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Postural control in idiopathic scoliosis: comparison between healthy and scoliotic subjects - 06/05/08

Doi : RCOE-05-2004-90-3-0035-1040-101019-200514052 

V. Silferi [1],

P. Rougier [1],

H. Labelle [2],

P. Allard [2]

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Abstract

Purpose of the study

To assess the effects of idiopathic scoliosis on undisturbed postural control in young female teenagers.

Material and methods

The center of pressure (CP) displacements, measured through a force platform, were decomposed into two elementary components in order to differentiate the net postural performance, as revealed by the horizontal motions of the center of gravity (CGh) and the level of muscular activity expressed by the vertical difference CP-CGv. The CG horizontal displacements were estimated from those of the CP with a low pass filter taking into account the subjects' anthropometry. Fifteen healthy teenagers and fifteen teenagers with idiopathic scoliosis were asked to stand still upright for three successive trials of 64s, rest periods of similar duration being allowed between each trial.

Results

The results indicate differences in the postural control between the two populations: scoliotic CG motions are more ample than those of healthy subjects. In the medio-lateral direction, the CGh motions can be primarily explained by the concomitant increase observed at the CP-CGv level. To be more precise, one should have in mind that the CP-CGv amplitudes determine the horizontal acceleration communicated to CGh. On the other hand, despite significant increases of the CP-CGv in the antero-posterior direction, the CGh motions appear to be unaffected by these initial conditions. This feature suggests that appropriate control mechanisms can intervene in this antero-posterior direction for the scoliotic group whereas a similar organization cannot be observed in the medio-lateral direction.

Discussion

The differences observed in the postural performance for the healthy and scoliotic groups can be explained in various ways. The capacity of the scoliotic group to counteract significant CP-CGv motion may be linked to the location of the postural muscles involved in this control: the triceps surae for the antero-posterior direction, and the abductor-adductor hip muscles for the medio-lateral one. Only the action of the latter group can be indeed perturbed by the specific constraints occurring at the hip level and resulting from the scoliosis. On the other hand, the general increase of the CP-CGv motions, by expressing an overwhelming muscular activity in the whole set of postural muscles, does suggest that the drive of the descending motor commands is largely modulated and is likely the consequence of central dysfunction.

Keywords: Idiopathic scoliosis , centre of gravity , centre of pressure , muscular stiffness , undisturbed upright stance


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Vol 90 - N° 3

P. 215-224 - mai 2004 Retour au numéro

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