Using the Scoliometer and a Surface Topography Apparatus to Check if Back Trunk Asymmetry Changes in Children and Adolescents in the Forward Flexion and Standing Erect Positions.

Background The purpose of this study is to evaluate the effects of the forward bending (FB) test versus the standing erect (SE) position on back trunk asymmetry (TA). The Scoliometer in the FB position and the 4D Formetric (4DF; Diers International, Schlangenbad, Germany) readings in the SE position were assessed. Method The angle of trunk inclination (ATI) was measured at the midthoracic, thoracolumbar, and lumbar levels using the Scoliometer in the FB position and the 4DF in the SE position. A total of 134 subjects attending the scoliosis clinic (86 girls and 48 boys), age ranging from seven to 18 years, were assessed. The children and adolescents were divided into three groups according to the severity of TA, symmetric group 1 (0-2 degrees), asymmetry group 2 (2 to 6 degrees), and group 3 having asymmetry of seven or more degrees. Children with leg length discrepancy were excluded from the study. The IBM SPSS v.20 package (IBM Corp., Armonk, NY) was used for analysis. Results At the midthoracic level comparing the Scoliometer to 4DF readings in males in group 1, the Wilcoxon signed ranks test was p=0.451 while for the Spearman's Rho, it was -0.138; in group 2, p=0.184 and Rho=0.204; and in group 3, p=0.109 and Rho=0.500. For females in group 1, p=0.000 while Rho=0.003; in group 2, p=0.008 and Rho=0.000, and in group 3, p=0.003 while Rho=0.642. At the thoracolumbar level in males for group 1, p=0.004 and Rho=-0.517; in group 2, p=0.006 and Rho=0.000; and in group 3, p=0.043 while Spearman's Rho=0.053. For females in group 1, p=0.000 and Rho=-0.095; in group 2, p=0.000 and Rho=-0.171; in group 3, p=0.001 while Rho= -0.081. At the lumbar level for males in group 1 p=0.000 while Rho=0.149; in group 2, p=0.003 and Rho=0.373; while in group 3, p=0.109 and Rho= (-). For females in group 1, p=0.000 while Rho=-0.072; in group 2, p=0.001 and Rho=0.168; and in group 3, p=0.068 while Rho=0.500. Conclusion The results of this study show that the back TA in children and adolescents is not similar in the FB and SE positions. This phenomenon probably is attributed to the complicated trunkal (spinal, thoracic, and pelvic) anatomy, and the results of this study may be used as a useful foundation for further understanding of torso dynamics.