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gerbo
21st October 2005, 05:44 PM
OK, someone has to make sure something relevant appears on this new forum.

For info, down loaded an article re torsion rotation exercises to "downloads", interesting reading, whether you think it applies to you or not, with some nice theoretical background.

It is one of the approaches we try with Laura. Medx machine isn't available in UK, but we think we have found something similar in our local gym.

gerbo :spin: :spin:

scoligirl
27th October 2005, 11:32 PM
where can we download this article from please?

gerbo
28th October 2005, 12:01 AM
see main menu, go to "downloads", then go to "external articles and papers", should find it there

Let me know if you have trouble finding it, otherwise tell me what you think about it

gerbo

RosieRich
18th November 2005, 05:04 PM
It is one of the approaches we try with Laura. Medx machine isn't available in UK, but we think we have found something similar in our local gym.

Gerbo,
Which exercises do you use at the gym with Laura? I've just got permission for my daughter Megan (she's 9) to use our local gym provided we get a letter from a GP or consultant( which I've yet to do). I don't yet know if they have anything for torsion rotation but I figured anything that built up the back muscles would help. She has had a lot of muscle wastage since getting her brace.
Thanks

gerbo
21st November 2005, 09:31 AM
Two reasons for regular exercise

1) Loss of neuromuscular coordination and general muscle atrophy by wearing the brace; any exercise program focussing on trunk muscles sould help, in our case: regular ballet, swimming. In your case in the gym they could look at a corestabilty program, as is very commonly used for adults

2) The assumption that muscle assymetry (muscles on convex side of the curve a are thicker and stronger then the ones on the concave (hollow) side) contributes to the worsening of the curve. we are using three sets of resistance exercises to address this

- Torso rotation or torsotwist; this is the one from the article, hence some evidennce behind it. We were lucky that our local gym had a similar machine, though big problem is that it is an adult machine, and Laura can just about manage with the seat at its highest and rtesistance at its lowest, whether your 9 year old is big/ strong enough, i don't know.
We did notice though that initially Laura could hardly do the turn to the left, whilst the turn to the right was much easier; we therefor decided to give the left turn twice as much exposure then the right turn, and it appears that the left side (our concave side) is getting stronger. Whether it is the twisting action which is important, or whether it is the fact that in the twisting movement paraspinal muscles from left and right side are seperately addressed i don't know, maybe it is a bit of both

- back extension; this addresses lumbar muscles symmetrically, strength wise easier to do, but fitting on the equipment was main issue again

- noting the weakness of the muscles controlling the left scapula, we are also using a machine where she pulls her arms backwards against resistance, specifically addressing the shoulder/ upper back muscles. Again, currently, we are using left twice as much as right, allowing left to "catch up"

I am afraid there is a lot of "making it up as we go along" involved and I think that a "coach" with detailed knowledge of human body and exercise physiology is essential for succes. (Succes? No garantee ofcourse, one can only try......)

gerbo

Marti
23rd November 2005, 12:19 AM
we have torso rotation machines in the circuit center in my school. I could see how it could help before surgery, but note to anyone who's had any lumbar vertabrae fused: DON'T DO IT! I tried to use the machine once and couldn't lift weights for the rest of the gym period. Later, I figured out why: the sign says that the normal spine has a rotation of 30 degrees.

jfkimberly
23rd November 2005, 07:13 AM
Yeah, fusion and torso rotation don't exactly mix. I'm sorry you learned that the hard way, Marti. Ouch. Are you okay now?

Phil
23rd November 2005, 11:35 PM
- noting the weakness of the muscles controlling the left scapula, we are also using a machine where she pulls her arms backwards against resistance, specifically addressing the shoulder/ upper back muscles. Again, currently, we are using left twice as much as right, allowing left to "catch up"

Sounds like the seated row. very good machine! Sounds like you are making best use. Sorr you found out the hard way Marti. Sounds like the sort of thing i would do.

titch
24th November 2005, 12:59 AM
Hmm. I've done torso rotation machines (will try to find a picture of the short) while fused T10-L2, and while fused T3-L4. It's true that it has to be done carefully, and with the longer fusion it really is difficult to target the muscles that you really want to use, requires a fair bit of body awareness. However, most of it comes down to adequate instruction - rotation machines are very easy to injure yourself on if you have any kind of specific weakness and have not been shown (and then supervised by a sensitive instructor who actually has the ability to think beyond training big healthy blokes wanting to max out their muscle size) on how to move, and how much twist to use - particularly if you use too high a weight. The trouble is that the exercise tends not to feel all that straining initially, so it can be tempting to use far too high a weight - as with all things, if in any doubt work well within your capacity, but with rotational exercises I would always recommend to stay low, or you'll end up using muscles that you shouldn't be.

jfkimberly
24th November 2005, 05:56 AM
I shudder to think about it. But I'm not particularly flexible in my spine. It's not especially long to begin with, and half of what I have is fused solid. I don't twist.

gerbo
24th November 2005, 09:09 AM
Originally posted by titch@Nov 23 2005, 11:59 PM
with rotational exercises I would always recommend to stay low, or you'll end up using muscles that you shouldn't be.
we started with no added weight at all and only now, after about 2 months, feel that Laura is able to move it in a reasonable contrlooed manner. We have been advised to stick to this "no weight" and just add repetitions for now

titch
24th November 2005, 02:15 PM
With the fact you've been so careful, and have had a physio with you to assist and advise, I never thought there would be any problems with the approach taken :-) I was mostly waffling for the benefit of anyone who has to deal with a macho instructor who tries to push to the max. Definitely sounds like the right approach to increase reps rather than weights, it's always the safer approach. Whenever I feel able to go up a weight, I initially increase reps, then when comfy with that I'll up the weight for one round out of 3, then 2 rounds out of 3, then all, with the reps dropped back so for example:
10/10kg - 10/10kg - 10/10kg
12/10kg - 12/10kg - 12/10kg
8/15kg - 12/10kg - 12/10kg
8/15kg - 8/15kg - 12/10kg
8/15kg - 8/15kg - 8/15kg
10/15kg - 10/15kg - 10/15kg
then stay at 3 rounds of 10 reps until I feel ready to increase. It takes me a long time to actually go up a weight because I am so cautious about it and will stick where I am until I'm sure I'm ready to add the next notch, but I never injure myself. Because I like the burn, there are times when I thoroughly exhaust myself and spend the next day or two with a load of achy slightly strained muscles, but by that I mean strain in the good way, like if you've gone for a long walk when you don't normally walk that far. I've never actually injured anything though, and don't intend to start now ;-)

gerbo
21st July 2006, 11:42 AM
The first of the following abstracts confirms that there is some rational behind using torso rotation exercises, showing that rotation towards the concave side is weaker in scoliotic patients.

The second abstract confirms findings by vert mooney; i.e. rotational strength training halts or reverses progression

Note though that studygroup is very small.

Source is reliable, with Marc Asher being a spinal surgeon in the USA and a past president of the Scoliosis Research Society




Comparison of Isometric Trunk Rotational Strength of Adolescents with Idiopathic Scoliosis to Healthy Adolescents
Kevin McIntire, Marc Asher, Doug Burton, Wen Liu
Abstract


Trunk rotational strength asymmetry has been suggested in adolescents with idiopathic scoliosis (IS), but is unconfirmed. The sitting isometric trunk rotational strength, at neutral and 18°or 36°of right or left pre-rotation, of a group of healthy adolescent females (CG), n=12, is compared with a group of female adolescents with IS (ISG), n= 14. Torque values were normalized to lean body weight. There is a significant weakness when rotating towards the concavity found in patients with AIS at the 36 lo (p 0.07 marginal), 18 lo (p<0.03) and neutral positions (p<0.02), with no side strength asymmetry found in a cohort of healthy adolescents without AIS.




Trunk Rotational Strength Training for the Management of Adolescent Idiopathic Scoliosis (AIS)
Kevin Mcintire, Marc Asher, Doug Burton, Wen Liu
Abstract


Quantified trunk rotational strength training has shown promise as a non-operative management option for individuals with AIS. The purposes of our study are to test whether a quantified trunk rotational strength training protocol can increase trunk strength and stabilize or decrease curve size. Seven adolescents with AIS (5 female 2 male; mean 14yrs ± 2.6yrs; mean Cobb 28°± 6° range 20°–37°) underwent four months of supervised trunk rotational strength training, and repeat strength test. Trunk strength in both directions increased significantly after training (p<0.05). Average Cobb angle decreased to 23°± 11° (range 6°–35°). Four individuals showed reduction (>5°) in their original curve, and 3 remained the same (±5°). The strength training protocol significantly increased isometric rotational strength and scoliosis was stabilized short term.

titch
23rd July 2006, 08:32 PM
It's particularly interesting to note in the second abstract that although the cohort is small, they have only classed those as having a reduction greater than 5° as having reduction, and have not counted those who have stayed within 5° of the original measurement.

Of course measurement of curvature is known to have a variation of ±5° between measurements, and they're just allowing for that, but it means that the study is a lot more reliable than many which appear to show reductions with non operative, non bracing treatments, but count any reduction however small.