Grounds for special physical education practices for 17-23 year-old females diagnosed with stage I-III scoliosis

Фотографии: 

ˑ: 

Dr.Biol., Professor A.P. Shklyarenko1
Dr.Hab., Professor T.G. Kovalenko2
PhD D.A. Ulyanov2
1Slavyansk-on-Kuban affiliate of Kuban State University, Slavyansk-on-Kuban
2Volgograd State University, Volgograd

 

Keywords: scoliosis, cosmetic torso defects, corrective exercises, functional state.

 

Introduction. In order to prevent severe scoliosis (S), it is advisable to use the means and methods of physical education that activate a large group of muscles. An important therapeutic factor is to achieve the optimal compensation of malfunctions via genetic motor activity bundle [3]. It is necessary to amplify this theory by recommendations that substantiate the need to apply various means and methods of physical education to prevent severe postural disorders that incapacitate young women, limit their reproductive performance and put them under psychological pressure [3, 4]. At the same time, complex methodological approaches to physical education techniques should be most effectively applied precisely as a preventive measure, stopping the disease progression.

Objective of the study was to develop the techniques of correction of static disturbances and muscular function of the musculoskeletal system in the 17-23 year-old females by means of physical education.

Methods and structure of the study. The 17-23 year-old females (n=79) diagnosed with the I-III degree scoliosis sampled at the Slavyansk-on-Kuban affiliate of Kuban State University and Volgograd State University were involved in the study.

Results and discussion. The in-house clinical studies revealed that in 69% of the cases the scoliosis symptoms are localized on the right side of the thoracic spine. At the same time, we detected fixed spinal torsion, oblique shoulder girdle, pelvis, asymmetric shoulder blades and lumbar triangles, as well as a rib hump (gibbous costalis). Some girls (23%) diagnosed with the II-III degree scoliosis were found to have typical changes in the lumbar spine, which was curved to the left. A common complaint was pain in the thoracic and lumbar spine. Against the background of the formed scoliosis, back pain was more typical for the girls suffering from the III degree scoliosis, much less often – for those diagnosed with the I-II degree scoliosis.

The most serious complication at scoliosis is torso deformity. Cosmetic torso defects were characterized by the changes in the paravertebral tissues (bone, connective and neuromuscular ones) due to scoliosis progression and asymmetry in the body markings caused by it. They included: asymmetric shoulder blades and lumbar triangles, long-axis misalignment in torso, height of a rib hump (or muscular embankment). The mean value of the total amount of their asymmetry (in conventional units) was characterized as a torso deformity coefficient (TDC). In case of the I-II degree scoliosis, regardless of its localization and curvature rate, the maximum TDC did not exceed 2.2 and 6.2 conventional units, respectively. The most pronounced cosmetic torso defects were registered at the III degree thoracic dextroscoliosis (mean TDC equaled 15.6 conventional units). Torsion in the form of a rib hump or muscular embankment in the lumbar spine was an integral component of scoliosis.

Reportedly, 76% of the 17-23 year-old females diagnosed with the III degree scoliosis were found to have increased hypermobility of trunk extension. In their peers diagnosed with the I-II degree scoliosis, this indicator did not exceed 19%. Given this, it should be noted that the girls with increased hypermobility, diagnosed with scoliosis, should avoid all types of muscular activity that affect the spine in the longitudinal-vertical axis and develop its mobility. There was a direct correlation between the level of asymmetry of movements and dynamics of scoliosis. In the girls suffering from the III degree scoliosis, the total amount of asymmetry approached the absolute values ​​(89%).

Due to the relaxed back and abdominal muscles, the 17-23 year-old females with spinal hypermobility were diagnosed with a slack posture. Increased lumbar lordosis in a standing position and lumbar kyphosis in a sitting position were detected in 79% of the girls. They kept the target posture (without relaxing their muscles) for 6.2 and 7.0 minutes. The 17-23 year-old females diagnosed with the III degree scoliosis had the lowest indices of the back and abdominal muscle strength endurance. It can be assumed that these deviations form an inseparable unity with the morphofunctional characteristics of a sick child and the way of life during university studies. According to the in-house figures, the genetic need for movement in the 17-23 year-old females with a torso deformity of varying severity (from the I to III degree) is satisfied by 35-45% on the average.

In light of the functional shifts and pathological torso deformities of the I to III degrees, as well as emerging postural and motor stereotypes (manner of sitting, bending, walking, etc.), an original physical training system was designed for those training in gyms, fitness halls, swimming pools and optimized for the entire period of university studies.

The corrective effect was exerted through symmetric exercises implemented in individual and group training sessions. The absence of contraindications to symmetric corrective exercises at scoliosis is due to the fact that they do not require that the existing biomechanical changes in the deformed spine are taken into consideration while performing them. The number of asymmetric corrective exercises during the group training sessions was essentially limited to avoid the risk of their erroneous use.

For the 17-23 year-old girls diagnosed with the I-III degree scoliosis, a complex of corrective exercises with the use of orthopedic balls 0.6-0.8 m in diameter was developed. These exercises made it possible to align their posture and strengthen the basic muscle groups while in non-standard initial positions. The complexes included exercises building those muscle groups not affected by classic exercises. This physical rehabilitation method was optimal for the girls of the given age owing to positive emotions from the training sessions, individual approach in training.

In order to improve the overall motor coordination, strengthen the basic muscle groups and optimize the functional state of the cardiovascular and respiratory systems, we developed an original complex of physical exercises in water. The main part of the training sessions included exercises at the side of the pool and coordination exercises with the use of water and underwater aids, as well as strength exercises using a swimming simulator. During the classes, we made sure harmful additional movements (rotation of the pelvis, shoulder girdle and lateral torso movement on the side of spinal curvature) were eliminated.

The basic muscle groups in the 17-23 year-old females diagnosed with the I-III degree scoliosis were trained using simulators of various modifications. The training sessions with the use of the simulators were considered a special case aimed to improve the body's ability to perform cyclic work. The weight machines were used to simulate mechanical work for differentiated or local effects on a given muscle group. By changing the load intensity, amplitude and rate of movements, and trainees’ position, the simulators were used for varying severity and localization of the torso deformity. For the 17-23 year-old females diagnosed with the I-III degree scoliosis, at the initial stage we applied weights not exceeding 40-50% of the maximum norms recommended for their healthy peers, strictly eliminated asymmetry and longitudinal-vertical loads on the deformed spine.

The cumulative data on the training effects on the dynamics of scoliosis in the 17-23 year-old females trained according to the designed training program for 2, 3 and 5 years are presented in Table 1 below.

 

Table 1. Dynamics of scoliosis in 17-23 year-old females in different time periods with due regard to disease severity

 

Follow-up period

(years)

 

n

 

Characteristics of scoliosis and disease severity

progressing

stabilizing

positive

I

II

III

I

II

III

I

II

III

2

46

 

1

2

16

12

4

6

5

 

3

19

 

 

1

4

6

5

1

2

 

5

14

 

1

1

2

5

3

1

1

 

 

The research findings were divided into three groups. The first group (good results) was made of the girls demonstrating positive dynamics in stabilization of the torso deformity (TDC decreased by 20%); the second group (satisfactory results) - stabilization of changes (TDC±10%); the third group (poor results) - scoliosis progression contributed to an increase in TDC by 20%.

The analysis of the data obtained revealed that the 17-23 year-old females diagnosed with the I degree scoliosis (n=30) who had been training according to the developed methodology for 2, 3 and 5 years had no further disease progression in terms of TDC. At the same time, active postural alignment by means of strengthening the muscular system made a difference in 27% of the subjects (TDC decreased on average by 20%).

In the girls diagnosed with the II degree scoliosis, the late functional results were less than desired. A positive TDC dynamics was observed in 25% of the girls, stabilizing and progressing - in 69 and 6%, respectively. The positive changes in those with the II degree scoliosis were owing to the lack or decrease in the asymmetry of the shoulder blades and lumbar triangles and stabilization of the height of the rib hump (or muscular embankment).

The majority (75%) of the girls diagnosed with the III degree scoliosis achieved stable disease in view of the positive dynamics of TDC and even had some regression in the degree of thoracic asymmetry. The physical training sessions helped minimize the long-axis misalignment in their torso, as well as align asymmetric shoulder blades and lumbar triangles. At the same time, the TDC criteria in 25% of the girls on average continued to show a downward trend characterizing further progression of scoliosis.

Conclusion. Broadly speaking, the proposed rehabilitation program provides optimal functional and cosmetic rehabilitation treatment for the 17-23 year-old females diagnosed with the I-III degree scoliosis.

 

References

  1. Shklyarenko A.P., Kovalenko T.G., Ulyanov D.A. Kompleksny podkhod v ispolzovanii fizicheskikh uprazhneniy pri narusheniyakh osanki u detey 8-11 let [Integrated approach to physical exercises for 8-11 year-olds diagnosed with postural disorders]. Vestnik Volgogradskogo gosudarstvennogo universiteta. Ser. 11: Estestvennye nauki, 2016, no. 2 (16), pp. 22-27.

  2. Shklyarenko A.P., Kovalenko T.G., Ulyanov D.A. Novye aspekty v lechebnoy fizicheskoy kulture pri skolioticheskoy bolezni u detey i podrostkov [New aspects in exercise therapy for children and adolescents diagnised with scoliotic disease]. Mater. V Vseros. nauch.-prakt. konf. s mezhdunar. uchastiem 'Lechebnaya fizicheskaya kultura: dostizheniya i perspektivy razvitiya' [Proc. V nat. res.-pract. conf. with intern. participation 'Exercise therapy: achievements and prospects of development']. Moscow, 2016, pp. 266-272

  3. Shklyarenko A.P., Kovalenko T.G., Ulyanov D.A. Funktsionalnaya korrektsiya skolioticheskoy bolezni sredstvami fizicheskoy kultury u detey i podrostkov [Functional correction of scoliotic disease in children and adolescents via physical training]. Volgograd: VolSU publ., 2016, 232 p.

  4. Shklyarenko, A., Kovalenko, T.,  Ulyanov, D. Strength training usage with scoliosis of II degree in view of body defects for girls 17-19 years old. European College of Sport Science: Book of Abstracts of the 21st Annual Congress of the  European College of Sport Science – 6th - 9th June 2016,  Vienna – Austria. 619-620.

 

Corresponding author: sportvolsu@rambler.ru

 

Abstract

The study analyzes anthropometric and physiological characteristics, spinal functionality, movement coordination and postural control in the 17-23 year-old females (n=79) diagnosed with the I-III degree scoliosis sampled at the Slavyansk-on-Kuban affiliate of Kuban State University and Volgograd State University. The study provides grounds for new physical education models and tools customizable to the degrees of scoliosis, with a set of progress rating criteria that may be applied to monitor the effects of special physical practices on the bodily condition and cosmetic defects in this health group.