Pulmonary function and spinal characteristics: Their relationships in persons with idiopathic and postpoliomyelitic scoliosis

• Published in: Archives of physical medicine and rehabilitation Vol. 82; no. 3; pp. 335 - 341
• Main Authors: Lin, Meng-Chih, Liaw, Mei-Yun, Chen, Wen-Jer, Cheng, Pao-Tsai, Wong, Alice May-Kuen, Chiou, Wen-Ko
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2001; Elsevier
• Subjects: Adult; Analysis of Variance; Biological and medical sciences; Breathing exercises; Diseases of the osteoarticular system; Diseases of the spine; Female; Humans; Male; Medical sciences; Postpoliomyelitis syndrome; Postpoliomyelitis Syndrome - complications; Postpoliomyelitis Syndrome - physiopathology; Postpoliomyelitis Syndrome - rehabilitation; Prospective Studies; Rehabilitation; Respiration Disorders - etiology; Respiration Disorders - physiopathology; Respiratory Function Tests; Respiratory Mechanics; Respiratory Muscles; Scoliosis; Scoliosis - complications; Scoliosis - physiopathology; Scoliosis - rehabilitation; Statistics, Nonparametric; Tropical medicine; Postpoliomyelitis syndrome; Breathing exercises; Rehabilitation; Scoliosis; Respiratory function tests; Human; Spirometry; Deformation; Respiratory disease; Spine; Diseases of the osteoarticular system; Idiopathic; Spine disease; Infection; Lung function; Respiratory failure; Viral disease; Complication; Polioencephalomyelitis; Predictive factor; Comparative study
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1053/apmr.2001.21528

Lin M-C, Liaw M-Y, Chen W-J, Cheng P-T, Wong AM-K, Chiou W-K. Pulmonary function and spinal characteristics: their relationships in persons with idiopathic and postpoliomyelitic scoliosis. Arch Phys Med Rehabil 2001;82:335-41. Objective: To identify what influence the various features of spinal deformity have on pulmonary function in persons with idiopathic and the postpoliomyelitic scoliosis. Design: Prospective, cohort, observational study with clinical and radiologic evaluations. Setting: Hospital-based rehabilitation units. Patients: Forty-four patients with idiopathic scoliotis and 16 with postpoliomyelitic scoliotis. Each group was divided into subgroups: normal and abnormal pulmonary function. Intervention: Clinical and radiologic evaluation of spinal deformity, full pulmonary functional test and respiratory muscle strength were performed. Presence of dyspnea on exertion and low back pain (LBP) was recorded. Main Outcome Measures: Pulmonary function: spirometry, lung volume test, and diffusing capacity. Respiratory muscle strength: maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). Presence of dyspnea on exertion (DOE), and LBP were also recorded. Characteristics of spinal deformity: direction of convexity, uppermost vertebra, number of involved vertebrae, Cobb angle, the apical vertebra, degree of rotation at the apical vertebra, type of scoliotic curve, and presence of balanced spine and pelvic obliquity. Chi-square analyses and Mann-Whitney U test for between-groups comparisons. Spearman's rho correlation coefficient to determine the existence and magnitude of a relationship. Results: We found significant differences between the idiopathic and postpoliomyelitis groups in the degree of rotation at the apical vertebra, MIP, average percentage of predicted vital capacity, residual volume/total lung capacity, presence of double or triple curves, pelvic obliquity, and DOE. Between the idiopathic scoliotis subgroups we found significant differences in the uppermost vertebra and number of vertebrae in the scoliotic curve. Between the subgroups of the postpoliomyelitis group were significant differences in the location of the apical vertebra and the uppermost vertebral body of scoliotic curve. In the idiopathic group, pulmonary function was mostly related to scoliotic angle, number of vertebrae in the scoliotic curve, location of the uppermost vertebra, and the patients' age; MIP and MEP were negatively related to the scoliotic angle and degree of rotation of apical vertebra. In the postpoliomyelitis group, pulmonary function was mostly related to scoliotic angle, kyphotic angle, location of the uppermost vertebra of the scoliotic curve, and age. Conclusion: No single factor can predict the severity of impairment in scoliotic patients' pulmonary function. In both groups, severity of pulmonary impairment was related to the combined features of the spinal deformity. However, uppermost vertebra, scoliotic angle, and patient's age may play important roles influencing pulmonary function in both groups.