Evaluation of locoregional ventilation repartition in girls with adolescent idiopathic scoliosis and healthy adolescents : the effect of the three dimensional schroth ‘rotational breathing’ exercise

Details

Supervisors

Mahaudens, Philippe

Faculty

Faculté des sciences de la motricité

Degree label

Master [120] en sciences de la motricité, orientation générale

Abstract

Study Design. Prospective 2-cohorte comparative analyses of data collected prospectively in girls with adolescent idiopathic scoliosis (AIS) and controls. Objective. To assess the immediate lung’s locoregional ventilation activity occurring when Schroth ‘rotational breathing’ exercise was performed. Summary of Background Data Adolescent idiopathic scoliosis (AIS) treatments, including the ‘Schroth Method’, are developed to improve AIS’ Vital Capacity, muscle strength, vertebral derotation, and Cobb angle. Schroth clinicians are training patients to exert specific breathing exercises on basis of an assumed scoliotic enhanced ventilation distribution in areas called ‘Humps’ (dorsal right and ventral left thorax) and the patient’s ability to voluntary direct their ventilation in thorax areas presumed little ventilated and called ‘Flats’ (ventral right and dorsal left thorax). But neither the asymmetric ventilation assumption, neither patient’s ability to direct their ventilation has never been reported. Methods. 16 healthy girls and 17 AIS females, with right structural curves (10-45° Cobb) were included and performed 3 x 3 minute’s measurements sessions: rest breathing, maximal breathing, and Schroth’s ‘rotational breathing’. Simultaneously, Electrical Impedance Tomography (EIT) scans reconstructed cross-sectional images of locoregional ventilation’s distribution at T8-T9 level. EIT images were divided into 4 quadrants: anterior right (ROI 1), antero-left (ROI 2), posterior-right (ROI 3) and posterior-left (ROI 4) quadrants. In AIS sample, ‘Humps’ were the sum of ROI 2+ 3, ‘Flats’ were the sum of ROI 1+4. The same division was made in control’s thorax. To analyse the probability that exercises increases locoregional ventilation, Odds Ratios were calculated between ‘ROI 1+4’ and ‘ROI 2+3’ on EIT 3 minute’s recordings during each exercise and for both samples. Results. There were no significant differences between any groups and between any exercises. Ventilation was homogeneous in both populations and in every exercise modality. Conclusion. Schroth ‘rotational breathing’ postulate was not confirmed by our study.