Five days of inpatient scoliosis-specific exercises improve preoperative spinal flexibility and facilitate curve correction of patients with rigid idiopathic scoliosis
Preoperative spine flexibility plays a key role in the intraoperative treatment course of severe scoliosis. In this cohort study, we examined the effects of 5 day inpatient scoliosis-specific exercise (SSE) on the spinal flexibility of patients with adolescent idiopathic scoliosis before surgery. A...
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| creator | Fan, Yunli To, Michael K. T. Kuang, Guan-Ming Lou, Nan Zhu, Feng Tao, Huiren Li, Guangshuo Yeung, Eric H. K. Cheung, Kenneth M. C. Cheung, Jason P. Y. |
| description | Preoperative spine flexibility plays a key role in the intraoperative treatment course of severe scoliosis. In this cohort study, we examined the effects of 5 day inpatient scoliosis-specific exercise (SSE) on the spinal flexibility of patients with adolescent idiopathic scoliosis before surgery. A total of 65 patients were analyzed. These patients were divided into a prospective cohort (
n
= 43, age: 15 ± 1.6 years, 36 girls and 7 boys, Lenke class 1 and 2, Cobb angle: 64 ± 11°) who underwent spinal fusion in 2020, and a retrospective cohort (
n
= 22, age: 15 ± 1.5 years, 17 girls and 5 boys, Lenke class 1 or 2, Cobb angle: 63 ± 10°), who underwent surgery between 2018 and 2019 and did not receive preoperative SSE. Rigid scoliosis was defined as a reduction of less than 50% in Cobb angle between the preoperative fulcrum bending and initial standing curve magnitude. In the prospective cohort, 21 patients (Cobb angle: 65 ± 11°) presented with rigid thoracic scoliosis (pre-SSE fulcrum bending: 40 ± 9°, 39% reduction), and therefore received 5-day SSE to improve their preoperative spinal flexibility (SSE group), whereas 22 patients (Cobb angle: 63 ± 12°) presented with flexible thoracic scoliosis (pre-SSE fulcrum bending: 27 ± 8°, 58% reduction), and therefore underwent surgery without preoperative SSE (non-SSE group). For patients who received 5-day preoperative SSE for 4 h every day, the International Schroth Three-Dimensional Scoliosis Therapy technique was implemented with an inpatient model. After 5 days of SSE, improvements in Cobb angle with post-SSE fulcrum-bending radiography (23 ± 7°, 66% reduction) and pulmonary function (forced expiratory volume in 1 s/forced expiratory volume: 87% before SSE and 92% after SSE,
p
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| doi_str_mv | 10.1007/s43390-024-00965-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11729093</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3109977442</sourcerecordid><originalsourceid>FETCH-LOGICAL-c328t-654217b9446e659c09bdebbfa28d9126f0d28e979620ac4fd68bdaffcd377d3c3</originalsourceid><addsrcrecordid>eNp9UctuEzEUHSEQrUp_gAXyks2AX_PwCqGKlkqV2IDEzvLY18mtJuPBd1KaL-I3cZoQwQZv7Ot7XtKpqteCvxOcd-9JK2V4zaWuOTdtU4tn1bmUQtZCNf3z01t_P6suie55OX2vRd-8rM6UUbJRip9Xv67xAVhwO2IpMpxmtyBMCyOfRkyEVNMMHiN6Bo-QPRIQw82cU6HNGdIMuVDKQDNObmRxhEcccMRlx9wUWHR-P7gFmN_mgvMpZ_ALpmnvePQj9hOXNcu4wsAwYCr_6-J5ivGqehHdSHB5vC-qb9efvl59ru--3NxefbyrvZL9UreNlqIbjNYttI3x3AwBhiE62QcjZBt5kD2YzrSSO69jaPshuBh9UF0XlFcX1YeD7rwdNhB8yZbdaOeMG5d3Njm0_24mXNtVerBCdNJwo4rC26NCTj-2QIvdIHkYRzdB2pJVghvTdVrLApUHqM-JKEM8-Qhu9y3bQ8u2tGyfWraikN78nfBE-dNpAagDgMpqWkG292mbSzf0P9nffNK55g</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3109977442</pqid></control><display><type>article</type><title>Five days of inpatient scoliosis-specific exercises improve preoperative spinal flexibility and facilitate curve correction of patients with rigid idiopathic scoliosis</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Fan, Yunli ; To, Michael K. T. ; Kuang, Guan-Ming ; Lou, Nan ; Zhu, Feng ; Tao, Huiren ; Li, Guangshuo ; Yeung, Eric H. K. ; Cheung, Kenneth M. C. ; Cheung, Jason P. Y.</creator><creatorcontrib>Fan, Yunli ; To, Michael K. T. ; Kuang, Guan-Ming ; Lou, Nan ; Zhu, Feng ; Tao, Huiren ; Li, Guangshuo ; Yeung, Eric H. K. ; Cheung, Kenneth M. C. ; Cheung, Jason P. Y.</creatorcontrib><description>Preoperative spine flexibility plays a key role in the intraoperative treatment course of severe scoliosis. In this cohort study, we examined the effects of 5 day inpatient scoliosis-specific exercise (SSE) on the spinal flexibility of patients with adolescent idiopathic scoliosis before surgery. A total of 65 patients were analyzed. These patients were divided into a prospective cohort (
n
= 43, age: 15 ± 1.6 years, 36 girls and 7 boys, Lenke class 1 and 2, Cobb angle: 64 ± 11°) who underwent spinal fusion in 2020, and a retrospective cohort (
n
= 22, age: 15 ± 1.5 years, 17 girls and 5 boys, Lenke class 1 or 2, Cobb angle: 63 ± 10°), who underwent surgery between 2018 and 2019 and did not receive preoperative SSE. Rigid scoliosis was defined as a reduction of less than 50% in Cobb angle between the preoperative fulcrum bending and initial standing curve magnitude. In the prospective cohort, 21 patients (Cobb angle: 65 ± 11°) presented with rigid thoracic scoliosis (pre-SSE fulcrum bending: 40 ± 9°, 39% reduction), and therefore received 5-day SSE to improve their preoperative spinal flexibility (SSE group), whereas 22 patients (Cobb angle: 63 ± 12°) presented with flexible thoracic scoliosis (pre-SSE fulcrum bending: 27 ± 8°, 58% reduction), and therefore underwent surgery without preoperative SSE (non-SSE group). For patients who received 5-day preoperative SSE for 4 h every day, the International Schroth Three-Dimensional Scoliosis Therapy technique was implemented with an inpatient model. After 5 days of SSE, improvements in Cobb angle with post-SSE fulcrum-bending radiography (23 ± 7°, 66% reduction) and pulmonary function (forced expiratory volume in 1 s/forced expiratory volume: 87% before SSE and 92% after SSE,
p
< 0.01) were observed. At the postoperative day 5, the degree of scoliosis had reduced from 44 ± 6.6° to 22 ± 6° in the SSE group, which is 1° less than the Cobb angle obtained on post-SSE fulcrum-bending radiography. In the non-SSE group, the degree of scoliosis decreased to 26 ± 5.7°. In the retrospective cohort, the degree of scoliosis decreased to 35 ± 5°, with the group also having higher postoperative pain (Visual Analog Scale score = 7, range = 5–10) and an extended hospitalization duration (11 ± 3 days). At 2-year follow-up, curve correction was found to be maintained without adding-on or proximal junctional kyphosis. Compared with the non-SSE group, the SSE group exhibited a greater curve correction (66%) with a shorter hospitalization duration (5 ± 1 days) and a lower degree of postoperative pain (Visual Analog Scale score = 4, range = 3–8). Taken together, our findings indicate that 5 day SSE improves preoperative spinal flexibility and facilitates curve correction.</description><identifier>ISSN: 2212-134X</identifier><identifier>ISSN: 2212-1358</identifier><identifier>EISSN: 2212-1358</identifier><identifier>DOI: 10.1007/s43390-024-00965-1</identifier><identifier>PMID: 39325330</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adolescent ; Case Series ; Exercise Therapy - methods ; Female ; Humans ; Inpatients ; Male ; Medicine ; Medicine & Public Health ; Orthopedics ; Preoperative Exercise ; Prospective Studies ; Range of Motion, Articular ; Retrospective Studies ; Scoliosis - diagnostic imaging ; Scoliosis - surgery ; Spinal Fusion - methods ; Spine - surgery ; Time Factors ; Treatment Outcome</subject><ispartof>Spine deformity, 2025-01, Vol.13 (1), p.165-175</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c328t-654217b9446e659c09bdebbfa28d9126f0d28e979620ac4fd68bdaffcd377d3c3</cites><orcidid>0000-0001-9936-8857</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s43390-024-00965-1$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s43390-024-00965-1$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39325330$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fan, Yunli</creatorcontrib><creatorcontrib>To, Michael K. T.</creatorcontrib><creatorcontrib>Kuang, Guan-Ming</creatorcontrib><creatorcontrib>Lou, Nan</creatorcontrib><creatorcontrib>Zhu, Feng</creatorcontrib><creatorcontrib>Tao, Huiren</creatorcontrib><creatorcontrib>Li, Guangshuo</creatorcontrib><creatorcontrib>Yeung, Eric H. K.</creatorcontrib><creatorcontrib>Cheung, Kenneth M. C.</creatorcontrib><creatorcontrib>Cheung, Jason P. Y.</creatorcontrib><title>Five days of inpatient scoliosis-specific exercises improve preoperative spinal flexibility and facilitate curve correction of patients with rigid idiopathic scoliosis</title><title>Spine deformity</title><addtitle>Spine Deform</addtitle><addtitle>Spine Deform</addtitle><description>Preoperative spine flexibility plays a key role in the intraoperative treatment course of severe scoliosis. In this cohort study, we examined the effects of 5 day inpatient scoliosis-specific exercise (SSE) on the spinal flexibility of patients with adolescent idiopathic scoliosis before surgery. A total of 65 patients were analyzed. These patients were divided into a prospective cohort (
n
= 43, age: 15 ± 1.6 years, 36 girls and 7 boys, Lenke class 1 and 2, Cobb angle: 64 ± 11°) who underwent spinal fusion in 2020, and a retrospective cohort (
n
= 22, age: 15 ± 1.5 years, 17 girls and 5 boys, Lenke class 1 or 2, Cobb angle: 63 ± 10°), who underwent surgery between 2018 and 2019 and did not receive preoperative SSE. Rigid scoliosis was defined as a reduction of less than 50% in Cobb angle between the preoperative fulcrum bending and initial standing curve magnitude. In the prospective cohort, 21 patients (Cobb angle: 65 ± 11°) presented with rigid thoracic scoliosis (pre-SSE fulcrum bending: 40 ± 9°, 39% reduction), and therefore received 5-day SSE to improve their preoperative spinal flexibility (SSE group), whereas 22 patients (Cobb angle: 63 ± 12°) presented with flexible thoracic scoliosis (pre-SSE fulcrum bending: 27 ± 8°, 58% reduction), and therefore underwent surgery without preoperative SSE (non-SSE group). For patients who received 5-day preoperative SSE for 4 h every day, the International Schroth Three-Dimensional Scoliosis Therapy technique was implemented with an inpatient model. After 5 days of SSE, improvements in Cobb angle with post-SSE fulcrum-bending radiography (23 ± 7°, 66% reduction) and pulmonary function (forced expiratory volume in 1 s/forced expiratory volume: 87% before SSE and 92% after SSE,
p
< 0.01) were observed. At the postoperative day 5, the degree of scoliosis had reduced from 44 ± 6.6° to 22 ± 6° in the SSE group, which is 1° less than the Cobb angle obtained on post-SSE fulcrum-bending radiography. In the non-SSE group, the degree of scoliosis decreased to 26 ± 5.7°. In the retrospective cohort, the degree of scoliosis decreased to 35 ± 5°, with the group also having higher postoperative pain (Visual Analog Scale score = 7, range = 5–10) and an extended hospitalization duration (11 ± 3 days). At 2-year follow-up, curve correction was found to be maintained without adding-on or proximal junctional kyphosis. Compared with the non-SSE group, the SSE group exhibited a greater curve correction (66%) with a shorter hospitalization duration (5 ± 1 days) and a lower degree of postoperative pain (Visual Analog Scale score = 4, range = 3–8). Taken together, our findings indicate that 5 day SSE improves preoperative spinal flexibility and facilitates curve correction.</description><subject>Adolescent</subject><subject>Case Series</subject><subject>Exercise Therapy - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Inpatients</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Preoperative Exercise</subject><subject>Prospective Studies</subject><subject>Range of Motion, Articular</subject><subject>Retrospective Studies</subject><subject>Scoliosis - diagnostic imaging</subject><subject>Scoliosis - surgery</subject><subject>Spinal Fusion - methods</subject><subject>Spine - surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>2212-134X</issn><issn>2212-1358</issn><issn>2212-1358</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9UctuEzEUHSEQrUp_gAXyks2AX_PwCqGKlkqV2IDEzvLY18mtJuPBd1KaL-I3cZoQwQZv7Ot7XtKpqteCvxOcd-9JK2V4zaWuOTdtU4tn1bmUQtZCNf3z01t_P6suie55OX2vRd-8rM6UUbJRip9Xv67xAVhwO2IpMpxmtyBMCyOfRkyEVNMMHiN6Bo-QPRIQw82cU6HNGdIMuVDKQDNObmRxhEcccMRlx9wUWHR-P7gFmN_mgvMpZ_ALpmnvePQj9hOXNcu4wsAwYCr_6-J5ivGqehHdSHB5vC-qb9efvl59ru--3NxefbyrvZL9UreNlqIbjNYttI3x3AwBhiE62QcjZBt5kD2YzrSSO69jaPshuBh9UF0XlFcX1YeD7rwdNhB8yZbdaOeMG5d3Njm0_24mXNtVerBCdNJwo4rC26NCTj-2QIvdIHkYRzdB2pJVghvTdVrLApUHqM-JKEM8-Qhu9y3bQ8u2tGyfWraikN78nfBE-dNpAagDgMpqWkG292mbSzf0P9nffNK55g</recordid><startdate>20250101</startdate><enddate>20250101</enddate><creator>Fan, Yunli</creator><creator>To, Michael K. T.</creator><creator>Kuang, Guan-Ming</creator><creator>Lou, Nan</creator><creator>Zhu, Feng</creator><creator>Tao, Huiren</creator><creator>Li, Guangshuo</creator><creator>Yeung, Eric H. K.</creator><creator>Cheung, Kenneth M. C.</creator><creator>Cheung, Jason P. Y.</creator><general>Springer International Publishing</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9936-8857</orcidid></search><sort><creationdate>20250101</creationdate><title>Five days of inpatient scoliosis-specific exercises improve preoperative spinal flexibility and facilitate curve correction of patients with rigid idiopathic scoliosis</title><author>Fan, Yunli ; To, Michael K. T. ; Kuang, Guan-Ming ; Lou, Nan ; Zhu, Feng ; Tao, Huiren ; Li, Guangshuo ; Yeung, Eric H. K. ; Cheung, Kenneth M. C. ; Cheung, Jason P. Y.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c328t-654217b9446e659c09bdebbfa28d9126f0d28e979620ac4fd68bdaffcd377d3c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Adolescent</topic><topic>Case Series</topic><topic>Exercise Therapy - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Inpatients</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Preoperative Exercise</topic><topic>Prospective Studies</topic><topic>Range of Motion, Articular</topic><topic>Retrospective Studies</topic><topic>Scoliosis - diagnostic imaging</topic><topic>Scoliosis - surgery</topic><topic>Spinal Fusion - methods</topic><topic>Spine - surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fan, Yunli</creatorcontrib><creatorcontrib>To, Michael K. T.</creatorcontrib><creatorcontrib>Kuang, Guan-Ming</creatorcontrib><creatorcontrib>Lou, Nan</creatorcontrib><creatorcontrib>Zhu, Feng</creatorcontrib><creatorcontrib>Tao, Huiren</creatorcontrib><creatorcontrib>Li, Guangshuo</creatorcontrib><creatorcontrib>Yeung, Eric H. K.</creatorcontrib><creatorcontrib>Cheung, Kenneth M. C.</creatorcontrib><creatorcontrib>Cheung, Jason P. Y.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Spine deformity</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fan, Yunli</au><au>To, Michael K. T.</au><au>Kuang, Guan-Ming</au><au>Lou, Nan</au><au>Zhu, Feng</au><au>Tao, Huiren</au><au>Li, Guangshuo</au><au>Yeung, Eric H. K.</au><au>Cheung, Kenneth M. C.</au><au>Cheung, Jason P. Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Five days of inpatient scoliosis-specific exercises improve preoperative spinal flexibility and facilitate curve correction of patients with rigid idiopathic scoliosis</atitle><jtitle>Spine deformity</jtitle><stitle>Spine Deform</stitle><addtitle>Spine Deform</addtitle><date>2025-01-01</date><risdate>2025</risdate><volume>13</volume><issue>1</issue><spage>165</spage><epage>175</epage><pages>165-175</pages><issn>2212-134X</issn><issn>2212-1358</issn><eissn>2212-1358</eissn><abstract>Preoperative spine flexibility plays a key role in the intraoperative treatment course of severe scoliosis. In this cohort study, we examined the effects of 5 day inpatient scoliosis-specific exercise (SSE) on the spinal flexibility of patients with adolescent idiopathic scoliosis before surgery. A total of 65 patients were analyzed. These patients were divided into a prospective cohort (
n
= 43, age: 15 ± 1.6 years, 36 girls and 7 boys, Lenke class 1 and 2, Cobb angle: 64 ± 11°) who underwent spinal fusion in 2020, and a retrospective cohort (
n
= 22, age: 15 ± 1.5 years, 17 girls and 5 boys, Lenke class 1 or 2, Cobb angle: 63 ± 10°), who underwent surgery between 2018 and 2019 and did not receive preoperative SSE. Rigid scoliosis was defined as a reduction of less than 50% in Cobb angle between the preoperative fulcrum bending and initial standing curve magnitude. In the prospective cohort, 21 patients (Cobb angle: 65 ± 11°) presented with rigid thoracic scoliosis (pre-SSE fulcrum bending: 40 ± 9°, 39% reduction), and therefore received 5-day SSE to improve their preoperative spinal flexibility (SSE group), whereas 22 patients (Cobb angle: 63 ± 12°) presented with flexible thoracic scoliosis (pre-SSE fulcrum bending: 27 ± 8°, 58% reduction), and therefore underwent surgery without preoperative SSE (non-SSE group). For patients who received 5-day preoperative SSE for 4 h every day, the International Schroth Three-Dimensional Scoliosis Therapy technique was implemented with an inpatient model. After 5 days of SSE, improvements in Cobb angle with post-SSE fulcrum-bending radiography (23 ± 7°, 66% reduction) and pulmonary function (forced expiratory volume in 1 s/forced expiratory volume: 87% before SSE and 92% after SSE,
p
< 0.01) were observed. At the postoperative day 5, the degree of scoliosis had reduced from 44 ± 6.6° to 22 ± 6° in the SSE group, which is 1° less than the Cobb angle obtained on post-SSE fulcrum-bending radiography. In the non-SSE group, the degree of scoliosis decreased to 26 ± 5.7°. In the retrospective cohort, the degree of scoliosis decreased to 35 ± 5°, with the group also having higher postoperative pain (Visual Analog Scale score = 7, range = 5–10) and an extended hospitalization duration (11 ± 3 days). At 2-year follow-up, curve correction was found to be maintained without adding-on or proximal junctional kyphosis. Compared with the non-SSE group, the SSE group exhibited a greater curve correction (66%) with a shorter hospitalization duration (5 ± 1 days) and a lower degree of postoperative pain (Visual Analog Scale score = 4, range = 3–8). Taken together, our findings indicate that 5 day SSE improves preoperative spinal flexibility and facilitates curve correction.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>39325330</pmid><doi>10.1007/s43390-024-00965-1</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-9936-8857</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Case Series Exercise Therapy - methods Female Humans Inpatients Male Medicine Medicine & Public Health Orthopedics Preoperative Exercise Prospective Studies Range of Motion, Articular Retrospective Studies Scoliosis - diagnostic imaging Scoliosis - surgery Spinal Fusion - methods Spine - surgery Time Factors Treatment Outcome |
| title | Five days of inpatient scoliosis-specific exercises improve preoperative spinal flexibility and facilitate curve correction of patients with rigid idiopathic scoliosis |
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