Regional pulmonary ventilation and perfusion distribution in patients with untreated idiopathic scoliosis

Regional lung function using xenon-133 was studied in 45 seated patients aged 11 to 78 years with untreated idiopathic scoliosis and angulation of curvature between 10 and 190°. Perfusion distribution was assessed by intravenous bolus injection of ¹³³Xe and distribution of ventilation to volume ratios by washouts after inhalation and intravenous injection.     

A comparison of sonography and myelography in clinically suspected spinal stenosis

Anterio-posterior measurements of the subarachnoidal space of the lumbar spinal canal were obtained by myelography and by ultrasound. The correlation between the measurements is low and the distribution of the regression coefficient is considerable. The usefulness of diagnostic ultrasound as a screening procedure for patients with clinically suspected spinal stenosis, therefore, is limited. The noninvasive ultrasound method, nevertheless, has a certain value for selecting patients for myelography. An ultrasound measurement of 14 mm or more will exclude that the corresponding anterio-posterior measurement obtained at myelography is 8 mm or below.     

Joint flexibilities in structurally normal girls and girls with idiopathic scoliosis

Seven clinical measurements of joint flexibilities were made in 51 girls with untreated mild idiopathic scoliosis and 65 girls with structurally normal spines. Subject ages ranged from 10 to 16 years. Abilities to have the index finger passively extended, the wrist bent, and the elbow and the knee hyperextended, along with abilities to bend the trunk voluntarily forward and to the right and left sides, were measured. The girls with scoliosis in the mean either had the same flexibilities or were less flexible than the normal girls. The study provided no evidence that untreated mild idiopathic scoliosis occurs or progresses because of increased joint flexibilities.     

Mobility, strength, and fitness after a graded activity program for patients with subacute low back pain. A randomized prospective clinical study with a behavioral therapy approach.

Patients with nonspecific mechanical low back pain (n = 103), examined by an orthopaedic surgeon and a social worker, were randomized to an activity group (n = 51) and a control group (n = 52). Patients with defined orthopaedic, medical, or psychiatric diagnoses were excluded before randomization. No patients were excluded due to place of birth or difficulties in speaking or understanding the Swedish language. The purpose of the study was to compare mobility, strength and fitness after traditional care and after traditional care plus a graded activity program with a behavioral therapy approach. A graded activity program, with a behavioral therapy approach was given under the guidance of a physical therapist. The endpoint of the graded activity program was return to work. This program significantly increased mobility, strength, and fitness more than could be explained by only a time recovery effect, especially in males. The patients in the activity group returned to work earlier than did the patients in the control group. Spinal rotation, abdominal muscle endurance time and lifting capacity were significantly correlated to rate of return to work. Traditional care plus a graded activity program were superior to only traditional care, evaluated in terms of mobility, strength and fitness. The graded activity program proved to be a successful method of restoring occupational function and facilitating return to work in subacute low back pain patients. The patients in the graded activity program learned that it is safe to move, while regaining function.     

Respiratory failure in scoliosis and other thoracic deformities. A survey of patients with home oxygen or ventilator therapy in Sweden.

Registers covering Swedish patients with home ventilator or long-term oxygen therapy were used to study respiratory failure caused by thoracic deformities. In all, 107 patients were studied. Postpolio scoliosis was found in 47 patients. The age of starting therapy varied between 28 and 80 years. Fourteen patients had thoracic deformities other than scoliosis. The mean scoliotic angle was 135 degrees among the patients with scoliosis, and the mean vital capacity was 26% (range, 13-54%) of predicted normal. The yearly demand for home ventilator or oxygen therapy is calculated to three per million inhabitants. No operated patients had respiratory failure, and no patients were found with idiopathic scoliosis and respiratory failure younger than 30 years of age, which may indicate a preventive effect of corrective surgery on the development of respiratory failure.     

Standing and supine Cobb measures in girls with idiopathic scoliosis

The standing Cobb measure in a group of 287 girls with idiopathic scoliosis at the start of treatment was in the mean approximately 9 degrees larger than the supine Cobb measure. This mean standing-supine difference was essentially independent of curve severity expressed by the supine Cobb measure. Because of this, when the difference was expressed as a percentage of the supine Cobb measure, the mean values of this ratio decreased substantially with increasing curve severity. The mean difference decreased only slightly with age through adolescence, indicating that spine lateral curves stiffen little as patients mature. The standard deviations in the standing minus supine Cobb differences were approximately 6 degrees in the majority of the age and severity groupings studied. Ninety-three percent of these patients had standing-supine Cobb measure differences that were between 0 degrees and 20 degrees.     

Children with surgically corrected hand deformities and upper limb deficiencies: self-concept and psychological well-being

We studied self-concept and psychological well-being in children with hand deformities and upper limb deficiencies. Ninety-two children, 53 boys, 39 girls, aged 9-11 years were included. The children were divided into two subgroups - one with milder (less visible) deformities and one with severe (more complex and visible) finger-hand-arm deformities. Of the 92 children, 79 had received reconstructive surgery, and 13 had been treated with prostheses. The Piers-Harris Children's Self-Concept Scale (PHCSCS) was used to measure self-esteem and well-being. Overall PHCSCS scores showed that the whole hand deformity group had 'good' self-concept with mean scores in excess of 60 points, equal to a comparison group of healthy children. Within the hand deformity group, those with mild deformities had lower scores than those with severe deformities. This result was also found in the group of boys but not in the girls. The children with severe deformities had even higher scores than the comparison group regarding the subscale 'Intellectual and School Status'. The children with milder deformities had lower scores than the comparison group regarding the subscale 'Popularity'.