Gymnastics is noted for involving highly specialized strength, power, agility and flexibility. Flexibility is perhaps the single greatest discriminator of gymnastics from other sports. The extreme ranges of motion achieved by gymnasts require long periods of training, often occupying more than a decade. Gymnasts also start training at an early age (particularly female gymnasts), and the effect of gymnastics training on these young athletes is poorly understood. One of the concerns of many gymnastics professionals is the training of the spine in hyperextension—the ubiquitous ‘arch’ seen in many gymnastics positions and movements. Training in spine hyperextension usually begins in early childhood through performance of a skill known as a back-bend. Does practising a back-bend and other hyperextension exercises harm young gymnasts? Current information on spine stretching among gymnasts indicates that, within reason, spine stretching does not appear to be an unusual threat to gymnasts’ health. However, the paucity of information demands that further study be undertaken.

Final publication is available at http://www.plosgenetics.org/article/related/info%3Adoi%2F10.1371%2Fjournal.pgen.1005802 / 京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19627号 / 医博第4134号 / 新制||医||1016(附属図書館) / 32663 / 京都大学大学院医学研究科医学専攻 / (主査)教授 萩原 正敏, 教授 松田 秀一, 教授 瀬原 淳子 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Adolescent idiopathic scoliosis (AIS) is characterized by a three-dimensional curve within the spine thus creating asymmetries within the trunk. In addition to modifying the trunk geometry, these structural asymmetries change the location of the center of mass. Gait patterns in people with AIS may possibly be altered on the basis of these structural changes. The purpose of this study was to identify differences in gait kinematics and kinetics as well as left-right symmetry as a function of the severity of adolescent idiopathic scoliosis. Forty-five girls divided into a control group, a mild-to-moderate AIS group and a severe AIS group participated in data collection. Gait analysis included bilateral kinematic and kinetic measurements. The maximal joint ranges of motion at the ankle, knee, hip and trunk-pelvis were analyzed. Maxima and minima in the antero-posterior, medio-lateral and vertical components of ground reaction force (GRF) were compared between the three groups as well as the median frequencies obtained from a frequency spectrum analysis of GRF. A symmetry index was computed between the primary curve side and the contralateral side for each kinematic and kinetic variable. Both AIS groups differed from controls in their range of motion at the ankle and at the knee but for the AIS group with severe curves, this was also observed at the hip. Both local maxima in the vertical component and the maximum of the antero-posterior component of the ground reaction force were decreased while the local minimum of the vertical component and the antero-posterior component of GRF increased in the severe AIS group compared to the control group. Higher median frequency contents in the antero-posterior and vertical component of ground reaction force were found in the AIS groups than in controls. No difference in asymmetry was found in any of the variables between all groups. These results seem to indicate that severe AIS participants have a more altered gait pattern than the mild-to-moderate AIS group. Findings from this study point toward greater changes in kinematics and kinetics during stance between all AIS groups and the control group.

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Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal. / Le but de cette étude est d'évaluer les caractéristiques associées à la mobilité de la colonne vertébrale chez les patients ayant une scoliose idiopathique. Selon les études antérieures, une augmentation de la flexibilité et de la mobilité de la colonne vertébrale serait reliée à une courbure scoliotique. Une meilleure compréhension de ce phénomène serait utile à révolution et au traitement de cette maladie. De plus, la caractérisation des mouvements normaux pourrait servir d'indicateur complémentaire au pronostique. Cette étude porte sur l'évaluation de la mobilité de la colonne vertébrale chez les patients scoliotiques. Les résultats ont été comparés à ceux de sujets témoins normaux afin d'établir s'il existe une relation entre la mobilité de la colonne vertébrale et certaines variables biodémographiques. Soixante-cinq adolescents ayant une scoliose idiopathique ont constitué le groupe patient alors que des sujets (13 garçons et 7 filles) d'âge comparable formaient le groupe témoin. Les patients avaient un âge moyen de 14 ans et n avaient pas été opères' à la colonne vertébrale bien qu' une scoliose était présente. Tous les sujets ont été mesurés et évalués à la clinique de scoliose de l' hôpital Sainte-Justine. L'âge, la hauteur et le poids ont été mesurés. Les mesures de la mobilité ont été effectuées dans les trois plans à l'aide d'un inclinomètre. Un test-t de Student et une analyse de régression multiple ont été utilisées pour déterminer la présence de différences significatives entre les deux groupes et l'importance relative des variables biodémographiques sur la mobilité de la colonne vertébrale. Une valeur de p < 0.001 pour le test-t et de p < 0.05 pour les corrélations et les régressions multiples ont été arbitrairement choisies. La mobilité de la colonne vertébrale du groupe sujets était significativement différente de celle du groupe témoin. Elle était plus petite chez les 'atients dans les plans sagittal et transverse, un résultat qui n'appuie pas l'hypothèse d'une flexibilité excessive chez les patients scoliotiques. Très peu de corrélation a été trouvée entre les différentes variables biodémographiques et plus particulièrement avec l'angle de Cobb qui indique la sévérité des courbures. L'implication clinique de ce travail porte sur l'importance possible de maintenir une amplitude normale de mouvement dans les régions thoraco-lombaire. / The primary purpose of this study was to evaluate the characteristics of spinal mobility in adolescent idiopathic scoliosis. Earlier studies have indicated that an increase in flexibility and spinal mobility may be of importance in producing deviation of spine. Knowledge of the effect of adolescent idiopathic scoliosis on spinal mobility could be useful in the evaluation and treatment of the disease. Furthermore, characterization of the abnormal motion may be of prognostic value. This study focused on the assessment of spinal mobility in adolescent idiopathic scoliosis as compared to that of normal subjects and tried to establish a relationship between the likely spinal mobility differences and some biodemographic variables. Sixty five girls with progressive adolescent idiopathic scoliosis formed the patient group while 20 age-matched controls (13 boys and 7 girls) with normal spine comprised the able-bodied group. The scoliofcic patients were girls with a mean age of 14 years, and all had combined thoracic and lumbar nonoperated curves. All subjects were measured and evaluated in the scoliosis clinic of Sainte-Justine Hospital. Age, height, and weight were determined. Measurements of the mobility were done in three planes with an inclinometer. Student t-test technique and multivariate regression analysis were used to determine the significant differences between the two groups and the relative importance of the biodemographic variables on spinal mobility with a p value of 0.001 for t-test and 0.05 for correlation and mutivariate regression. Spinal mobility of the patient group was found to be significantly different from those of normals. Spinal mobility was more restricted among scoliotic patients in the sagittal and transverse planes, a finding which does not support the hypothesis of excessive flexibility of the spine in idiopathic scoliosis. Very little correlation could be detected between biodemographic variables, and specially the Cobb angle which measured severity of curves even though the spinal mobility was reduced in scoliotic patients. The clinical implication of this work may be that preservation of a normal range of motion in the thoracolumbar spine should be one of the aims of treatment.

В диссертационном исследовании экспериментально обоснована целесообразность использования лечебной фитбол-гимнастики как основного средства при коррекции нарушений осанки у детей старшего дошкольного возраста, установлено, что эффективность процесса коррекции сколиоза существенно повышается при включении упражнений лечебной фитбол-гимнастики с учетом индивидуальных отклонений в формировании осанки детей старшего дошкольного возраста. / In the dissertation study experimentally the appropriateness of the therapeutic fitball-gymnastics as the main means for the correction of violations of posture in children of preschool age, found that the effectiveness of the process of correction of scoliosis significantly increases with the inclusion of therapeutic exercises, fitball-gymnastics according to individual deviations in the formation of posture children of preschool age.

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