Generalised Joint Hypermobility in Caucasian Girls with Idiopathic Scoliosis: Relation with Age, Curve Size, and Curve Pattern

The aim of the study was to assess the prevalence of generalised joint hypermobility (GJH) in 155 girls with idiopathic scoliosis (IS) (age 9–18 years, mean 13.8 ± 2.3). The control group included 201 healthy girls. The presence of GJH was assessed with Beighton (B) test. GJH was diagnosed in 23.2% of IS girls and in 13.4% of controls (P=0.02). The prevalence of GJH was significantly (P=0.01) lower in IS girls aged 16–18 years in comparison with younger individuals. There was no difference regarding GJH occurrence between girls with mild (11–24°), moderate (25–40°), and severe scoliosis (>40°) (P=0.78), between girls with single thoracic, single lumbar, and double curve scoliosis (P=0.59), and between girls with thoracic scoliosis length ≤7 and >7 vertebrae (P=0.25). No correlation between the number of points in B and the Cobb angle (P=0.93), as well as between the number of points in B and the number of the vertebrae within thoracic scoliosis (P=0.63), was noticed. GJH appeared more often in IS girls than in healthy controls. Its prevalence decreased with age. No relation between GJH prevalence and curve size, curve pattern, or scoliosis length was found

Joint hypermobility in children with idiopathic scoliosis: SOSORT award 2011 winner

<p>Abstract</p> <p>Background</p> <p>Generalized joint hypermobility (JHM) refers to increased joint mobility with simultaneous absence of any other systemic disease. JHM involves proprioception impairment, increased frequency of pain within joints and tendency to injure soft tissues while performing physical activities. Children with idiopathic scoliosis (IS) often undergo intensive physiotherapy requiring good physical capacities. Further, some physiotherapy methods apply techniques that increase joint mobility and thus may be contraindicated.</p> <p>The aim of this paper was to assess JHM prevalence in children with idiopathic scoliosis and to analyze the relationship between JHM prevalence and the clinical and radiological parameters of scoliosis. The methods of assessment of generalized joint hypermobility were also described.</p> <p>Materials and methods</p> <p>This case-control study included 70 subjects with IS, aged 9-18 years (mean 13.2 ± 2.2), Cobb angle range 10°-53° (mean 24.3 ± 11.7), 34 presenting single curve thoracic scoliosis and 36 double curve thoracic and lumbar scoliosis. The control group included 58 children and adolescents aged 9-18 years (mean 12.6 ± 2.1) selected at random. The presence of JHM was determined using Beighton scale complemented with the questionnaire by Hakim and Grahame. The relationship between JHM and the following variables was evaluated: curve severity, axial rotation of the apical vertebra, number of curvatures (single versus double), number of vertebrae within the curvature (long versus short curves), treatment type (physiotherapy versus bracing) and age.</p> <p>Statistical analysis was performed with Statistica 8.1 (StatSoft, USA). The Kolmogorov-Smirnov test, U Mann-Whitney test, Chi²test, Pearson and Spermann correlation rank were conducted. The value <it>p </it>= 0.05 was adopted as the level of significance.</p> <p>Results</p> <p>JHM was diagnosed in more than half of the subjects with idiopathic scoliosis (51.4%), whilst in the control group it was diagnosed in only 19% of cases (<it>p </it>= 0.00015). A significantly higher JHM prevalence was observed in both girls (<it>p </it>= 0.0054) and boys (<it>p </it>= 0.017) with IS in comparison with the corresponding controls. No significant relation was found between JHM prevalence and scoliosis angular value (<it>p </it>= 0.35), apical vertebra rotation (<it>p </it>= 0.86), the number of vertebrae within curvature (<it>p </it>= 0.8), the type of applied treatment (<it>p </it>= 0.55) and the age of subjects (<it>p </it>= 0.79). JHM prevalence was found to be higher in children with single curve scoliosis than in children with double curve scoliosis (<it>p </it>= 0.03).</p> <p>Conclusions</p> <p>JHM occurs more frequently in children with IS than in healthy sex and age matched controls. No relation of JHM with radiological parameters, treatment type and age was found. Systematically searched in IS children, JHM should be taken into account when physiotherapy is planned.</p

The Influence of Self-Stretching Based on Postisometrical Relaxation, Static Stretching Combined with Stabilizing Exercises, and Stabilizing Exercises Only on the Flexibility of One-Joint and Two-Joint Hip Flexors

Background and Objective. The limitations of muscle flexibility are a common dysfunction of the musculoskeletal system. Therefore, various therapeutic techniques are used in rehabilitation programs to increase their flexibility. The aim of this prospective, randomized, single-blind study was to evaluate the changes in the flexibility of hip flexors in children who participated in a 6-week therapeutic program consisting of one physiotherapy session per week with a physiotherapist and daily home exercises. Material and Methods. A total of 94 children aged 10–13 years were randomly assigned to 3 experimental groups: postisometrical relaxation group (PIR group), static stretching combined with stabilizing exercise group (SE/SS group), and stabilizing exercise group (SS group). To assess the flexibility of one- and two-joint hip flexors, the modified Thomas test was used. The examination was conducted by blinded observers. Results. A significant improvement in the flexibility of one-joint hip flexors was documented in all 3 groups (P&lt;0.01). The flexibility of two-joint hip flexors increased significantly only in the SS/SE group (P&lt;0.05). After the program, the highest range of motion of the hip extension (test for one-joint hip flexors) was recorded in the SS/SE group (20.6°±4.5°), and it was significantly greater than in the SE group (16.6°±4.0°, P&lt;0.05). There were no significant differences in the knee flexion (test for two-joint hip flexors) among all 3 groups (P&gt;0.05). Conclusions. The 6-week therapeutic program regardless of the technique applied (postisometrical muscle relaxation, static stretching with stabilizing exercises, and stabilizing exercises only) resulted in the increased flexibility of one-joint hip flexors. Only static stretching combined with stabilizing exercises led to a significant increase in the flexibility of two-joint hip flexors

Physical Education Students’ Knowledge of Selected Safe and Non-Recommended Exercises Strengthening the Abdominal Muscles

Abstract Introduction. The aim of the study was to assess final-year physical education (PE) students’ knowledge of exercises strengthening the abdominal muscles which are used in the introductory part of a PE lesson. Material and methods. The research involved 467 final-year physical education students. The group examined included undergraduate (Bachelor) and postgraduate (Master) students from four universities in Poland. A knowledge test with photographs was used to conduct the study. The students completed the knowledge test with one of the authors present. If the students had any questions regarding the exercises included in the test, they were demonstrated by the person in the photographs. The data were analysed using the Mann- Whitney-Wilcoxon test. Kendall’s concordance coefficient was used to assess reliability and measure the agreement between the opinions of a group of experts who were asked to rate the exercises in terms of their safety and effectiveness. The calculations were made with the use of statistical and calculation software (SPSS 9.0 for Windows). An alpha value &lt; 0.05 was accepted as the level of significance of differences between the groups of undergraduate and postgraduate students. Results. Eighty-two participants (17.6%) performed the task correctly, selecting all the safe exercises, 139 students (29.8%) made one error, while 110 marked all the overloading and ineffective exercises as safe. Conclusions. The students’ knowledge of safe exercises strengthening the abdominal muscles was insufficient. Both undergraduate and postgraduate students demonstrated similar knowledge concerning these exercises.</jats:p