Optimising spinal alignment and chest wall expansion in adolescents with idiopathic scoliosis using postural correction

Aim
Progressive spinal deformity may contribute to impaired pulmonary function over time. This study investigated the extent of correctability of spinal alignment and associated change in chest wall expansion in individuals with idiopathic scoliosis.

Design
A cross-sectional study.

Method
Real-time 3D spinal alignment and chest wall expansion of subjects with idiopathic scoliosis were measured by surface topography and motion capturing system respectively, in natural and corrected postures in sitting. Spinal alignment in both angular and linear dimensions in coronal plane, and chest wall expansion and its side-to-side symmetry were compared before and after postural correction.

Results
20 young subjects (15F:5M, aged 21.05 years ± 4.03) with idiopathic scoliosis participated in this study. Mean Cobb’s angle was 23.5° ± 9.99°, with scoliotic apex at mid-thoracic apex (T6-9, n=7), lower thoracic apex (T10-T12, n=9) and upper lumbar apex (L1-L3, n=4).

The mean change of corrected-to-natural in Cobb's angle equivalent angle, coronal imbalance, pelvic obliquity, and apical deviation were -4.65° (±6.08°), -5.8mm (±9.93), -1.55mm (±5.82), and -5mm (±8.40) respectively. The mean change of tidal volume over concave and convex sides were +24.86ml (±110.34), and +39.56ml (±131.39) respectively. 9 and 6 subjects exhibited improvements in side-to-side symmetry in normal breathing and deep breathing after postural correction respectively.

Conclusion
Spinal alignment and tidal volume but not total lung capacity improved after Schroth correction in young individuals with mild degree of scoliosis.

Key practice points
Postural correction alone is insufficient to improve total lung volume nor to optimize chest expansion asymmetry in individuals with mild scoliosis.