Hamstrings muscles tightness in adolescences with a thoracic hyperkyphosis: Comparison of muscles flexibility and joint mobility in patients with scheuermann juvenile kyphosis versus postural thoracic hyperkyphosis
Journal Title: Medpulse International Journal of Orthopedics - Year 2019, Vol 9, Issue 2
Abstract
Background: Thoracic hyperkyphosis is classified as non-structural or structural. The Scheuermann’s disease (SD) is one of the most common structural spine hyperkyphosis in adolescents while postural hyperkyphosis (PHK) is non-structural. The tight hamstring muscles (HS) were reported in SD. Aim: The aim of this study was to evaluate the difference in muscles tightness and generalized joint hypermobility between the SD and PHK patients. Material and methods: The study group consisted of 40 SD patients (29 boys and 11 girls) in the age of 13.9 ±1.8 years. The control group consisted of 30 PHK patients (9 boys and 21 girls) in age of 13.0 ±2.1 years. The diagnosis was confirmed radiologically. The following measures were performed in clinical examination: sacral slope, lumbar lordosis, thoracic kyphosis, proximal thoracic kyphosis Th1-Th6, distal thoracic kyphosis Th6-Th12, popliteal angle (PA), fingertip-to-floor test (FTF), modified Thomas test, the gastrocnemius and the pectoralis major muscles flexibility tests. The angles were measured with Saunders digital inclinometer. The occurrence of generalized joint hypermobility (GJH) was evaluated using the Beighton scale. Observations and results: There were no significant differences of the sagittal spine alignment parameters. There were 2 cases of GJH in the PHK patients vs. 0 in SD patients, p=0.4906. The differences between SD patients vs. PHK patients were as follows: PA 51.9 ±8.3° vs. 46.7 ±11.6°, p=0.0262, FTF distance 13.1 ±11.3 vs. 6.8 ±10.1 cm, p=0.0189, Thomas test 57.8 ±6.2° vs. 58.6 ±7.1°, p=0.3205. The decreased flexibility of the pectoralis major and the gastrocnemius muscle was found in 60% vs. 53.3% and in 65% vs. 53.3%, p=0.6253 and p=0.2814, respectively. Conclusions: Patients with Scheuermann`s disease reveal more significant tightness of the hamstring muscles, than patients with postural hyperkyphosis. The generalized joints hypermobility is not common in patients with Scheuerman’s disease.
Authors and Affiliations
P Janusz, K Politarczyk, M. Kozinoga, T Kotwicki
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