Clinical equilibration tests, proprioceptive system and Adolescent Idiopathic Scoliosis (AIS)
Mrs Morgane LE BERREa, Mr Marc GUYOTb, Mr Olivier AGNANIb, Mrs Marie-Christine VERSYPc, Mrs Isabelle BOURDEAUDUCQc, Dr Cécile DONZÉb, Dr Jean-François CATANZARITId
a Service de MPR, Hôpital Swynghedauw, CHRU de Lille (France), b Service MPR, Hôpital Saint Philibert, GHICL, Lomme-Lille (France), c SSR pédiatrique Marc Sautelet de Villeneuve d'Ascq (France), d SSR pédiatrique Marc Sautelet de Villeneuve d'Ascq (France), GHICL Hôpital Saint Philibert de Lomme (France), CHRU de Lille (France)
Objective: The AIS is a three-dimensional deformation of the spine, frequent, potentially progressive, with unknown etiology. It is generally accepted as being multifactorial origin, incluing neurosensorial factors, with orthostatic postural control disorders. In particular, Assaiante et al showed a selective impaired of the dynamic proprioceptive tract. However, the procedures used to establish this impaired are complex and require motion analysis laboratories, inaccessible in routine clinical practice. Our objective is to determine whether, by clinical equilibration tests, simple, realizable in routine care, it is possible to find the same result.
Methods: A cross-sectional study comparing 114 adolescents with right thoracic AIS (including 94 girls, mean age 14.5 ± 1.9 years, Cobb angle 35.7 ± 15.3 °) with 81 matched non-scoliotic adolescents (including 69 girls, mean age 14.1 ± 1.9 years) was conducted between January 2013 and March 2015. Three clinical equilibration tests are performed: a dynamic test (Fukuda stepping test-Utenberger), two static tests (Romberg sensitized Support monopodal eyes closed).
Results: For the static tests, no significant difference between the 2 groups. The difference is significant for the dynamic test, for the distance travelled (p <0.01) and the deviation angle (p <0.0001).
Discussion: Our study confirms Assaiante’s results, suggesting a specific impairment of dynamic proprioceptive tract in AIS. This clinical equilibration tests can be performed in daily practice. It is necessary to assess their validity as a biomarker for screening and progression of the AIS.
De Sèze M, Cugy E. Pathogenesis of idiopathic scoliosis: a review. Ann Phys Rehabil Med 2012; 55:128-38.
Assaiante C, Mallau S, Jouve, J. et al Do adolescent idiopathic scoliosis (AIS) neglect proprioceptive information in sensory integration of postural control? PloS one 2012 ;7: e40646.
Assaiante C, Caudron S, Fortin C, et al. Contribution différentiée des informations proprioceptives statiques versus dynamiques dans le contrôle postural des adolescents avec scoliose. Clinical Neurophysiology 2011 ;41:202.
The authors are grateful to the Harps Association’s members, for their helpful comments.
Keywords : Adolescent idiopathic scoliosis, pathophysiology, proprioception, postural control