Association Between Postural Balance and Muscle Activity of the Lumbar and Lower Limb Muscles in Female With or Without Adolescent Idiopathic Scoliosis (AIS) During Standing Balance Tasks With Upper Limb Movement

NCT05127902 | Completed

• 1 other identifier: MHS_SRC_2021_010
• Study Type: observational
• Target: 15
• Locations: 1 country
• Sites: 1

Brief Summary

Adolescent idiopathic scoliosis (AIS) is the most common type of three-dimensional deformity of the spine in adolescence with a clear female predominance at a prevalence rate of 3.5% in Hong Kong. AIS increases the risk of spinal degeneration, back pain, and cardiorespiratory dysfunction. These impairments caused by AIS can be related to the abnormal lateral deviation, axial rotation, and reduction of sagittal curves of the spine. AIS has been associated with asymmetrical muscle activity and impaired postural balance performance. AIS who had convex side of the major curves to the right demonstrated an increase in right side thoracic and lumbar erector spinae muscle activity during pelvic anterior, posterior, and left tilting on an unstable sitting board as measured by electromyography (EMG). Postural balance is defined as the act of maintaining, achieving and restoring a state of balance during any posture or activity. The ability of maintaining postural balance in AIS is influenced by multiple factors including spinal deformities, asymmetrical muscle activities, alteration in sensory input, central integration or motor response. Previous studies have investigated the motor response in young adults. They were found to depend more on ankle strategy than hip strategy during a balance perturbation on a movable platform. Increased lateral gastrocnemius muscle activity was also observed when centre of gravity falls forward during an EMG measurement in quiet stance. In a study of low back pain patients, training regime involving single rapid arm movement in flexion and extension was found to promote the activation of the transversus abdominis muscle and improved the feedforward postural adjustment. There are limited studies to investigate the association between somatosensory input and motor response particularly lower limb muscle activity and upper limb movement on balance control in AIS. Recent evidence also suggested that AIS tend to overestimate the severity of their spinal deformity but their perception of their body schema and spinal curvature can be improved by enhancing motor skills. Therefore, training of postural balance that involved enhancing motor skills and stimulating somatosensory system will have the potential to improve motor response as well as improve self-perceived body schema in AIS.

Conditions

Adolescent Idiopathic Scoliosis

Outcome Measures

Primary Outcomes (2)

• Balance function

  Ellipse area (mm2), Perimeter (mm), Forward-backward standard deviation (mm), Medial-lateral standard deviation, Average center of pressure in the medial-lateral direction on X-axis projection (mm), Average center of pressure in the anterior-posterior direction on Y-axis projection (mm), Standard deviation of forward-backward displacement (mm), Standard deviation of medial-lateral displacement (mm), Average velocity for forward-backward displacement (mm/s), Average velocity for medial-lateral displacement (mm/s) and Standard deviation of Trunk sway (o).

  1 hour

• sEMG Muscle Activity

  1 hour

Secondary Outcomes (6)

• Angle of trunk rotation (ATR)

  10 minutes

• Anthropometric Measurements

  5 minutes

• Body composition

  5 minutes

• Sexual Maturity

  5 minutes

• Physical Activity Level

  5 minutes

Study Arms (2)

adolescent idiopathic scoliosis group

Female subjects aged 10 to 16 will be recruited if they are diagnosed with AIS by standard standing long X-ray examinations, with Cobb angle larger or equal to 15°, without prior treatment for their AIS and been cleared for physical activity by their doctors. Subjects were excluded if they had (i) Cobb angle larger or equal to 40°, (ii) scoliosis with any known aetiologies such as congenital, neuromuscular, metabolic, and skeletal dysplasia, (iii) known endocrine and connective tissue abnormalities, (iv) known heart condition or other diseases that could affect the safety of exercise, (v) eating disorders or gastrointestinal malabsorption disorders, and (vi) currently taking medications that affecting their bone or muscle metabolism. All subjects will be recruited in the community.

Diagnostic Test: Proprioceptive-stabilometric assessment machine (ProKin 252, TecnoBody®, Italy)

Control group

Ten healthy female subjects with matched for age, height and weight will be recruited as control.

Diagnostic Test: Proprioceptive-stabilometric assessment machine (ProKin 252, TecnoBody®, Italy)

Interventions

Proprioceptive-stabilometric assessment machine (ProKin 252, TecnoBody®, Italy) DIAGNOSTIC_TEST

Proprioceptive-stabilometric assessment machine (ProKin 252, TecnoBody®, Italy) Balance performance of subjects will be tested on the proprioceptive-stabilometric assessment machine. Noraxon wireless TELEmyo Direct Transmission System (TELEmyo DTS) with product code of 580 (Noraxon, USA Inc., USA) The sampling frequency will be of 1000Hz and bandwidth of 10-500Hz. Bipolar silver chloride electrodes of 15mm diameter will be used for EMG signals collection, the interelectrode distance will be fixed at 20mm. Normalization procedure will be done by asking subjects to perform isometric maximum voluntary contractions (MVC). The MVC will be measured by Lafayette hand-held dynamometer connected to flat stirrup. MVC will be tested as listed below. The sEMG signals during each experiment will be normalized to the sEMG at isometric MVC and expressed as percentages of the maximum sEMG activity (%EMG\_max) for comparison with normalization signal processing program in Noraxon System.

Also known as: Noraxon wireless TELEmyo Direct Transmission System (TELEmyo DTS) with product code of 580 (Noraxon, USA Inc., USA)

Control group; adolescent idiopathic scoliosis group

Eligibility Criteria

• Age: 10 Years - 16 Years
• Sex: female
• Age Groups: Child (0-17)
• Sampling Method: Non-Probability Sample

Study Population

Recruited from community

You may qualify if:

• (i) Cobb angle larger or equal to 40° (ii) scoliosis with any known aetiologies such as congenital, neuromuscular, metabolic, and skeletal dysplasia (iii) known endocrine and connective tissue abnormalities (iv) known heart condition or other diseases that could affect the safety of exercise (v) eating disorders or gastrointestinal malabsorption disorders (vi) currently taking medications that affecting their bone or muscle metabolism

Sponsors & Collaborators

• Tung Wah College: lead

Study Sites (1)

Tung Wah College

Hong Kong, 000, Hong Kong

Location

Related Publications (23)

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Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: November 9, 2021
• First Posted: November 19, 2021
• Study Start: October 15, 2021
• Primary Completion: December 31, 2021
• Study Completion: May 30, 2022
• Last Updated: March 14, 2023

Record last verified: 2023-03

Locations

HK (1)