [...] Read more.

Introduction: The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of patients who underwent posterior correction and fusion for thoracic hyperkyphosis, with a focus on determining the optimal distal fusion level. Methods: From 2006 to 2012, 26 patients with a median age of 16.8 years (range 14–25), diagnosed with either idiopathic hyperkyphosis or Scheuermann’s kyphosis, underwent posterior fusion and Ponte osteotomies at two medical centers. Radiographic evaluations were performed preoperatively, immediately postoperatively, and at the final follow-up and included assessments of fusion extension, Cobb angle, sagittal balance, and the presence of junctional kyphosis or discopathy. Results: The median follow-up period was 12.3 years (range 11–17). Good clinical outcomes were observed in 24 patients, with no cases of hardware failure. The distal fusion area included the first lordotic vertebra in 17 patients, the sagittal stable vertebra in four patients, and both in five patients. Cobb angle correction was maintained at 50% at the final follow-up (p > 0.05). Significant sagittal balance correction was achieved in 87% of patients immediately postoperatively and was maintained at the final follow-up (p > 0.05). Junctional kyphosis occurred in two patients whose fusion area included only the first lordotic vertebra. Conclusions: Including at least the first lordotic vertebra in the fusion area is crucial for preventing junctional kyphosis. Extending the fusion to the stable vertebra can reduce the incidence of distal junctional kyphosis, especially in symptomatic young adult patients, potentially avoiding the need for revision surgery. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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11 pages, 617 KiB

Open AccessArticle

Prediction of Back Disability Using Clinical, Functional, and Biomechanical Variables in Adults with Chronic Nonspecific Low Back Pain

by Omar M. Elabd, Paul A. Oakley and Aliaa M. Elabd

J. Clin. Med. 2024, 13(13), 3980; https://doi.org/10.3390/jcm13133980 - 8 Jul 2024

Cited by 2 | Viewed by 1444

Abstract

Background: Researchers are focusing on understanding the etiology and predisposing factors of chronic nonspecific low back pain (CNSLBP), a costly prevalent and disabling disorder. Related clinical, functional, and biomechanical variables are often studied, but in isolation. We aimed to identify key factors for [...] Read more.

Background: Researchers are focusing on understanding the etiology and predisposing factors of chronic nonspecific low back pain (CNSLBP), a costly prevalent and disabling disorder. Related clinical, functional, and biomechanical variables are often studied, but in isolation. We aimed to identify key factors for managing CNSLBP by examining the relationship between back disability and related clinical, functional, and biomechanical variables and developed prediction models to estimate disability using various variables. Methods: We performed a cross-sectional correlational study on 100 recruited patients with CNSLBP. Clinical variables of pain intensity (visual analog score), back extensor endurance (Sorenson test), functional variables of the back performance scale, 6 min walk test, and the biomechanical variable C7-S1 sagittal vertical axis were analyzed to predict disability (Oswestry disability index). Results: All variables independently, as well as in multi-correlation, were significantly correlated to disability (p < 0.05). The bivariate regression models were significant between back disability and pain intensity (Y = 11.24 + 2.189x), Sorensen results (Y = 105.48 − 0.911x), the back performance scale (Y = 6.65 + 2.486x), 6 min walk test (Y = 49.20 − 0.060x), and sagittal vertical axis (Y = 0.72 + 4.23x). The multi-regression model showed significant contributions from pain (p = 0.001) and Sorensen results (p = 0.028) in predicting back disability, whereas no significant effect was found for other variables. Conclusions: A multidisciplinary approach is essential not only for the management of but also for the assessment of chronic nonspecific low back pain, including its clinical, functional, and biomechanical characteristics. However, special emphasis should be placed on clinical characteristics, including the intensity of pain and back extensor endurance. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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12 pages, 1061 KiB

Open AccessArticle

Impact of Supine versus Prone Positioning on Segmental Lumbar Lordosis in Patients Undergoing ALIF Followed by PSF: A Comparative Study

by Sina Sadeghzadeh, Kelly H. Yoo, Ivan Lopez, Thomas Johnstone, Ethan Schonfeld, Ghani Haider, Neelan J. Marianayagam, Martin N. Stienen and Anand Veeravagu

J. Clin. Med. 2024, 13(12), 3555; https://doi.org/10.3390/jcm13123555 - 18 Jun 2024

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Abstract

Background: Anterior lumbar interbody fusion (ALIF) and posterior spinal fusion (PSF) play pivotal roles in restoring lumbar lordosis in spinal surgery. There is an ongoing debate between combined single-position surgery and traditional prone-position PSF for optimizing segmental lumbar lordosis. Methods: This [...] Read more.

Background: Anterior lumbar interbody fusion (ALIF) and posterior spinal fusion (PSF) play pivotal roles in restoring lumbar lordosis in spinal surgery. There is an ongoing debate between combined single-position surgery and traditional prone-position PSF for optimizing segmental lumbar lordosis. Methods: This retrospective study analyzed 59 patients who underwent ALIF in the supine position followed by PSF in the prone position at a single institution. Cobb angles were measured preoperatively, post-ALIF, and post-PSF using X-ray imaging. One-way repeated measures ANOVA and post-hoc analyses with Bonferroni adjustment were employed to compare mean Cobb angles at different time points. Cohen’s d effect sizes were calculated to assess the magnitude of changes. Sample size calculations were performed to ensure statistical power. Results: The mean segmental Cobb angle significantly increased from preoperative (32.2 ± 13.8 degrees) to post-ALIF (42.2 ± 14.3 degrees, Cohen’s d: −0.71, p < 0.0001) and post-PSF (43.6 ± 14.6 degrees, Cohen’s d: −0.80, p < 0.0001). There was no significant difference between Cobb angles after ALIF and after PSF (Cohen’s d: −0.10, p = 0.14). The findings remained consistent when Cobb angles were analyzed separately for single-screw and double-screw ALIF constructs. Conclusions: Both supine ALIF and prone PSF significantly increased segmental lumbar lordosis compared to preoperative measurements. The negligible difference between post-ALIF and post-PSF lordosis suggests that supine ALIF followed by prone PSF can be an effective approach, providing flexibility in surgical positioning without compromising lordosis improvement. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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12 pages, 2822 KiB

Open AccessArticle

Interscapular Pain after Anterior Cervical Discectomy and Fusion: Does Zygapophyseal Joints over Distraction Play a Role?

by Luca Ricciardi, Daniele Bongetta, Amedeo Piazza, Nicolò Norri, Antonella Mangraviti, Sokol Trungu, Evaristo Belli, Luca Zanin and Giorgio Lofrese

J. Clin. Med. 2024, 13(10), 2976; https://doi.org/10.3390/jcm13102976 - 18 May 2024

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Abstract

Introduction: Anterior cervical discectomy and fusion (ACDF) for cervical disc herniation (CDH) is commonly performed. Specific post-operative complications include dysphagia, dysphonia, cervicalgia, adjacent segment disorder, cage subsidence, and infections. However, interscapular pain is commonly reported by these patients after surgery, although its mechanisms [...] Read more.

Introduction: Anterior cervical discectomy and fusion (ACDF) for cervical disc herniation (CDH) is commonly performed. Specific post-operative complications include dysphagia, dysphonia, cervicalgia, adjacent segment disorder, cage subsidence, and infections. However, interscapular pain is commonly reported by these patients after surgery, although its mechanisms have not been clarified yet. Methods: This retrospective series of 31 patients undergoing ACDF for CDH at a single Academic Hospital. Baseline and post-operative clinical, radiological, and surgical data were analyzed. The linear regression analysis was conducted to identify any factor independently influencing the incidence rate of post-operative interscapular pain. Results: The mean age was 57.6 ± 10.8 years, and the M:F ratio was 2.1. Pre-operative mean VAS-arm was 7.15 ± 0.81 among the 20 patients reporting brachialgia, and mean VAS-neck was 4.36 ± 1.43 among those 9 patients reporting cervicalgia. At 1 month, interscapular pain was still reported by 8 out of the 17 patients who experienced it post-operatively, and it was recovered in all patients after 2 months. The regression analysis showed that interscapular pain was not directly associated with age (p = 0.74), gender (p = 0.46), smoking status (p = 0.44), diabetes (0.42), pre-operative brachialgia (p = 0.21) or cervicalgia (p = 0.48), symptoms duration (p = 0.13), baseline VAS-arm (p = 0.11), VAS-neck (p = 0.93), or mJOA (p = 0.63) scores, or disc height modification (p = 0.90). However, the post-operative increase in the mean zygapophyseal joint rim distance was identified as an independent factor in determining interscapular pain (p = 0.02). Conclusions: Our study revealed that the onset of interscapular pain following ACDF may be determined by over distraction of the zygapophyseal joint rim. Then, proper sizing of prosthetic implants could reduce this painful complication. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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12 pages, 259 KiB

Open AccessArticle

Impact of Self-Reported Loss of Balance and Gait Disturbance on Outcomes following Adult Spinal Deformity Surgery

by Bassel G. Diebo, Daniel Alsoof, Renaud Lafage, Mohammad Daher, Mariah Balmaceno-Criss, Peter G. Passias, Christopher P. Ames, Christopher I. Shaffrey, Douglas C. Burton, Vedat Deviren, Breton G. Line, Alex Soroceanu, David Kojo Hamilton, Eric O. Klineberg, Gregory M. Mundis, Han Jo Kim, Jeffrey L. Gum, Justin S. Smith, Juan S. Uribe, Khaled M. Kebaish, Munish C. Gupta, Pierce D. Nunley, Robert K. Eastlack, Richard Hostin, Themistocles S. Protopsaltis, Lawrence G. Lenke, Robert A. Hart, Frank J. Schwab, Shay Bess, Virginie Lafage and Alan H. Daniels Show full author list Hide full author list

J. Clin. Med. 2024, 13(8), 2202; https://doi.org/10.3390/jcm13082202 - 11 Apr 2024

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Abstract

Background: The objective of this study was to evaluate if imbalance influences complication rates, radiological outcomes, and patient-reported outcomes (PROMs) following adult spinal deformity (ASD) surgery. Methods: ASD patients with baseline and 2-year radiographic and PROMs were included. Patients were grouped according to [...] Read more.

Background: The objective of this study was to evaluate if imbalance influences complication rates, radiological outcomes, and patient-reported outcomes (PROMs) following adult spinal deformity (ASD) surgery. Methods: ASD patients with baseline and 2-year radiographic and PROMs were included. Patients were grouped according to whether they answered yes or no to a recent history of pre-operative loss of balance. The groups were propensity-matched by age, pelvic incidence–lumbar lordosis (PI-LL), and surgical invasiveness score. Results: In total, 212 patients were examined (106 in each group). Patients with gait imbalance had worse baseline PROM measures, including Oswestry disability index (45.2 vs. 36.6), SF-36 mental component score (44 vs. 51.8), and SF-36 physical component score (p < 0.001 for all). After 2 years, patients with gait imbalance had less pelvic tilt correction (−1.2 vs. −3.6°, p = 0.039) for a comparable PI-LL correction (−11.9 vs. −15.1°, p = 0.144). Gait imbalance patients had higher rates of radiographic proximal junctional kyphosis (PJK) (26.4% vs. 14.2%) and implant-related complications (47.2% vs. 34.0%). After controlling for age, baseline sagittal parameters, PI-LL correction, and comorbidities, patients with imbalance had 2.2-times-increased odds of PJK after 2 years. Conclusions: Patients with a self-reported loss of balance/unsteady gait have significantly worse PROMs and higher risk of PJK. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

13 pages, 2820 KiB

Open AccessArticle

The New Modular Sforzesco Brace (Modular Italian Brace) Is as Effective as the Classical One: A Retrospective Controlled Study from a Prospective Cohort

by Francesco Negrini, Francesca Febbo, Fabrizio Tessadri, Andrea Zonta, Marta Tavernaro, Sabrina Donzelli, Fabio Zaina and Stefano Negrini

J. Clin. Med. 2024, 13(7), 2075; https://doi.org/10.3390/jcm13072075 - 3 Apr 2024

Viewed by 1478

Abstract

Background: The Sforzesco brace is a very rigid push-up brace effective in adolescent idiopathic scoliosis (AIS). We recently developed a new Sforzesco brace based on modularity (the Modular Italian brace—MI brace) that could allow standardization, facilitating global expertise diffusion, increased modifiability and [...] Read more.

Background: The Sforzesco brace is a very rigid push-up brace effective in adolescent idiopathic scoliosis (AIS). We recently developed a new Sforzesco brace based on modularity (the Modular Italian brace—MI brace) that could allow standardization, facilitating global expertise diffusion, increased modifiability and adaptability, and cost savings due to longer brace life. We aimed to compare the short-term results of the two braces. Methods: The retrospective study included 231 consecutive AIS treated with a MI brace (N = 53) or Sforzesco brace (N = 178). The main outcome was the first 6-month follow-up out-of-brace radiograph Cobb angle change. Secondary outcomes included the in-brace Cobb degrees and aesthetics (TRACE), prominence (angle of trunk rotation and mm), kyphosis, and lordosis changes. Results: The two groups were similar at baseline, apart from more immature patients in MI brace. Both braces reduced the Cobb angle (−6° out-of-brace; −16° in-brace) without differences between groups. All secondary outcomes improved, apart from a statistically and clinically insignificant 3° kyphosis reduction. The MI brace participants were 4.9 times more likely to improve the Cobb angle than the Sforzesco brace (OR = 4.92; 95%CI 1.91–12.64; p = 0.001). Conclusions: These findings suggest that the MI-brace can be safely used instead of the classical Sforzesco brace. However, further studies of different designs and longer follow-ups are needed to confirm these findings. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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15 pages, 5288 KiB

Open AccessEditor’s ChoiceArticle

Improvement in Pain, Quality of Life, and Urinary Dysfunction following Correction of Lumbar Lordosis and Reduction in Lumbar Spondylolistheses Using Chiropractic BioPhysics^® Structural Spinal Rehabilitation: A Case Series with >1-Year Long-Term Follow-Up Exams

by Curtis A. Fedorchuk, Cole G. Fedorchuk and Douglas F. Lightstone

J. Clin. Med. 2024, 13(7), 2024; https://doi.org/10.3390/jcm13072024 - 30 Mar 2024

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Abstract

(1) Background: Lumbar spondylolisthesis affects ~20% of the US population and causes spine-related pain and disability. (2) Methods: This series reports on three patients (two females and one male) aged 68–71 years showing improvements in back pain, quality of life (QOL), and urinary [...] Read more.

(1) Background: Lumbar spondylolisthesis affects ~20% of the US population and causes spine-related pain and disability. (2) Methods: This series reports on three patients (two females and one male) aged 68–71 years showing improvements in back pain, quality of life (QOL), and urinary dysfunction following correction of lumbar spondylolistheses using CBP^® spinal rehabilitation. Pre-treatment radiographs showed lumbar hyperlordosis (−49.6°, ideal is −40°) and anterolisthesis (14.5 mm, ideal is 0 mm). Pre-treatment patient-reported outcome measures (PROMs) included a numeric rating scale (NRS) for back pain (7.3/10, ideal is 0), urinary urgency (8/10, ideal is 0), and SF-36 physical (PCS) and mental component score (MCS) (29.8 and 46.6, ideal is 46.8 and 52.8). Patients underwent 2–3 CBP^® sessions per week to correct lumbar hyperlordosis and lumbar anterolistheses. (3) Results: Post-treatment radiographs showed improvements in lumbar curvature (−42.8°) and anterolisthesis (4.2 mm). Post-treatment PROMs showed improvements in NRS for back pain (1/10), urinary urgency (2.3/10), and SF-36 PCS and MCS (50.2 and 57.7). Long-term follow-up radiographs and PROMs showed maintained improvements. (4) Conclusions: This series documents the first-recorded long-term corrections of lumbar spondylolisthesis and concomitant improvements in back pain, urinary urgency, and QOL using CBP^®. This series provides evidence for CBP^® as a non-surgical approach to lumbar spinal rehabilitation and the possible impacts of spinal alignment on pain, urinary dysfunction, and QOL. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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12 pages, 1343 KiB

Open AccessArticle

Identifying Predictors of Neck Disability in Patients with Cervical Pain Using Machine Learning Algorithms: A Cross-Sectional Correlational Study

by Ahmed A. Torad, Mohamed M. Ahmed, Omar M. Elabd, Fayiz F. El-Shamy, Ramzi A. Alajam, Wafaa Mahmoud Amin, Bsmah H. Alfaifi and Aliaa M. Elabd

J. Clin. Med. 2024, 13(7), 1967; https://doi.org/10.3390/jcm13071967 - 28 Mar 2024

Cited by 1 | Viewed by 1280

Abstract

(1) Background: Neck pain intensity, psychosocial factors, and physical function have been identified as potential predictors of neck disability. Machine learning algorithms have shown promise in classifying patients based on their neck disability status. So, the current study was conducted to identify predictors [...] Read more.

(1) Background: Neck pain intensity, psychosocial factors, and physical function have been identified as potential predictors of neck disability. Machine learning algorithms have shown promise in classifying patients based on their neck disability status. So, the current study was conducted to identify predictors of neck disability in patients with neck pain based on clinical findings using machine learning algorithms. (2) Methods: Ninety participants with chronic neck pain took part in the study. Demographic characteristics in addition to neck pain intensity, the neck disability index, cervical spine contour, and surface electromyographic characteristics of the axioscapular muscles were measured. Participants were categorised into high disability and low disability groups based on the median value (22.2) of their neck disability index scores. Several regression and classification machine learning models were trained and assessed using a 10-fold cross-validation method; also, MANCOVA was used to compare between the two groups. (3) Results: The multilayer perceptron (MLP) revealed the highest adjusted R2 of 0.768, while linear discriminate analysis showed the highest receiver characteristic operator (ROC) area under the curve of 0.91. Pain intensity was the most important feature in both models with the highest effect size of 0.568 with p < 0.001. (4) Conclusions: The study findings provide valuable insights into pain as the most important predictor of neck disability in patients with cervical pain. Tailoring interventions based on pain can improve patient outcomes and potentially prevent or reduce neck disability. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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16 pages, 5863 KiB

Open AccessArticle

The Improvement of Trunk Muscle Endurance in Adolescents with Idiopathic Scoliosis Treated with ScoliBrace^® and the ScoliBalance^® Exercise Approach

by Rosemary Marchese, Juan Du Plessis, Tamara Pooke and Jeb McAviney

J. Clin. Med. 2024, 13(3), 653; https://doi.org/10.3390/jcm13030653 - 23 Jan 2024

Cited by 2 | Viewed by 4110

Abstract

The impact of scoliosis bracing combined with physiotherapeutic scoliosis-specific exercises (PSSE) on trunk muscle endurance in adolescents with idiopathic scoliosis is unknown. ScoliBrace^®, a rigid, three-dimensional, over-corrective thoraco-lumbar-sacral orthosis (TLSO), and ScoliBalance^®, a PSSE program, were used to treat [...] Read more.

The impact of scoliosis bracing combined with physiotherapeutic scoliosis-specific exercises (PSSE) on trunk muscle endurance in adolescents with idiopathic scoliosis is unknown. ScoliBrace^®, a rigid, three-dimensional, over-corrective thoraco-lumbar-sacral orthosis (TLSO), and ScoliBalance^®, a PSSE program, were used to treat adolescent idiopathic scoliosis (AIS) patients. A retrospective study of the trunk muscle endurance of 33 AIS patients who received ScoliBrace^® and ScoliBalance^® was conducted. The patients were treated with ScoliBrace^® and an individualized ScoliBalance^® program. Trunk extensor muscle endurance (TE) and abdominal muscle endurance (AE) tests were performed at initial assessment and then at averages of 6.6 and 24.4 weeks of treatment. The data were analyzed using the Wilcoxon signed-rank test, Stata version 15.1. The participants were aged 13.24 years (SD = 1.64) with a mean Cobb angle of 38.97° (SD = 9.49°). TE improved significantly (p < 0.001) at both short- and medium-term intervals using ScoliBalance^® and ScoliBrace^® in the AIS patients. AE also showed significant improvement between baseline and short-term follow-up, with non-significant improvement at medium-term follow-up. Overall, trunk muscle endurance showed improvement in the AIS patients using ScoliBrace^® and ScoliBalance^®. Future research is required to determine the individual and combined effects of each treatment. However, it seems likely that trunk muscle endurance will not deteriorate in AIS patients with this combined treatment. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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20 pages, 3325 KiB

Open AccessArticle

Are Rotations and Translations of Head Posture Related to Gait and Jump Parameters?

by Nabil Saad, Ibrahim M. Moustafa, Amal Ahbouch, Nour Mustafa Alsaafin, Paul A. Oakley and Deed E. Harrison

J. Clin. Med. 2023, 12(19), 6211; https://doi.org/10.3390/jcm12196211 - 26 Sep 2023

Cited by 3 | Viewed by 3895

Abstract

This study assessed the relationship between head posture displacements and biomechanical parameters during gait and jumping. One hundred male and female students (20 ± 3 yrs) were assessed via the PostureScreen Mobile® app to quantify postural displacements of head rotations and translations including: [...] Read more.

This study assessed the relationship between head posture displacements and biomechanical parameters during gait and jumping. One hundred male and female students (20 ± 3 yrs) were assessed via the PostureScreen Mobile® app to quantify postural displacements of head rotations and translations including: (1) the cranio-vertebral angle (CVA) (°), (2) anterior head translation (AHT) (cm), (3) lateral head translation in the coronal plane (cm), and (4) lateral head side bending (°). Biomechanical parameters during gait and jumping were measured using the G-Walk sensor. The assessed gait spatiotemporal parameters were cadence (steps/min), speed (m/s), symmetry index, % left and right stride length (% height), and right and left propulsion index. The pelvic movement parameters were (1) tilt symmetry index, (2) tilt left and right range, (3) obliquity symmetry index, (4) obliquity left and right range, (5) rotation symmetry index, and (6) rotation left and right range. The jump parameters measured were (1) flight height (cm), (2) take off force (kN), (3) impact Force (kN), (4) take off speed (m/s), (5) peak speed (m/s), (6) average speed concentric phase (m/s), (7) maximum concentric power (kW), (8) average concentric power (kW) during the counter movement jump (CMJ), and (9) CMJ with arms thrust (CMJAT). At a significance level of p ≤ 0.001, moderate-to-high correlations (0.4 < r < 0.8) were found between CVA, AHT, lateral translation head, and all the gait and jump parameters. Weak correlations (0.2 < r < 0.4) were ascertained for lateral head bending and all the gait and jump parameters except for gait symmetry index and pelvic symmetry index, where moderate correlations were identified (0.4 < r < 0.6). The findings indicate moderate-to-high correlations between specific head posture displacements, such as CVA, lateral head translation and AHT with the various gait and jump parameters. These findings highlight the importance of considering head posture in the assessment and optimization of movement patterns during gait and jumping. Our findings contribute to the existing body of knowledge and may have implications for clinical practice and sports performance training. Further research is warranted to elucidate the underlying mechanisms and establish causality in these relationships, which could potentially lead to the development of targeted interventions for improving movement patterns and preventing injuries. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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16 pages, 2412 KiB

Open AccessArticle

Translational and Rotational Postural Aberrations Are Related to Pulmonary Functions and Skill-Related Physical Fitness Components in Collegiate Athletes

by May Tamim, Ibrahim M. Moustafa, Gopala K. Alaparthi, Paul A. Oakley and Deed E. Harrison

J. Clin. Med. 2023, 12(14), 4618; https://doi.org/10.3390/jcm12144618 - 11 Jul 2023

Cited by 5 | Viewed by 4938

Abstract

This study assessed the relationship between body posture displacements, cardiopulmonary exercise testing (CPET), and skill-related physical fitness tests. One hundred male (60%) and female collegiate athletes (22.2 ± 4 yrs) with normal body mass indexes (BMI up to 24.9) were assessed via the [...] Read more.

This study assessed the relationship between body posture displacements, cardiopulmonary exercise testing (CPET), and skill-related physical fitness tests. One hundred male (60%) and female collegiate athletes (22.2 ± 4 yrs) with normal body mass indexes (BMI up to 24.9) were assessed via the PostureScreen Mobile^® app to quantify postural displacements such as head, thorax, and pelvis rotations and translations. CPET and physical performance tests, including the agility t-test, vertical jump test, stork static balance test (SSBT), and dynamic Y-balance test (YBT), were performed. Spearman correlation (r) and p-values are reported. The postural parameters were found to have moderate-to-high associations with the CPET and agility test, moderate correlations with the vertical jump test and SSBT (head and pelvic postures only), and weak correlations with the YBT. As the postural parameters were more asymmetric, both the CPET and performance skills scores were worse. For example: (1) a medium positive correlation was found between cranio-vertebral angle (CVA) and the vertical jump test (r = 0.54; p-value < 0.001) and SSBT (r = 0.57; p-value < 0.001), while a strong negative correlation was found between CVA and the agility test (r = −0.86; p-value < 0.001). (2) A strong positive correlation was found between CVA and oxygen uptake efficiency slope, load watts VO2 at VT, VO2/kg, and load watts at the respiratory compensation point (RCP) (r = 0.65 and r = 0.71; p < 0.001). Conversely, a significant negative correlation was found between CVA and VE/VO2 at VT (r = −0.61; p < 0.001). Postural rotations and translations of the head, thorax, and pelvis were statistically correlated with the physical performance skills and CPET in the young collegiate athletes. There were moderate-to-high associations with cardiopulmonary functions and the agility tests, moderate correlations with the vertical jump test, and weak correlations with the YBT. Postural alignment may be important for optimal physical performance and optimal cardiopulmonary function. Further research is necessary to elucidate the reasons for these correlations found in our sample of young and healthy athletes. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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Review

Jump to: Research, Other

15 pages, 2952 KiB

Open AccessReview

Are the Spinal Changes in the Course of Scoliogeny Primary but Secondary?

by Theodoros B. Grivas, Elias Vasiliadis, Christina Mazioti, Despina Papagianni, Aristea Mamzeri, Michail Chandrinos, George Vynichakis, Konstantinos Athanasopoulos, Paschalis Christodoulides, Nikola Jevtic, Samra Pjanic, Danka Ljubojevic, Olga Savvidou, Angelos Kaspiris and Jarrett Grunstein

J. Clin. Med. 2024, 13(8), 2163; https://doi.org/10.3390/jcm13082163 - 9 Apr 2024

Viewed by 1197

Abstract

In this opinion article, there is an analysis and discussion regarding the effects of growth on the spinal and rib cage deformities, the role of the rib cage in scoliogeny, the lateral spinal profile in adolescent idiopathic scoliosis (AIS), the genetics and epigenetics [...] Read more.

In this opinion article, there is an analysis and discussion regarding the effects of growth on the spinal and rib cage deformities, the role of the rib cage in scoliogeny, the lateral spinal profile in adolescent idiopathic scoliosis (AIS), the genetics and epigenetics of AIS, and the interesting and novel field investigating the sleep impact at nighttime on AIS in relation to the sequence of the scoliogenetic changes in scoliotics. The expressed opinions are mainly based on the published peer-reviewed research of the author and his team of co-authors. Based on the analysis noted above, it can be postulated that the vertebral growth changes in the spine during initial idiopathic scoliosis (IS) development are not primary-intrinsic but secondary changes. The primary cause starting the deformity is not located within the vertebral bodies. Instead, the deformations seen in the vertebral bodies are the secondary effects of asymmetrical loads exerted upon them, due to muscular loads, growth, and gravity. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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16 pages, 483 KiB

Open AccessFeature PaperReview

Non-Surgical Approaches to the Management of Lumbar Disc Herniation Associated with Radiculopathy: A Narrative Review

by Ahmed M. El Melhat, Ahmed S. A. Youssef, Moustafa R. Zebdawi, Maya A. Hafez, Lamia H. Khalil and Deed E. Harrison

J. Clin. Med. 2024, 13(4), 974; https://doi.org/10.3390/jcm13040974 - 8 Feb 2024

Cited by 4 | Viewed by 12787

Abstract

Lumbar disc herniation associated with radiculopathy (LDHR) is among the most frequent causes of spine-related disorders. This condition is triggered by irritation of the nerve root caused by a herniated disc. Many non-surgical and surgical approaches are available for managing this prevalent disorder. [...] Read more.

Lumbar disc herniation associated with radiculopathy (LDHR) is among the most frequent causes of spine-related disorders. This condition is triggered by irritation of the nerve root caused by a herniated disc. Many non-surgical and surgical approaches are available for managing this prevalent disorder. Non-surgical treatment approaches are considered the preferred initial management methods as they are proven to be efficient in reducing both pain and disability in the absence of any red flags. The methodology employed in this review involves an extensive exploration of recent clinical research, focusing on various non-surgical approaches for LDHR. By exploring the effectiveness and patient-related outcomes of various conservative approaches, including physical therapy modalities and alternative therapies, therapists gain valuable insights that can inform clinical decision-making, ultimately contributing to enhanced patient care and improved outcomes in the treatment of LDHR. The objective of this article is to introduce advanced and new treatment techniques, supplementing existing knowledge on various conservative treatments. It provides a comprehensive overview of the current therapeutic landscape, thereby suggesting pathways for future research to fill the gaps in knowledge. Specific to our detailed review, we identified the following interventions to yield moderate evidence (Level B) of effectiveness for the conservative treatment of LDHR: patient education and self-management, McKenzie method, mobilization and manipulation, exercise therapy, traction (short-term outcomes), neural mobilization, and epidural injections. Two interventions were identified to have weak evidence of effectiveness (Level C): traction for long-term outcomes and dry needling. Three interventions were identified to have conflicting or no evidence (Level D) of effectiveness: electro-diagnostic-based management, laser and ultrasound, and electrotherapy. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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19 pages, 2954 KiB

Open AccessSystematic Review

Unveiling Timetable for Physical Therapy after Single-Level Lumbar Surgery for Degenerative Disc Disease: Insights from a Systematic Review and Meta-Analysis

by Alberto Ruffilli, Marco Manzetti, Alessandro Cargeli, Giovanni Viroli, Marco Ialuna, Matteo Traversari, Fabio Vita, Isabella Sofia Giannini and Cesare Faldini

J. Clin. Med. 2024, 13(9), 2553; https://doi.org/10.3390/jcm13092553 - 26 Apr 2024

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Abstract

Background: Postoperative physical therapy emerges as a pivotal element of the rehabilitation process, aimed at enhancing functional recovery, managing pain, and mitigating the risk of further complications. The debate concerning the optimal timing of physical therapy intervention post-surgery remains unresolved; in particular, whether [...] Read more.

Background: Postoperative physical therapy emerges as a pivotal element of the rehabilitation process, aimed at enhancing functional recovery, managing pain, and mitigating the risk of further complications. The debate concerning the optimal timing of physical therapy intervention post-surgery remains unresolved; in particular, whether to initiate physical therapy immediately or to wait weeks is of particular interest. The aim of this study is to review the available literature regarding the optimal timing of physical therapy initiation and the outcomes obtained. Methods: This review was carried out in accordance with the Preferential Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. This search was carried out in February 2024. Only peer-reviewed articles were considered for inclusion. Results: Fourteen studies were included. The primary outcomes assessed in the included studies were the following: 12-week and 12-month low back pain, return to work, function and disability, psychological status, patient satisfaction, and complications associated with early physical therapy. A meta-analysis was performed concerning low back pain after lumbar discectomy at 12 weeks and 12 months and complications after early physical therapy after lumbar discectomy and lumbar interbody fusion. A significant difference was found between early and standard physical therapy in terms of low back pain at 12–18 months (p = 0.0062); no significant differences were found in terms of complications, both for discectomy and arthrodesis. Conclusions: This review indicates that employing early rehabilitation strategies for intervertebral disc disease could enhance results in terms of pain and disability without an enhanced risk of complications. Full article

(This article belongs to the Special Issue Structural Rehabilitation of the Spine and Posture: Analysis, Techniques, and Outcomes in Clinical Research)

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