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Effect of physiotherapy on spinal alignment in children with postural defects

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Zmyślna A., Kiebzak W., Żurawski A., Pogorzelska J., Kotela I., Kowalski T. J., Śliwiński Z., Śliwiński G.

International Journal of Occupational Medicine and Environmental Health

2019

vol. 32

issue 1

25-32

Objectives This paper assesses the effect of neurophysiological rehabilitation in children with postural defects on the depth of thoracic kyphosis, lateral spinal deviation and rotation of spinal motor segments. Material and Methods A total of 201 patients aged 8–15 years old with a postural defect diagnosed by medical examination were enrolled. The analyzed parameters were determined using the DIERS system before the first therapeutic session and after 4 weeks of therapy. The angle of thoracic kyphosis, lateral deviation of the spine and spinal rotation were assessed. The therapy employed techniques associated with the proprioceptive neuromuscular facilitation (PNF) and Vojta’s approaches. The results were analyzed separately for both sexes and for patients rehabilitated solely with Vojta’s techniques vs. patients rehabilitated according to combined Vojta’s and PNF techniques. The χ² test was used for statistical analyses, at p < 0.05. Results There was improvement in the angle of thoracic kyphosis, ranging from 0.14 (among boys with kyphosis < 42°) to 5.47 (among girls with kyphosis ≥ 42°), spinal rotation, from 0.37 (among boys with kyphosis ≥ 42°) to 4.33 (among patients with kyphosis ≥ 42° rehabilitated solely according to Vojta’s method), and lateral deviations, ranging from 1.32 mm (among boys with kyphosis < 42°) to 2.99 mm (among patients with kyphosis ≥ 42° rehabilitated solely according to Vojta’s method). Conclusions Neurophysiological rehabilitation of patients with postural defects produced positive effects by improving the angle of thoracic kyphosis, spinal rotation and lateral deviation of the spine. Children with reduced thoracic kyphosis achieved less improvement in the kyphosis angle, lateral spinal deviation and spinal rotation than children with kyphosis ≥ 42°. The DIERS Formetric System enables precise monitoring of therapeutic outcomes. Int J Occup Med Environ Health. 2019;32(1):25–32

Efficacy of the use of the McKenzie and Vojta methods to treat discopathy-associated syndromes in the pediatric population

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Żurawski A., Kiebzak W., Zmyślna A., Pogożelska J., Kotela I., Kowalski T. J., Śliwiński Z., Śliwiński G.

International Journal of Occupational Medicine and Environmental Health

2019

vol. 32

issue 1

33-41

Objectives This paper evaluates the efficacy of using the McKenzie and Vojta methods for patients with low back pain and the use of the DIERS Formetric 4D system as an objective diagnostic tool. Material and Methods The study enrolled 28 patients aged 15–17 years old. The patients were hospitalized at the Department of Orthopedics and Traumatology of the Świętokrzyskie Center for Pediatrics in Kielce with a diagnosis of back pain associated with a discopathy. The patients were rehabilitated according to the McKenzie and Vojta methods. Assessment by means of the DIERS Formetric system had taken place before the first therapy session and on the day that pain was eliminated to evaluate trunk inclination, angle of thoracic kyphosis, angle of lumbar lordosis, lateral deviation, trunk torsion, surface rotation and pelvic obliquity. Pain intensity and change in pain intensity over time were assessed by means of a numerical rating scale. Results Pain intensity was reduced to 0 over 3–12 days. The study participants demonstrated reduction in anterior trunk inclination of the mean value at 1.83°. The angle of thoracic kyphosis was also reduced by 7.95°. The angle of lordosis increased by 7.6°. The lateral spinal curvature was reduced by 8.92 mm. There was a reduction of 4.64° in trunk torsion. Surface rotation was reduced by 1.61° and pelvic obliquity was reduced by 3.78°. Conclusions In discopathic patients, postural parameters comprising trunk inclination, angle of thoracic kyphosis, angle of lumbar lordosis, lateral deviation, trunk torsion, vertebral rotation and pelvic obliquity fail to reach Hartzmann’s physiological reference ranges. A therapeutic intervention based on the Vojta and McKenzie methods may normalize the posture to physiological reference ranges and is effective in the treatment of patients with back pain. The DIERS system is an objective tool for tracing the effects of therapy in patients with back pain. Int J Occup Med Environ Health. 2019;32(1):33–41

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2 International Journal of Occupational Medicine and Environmental Health

2 Kiebzak W.

2 Kotela I.

2 Kowalski T. J.

2 Zmyślna A.

2 Śliwiński G.

2 Śliwiński Z.

2 Żurawski A.

1 Pogorzelska J.

1 Pogożelska J.

2 2019

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Effect of physiotherapy on spinal alignment in children with postural defects

Efficacy of the use of the McKenzie and Vojta methods to treat discopathy-associated syndromes in the pediatric population