RESUMEN
BACKGROUND: Positive effects of brace treatments in adolescent idiopathic scoliosis patients on gait were proven. AIM: Therefore, this study examined whether the influence of brace therapy in combination with Schroth therapy influencing the plantar pressure distribution, pre and post intensive rehabilitative inpatient treatment. DESIGN: Prospective cohort study, longitudinal. SETTING: Scoliosis rehabilitation clinic "Asklepios Katharina-Schroth-Klinik" (Bad Sobernheim, Germany). POPULATION: Twenty (14f/6m) patients (12-16 years) had a medically diagnosed moderate idiopathic scoliosis (Cobb angle 20-50°, Median 30°) and an indication for combined brace and Schroth therapy with an inpatient stay (4 weeks) at the Asklepios Katharina Schroth Clinic (Germany). METHODS: At the beginning (T1) and at the end of the stay (T2), the plantar pressure distribution with (A) and without wearing a brace (B) was recorded (walking distance 10 m). RESULTS: No significant differences between the left and right foot were found at baseline (T1). The T1 - T2 comparison of one foot revealed significant differences (p ≤ 0.05 - 0.001, respectively) for (A): mean pressure right midfoot, loaded area total left foot, left midfoot, left inner ball of foot, right midfoot, impulse total right foot, right midfoot and for (B): mean pressure right midfoot, right outer ball of foot, loaded area total right foot, right heel, right midfoot, impulse right heel, right midfoot, right outer ball of foot. CONCLUSIONS: A combined brace and Schroth therapy maintains the initial symmetrical plantar pressure distribution over the duration of four weeks since the significant differences fall within the range of measurement error. CLINICAL REHABILITATION IMPACT: The insole measuring system can be used to objectively support therapeutic gait training as part of rehabilitation and to assess insole fitting based on foot shape. Due to its convenient handling and rapid data acquisition, it may be a suitable method for interim or follow-up diagnostics in the treatment of idiopathic scoliosis.
Asunto(s)
Tirantes , Pie , Presión , Escoliosis , Humanos , Escoliosis/terapia , Escoliosis/fisiopatología , Adolescente , Femenino , Masculino , Estudios Prospectivos , Niño , Pie/fisiopatología , Estudios Longitudinales , Resultado del Tratamiento , Terapia Combinada , MarchaRESUMEN
BACKGROUND: High intensity exercise is considered as an effective means for reducing body fat. The aims of the present study were to investigate (1) whether body mass would be lost and body composition would change and (2) whether variables of anaerobic fitness prior to the intervention period would be related to loss of body mass and changes in body composition in overweight and obese children and adolescents. METHODS: A total of 28 children and adolescents (19 boys, 9 girls) attended an 8-week multicomponent inpatient program. Caloric intake was based on the subject's weight and a daily energy deficit of ~500 kcal was targeted. At the beginning and at the end of the program, variables of anaerobic fitness were assessed using Wingate tests. Body composition was measured before and after the program using dual-energy X-ray absorptiometry. RESULTS: Body mass decreased by 11.4% ± 1.6% in boys and by 11.0% ± 2.8% in girls (P < 0.001). Fat mass decreased by 23.8% ± 6.1% in boys and by 21.5% ± 5.2% in girls (P < 0.001). The decrease in fat mass was associated with the decrease in body mass in boys (r = 0.54, P = 0.017) but not in girls (P > 0.05). The decrease in body mass and the decrease in fat mass were neither associated with overall energy expenditure nor with the energy deficit in both genders (P > 0.05). Mean power in W/kg increased in the Wingate tests by 95.4% ± 109.1% in boys and by 100.0% ± 119.9% in girls (P < 0.001). CONCLUSIONS: Adjustments of the chronically positive imbalance of energy intake and energy expenditure of obese children and adolescents living in obesogenic environments should be addressed in a multisectoral approach. Future research in multicomponent childhood and adolescent weight loss programs should be directed towards a better understanding of the underlying complex dynamics in energy homeostasis which promote weight loss and changes in body composition due to high intensity exercise interventions.