Locoregional lung ventilation distribution in girls with adolescent idiopathic scoliosis and healthy adolescents. The immediate effect of Schroth ‘derotational breathing’ exercise in a controlled-trial

ABSTRACT

Background

Scoliosis curves present transverse plane deviations due to vertebral rotation. The Schroth method supports thoracic derotation by training patients to exert “derotational” breathing based on assumed enhanced ventilation in areas called “humps” in scoliosis and a patient’s ability to voluntarily direct ventilation in less ventilated areas called “flats.”

Objective

To assess the asymmetric ventilation distribution and the ability of patients to direct their ventilation to perform derotational breathing.

Methods

Twelve girls with adolescent idiopathic scoliosis and 12 healthy girls performed 3 × 3 min of rest, maximal, and derotational breathing. Electrical impedance tomography was used to record locoregional lung ventilation distribution (LLVD) within 4 thoracic regions of interest: anterior right (ROI 1), anterior left (ROI 2), posterior right (ROI 3), and posterior left (ROI 4) quadrants. Humps and flats were the sums of ROI ‘2 + 3’ and ROI ‘1 + 4,’ respectively.

Results

Overall, no difference in LLVD was observed in the flats and humps between groups. At rest, the LLVD in the humps was more elevated than that in the flats (51.5 ± 8.1% versus 43.6 ± 7.9%; p = .021) when considering both groups. Maximal and derotational breathing led to a more homogeneous LLVD between the humps and flats.

Conclusion

The postulated derotational breathing effect was not confirmed.

KEYWORDS:

• Schroth method
• electrical impedance tomography (EIT)
• idiopathic scoliosis
• regional ventilation

Acknowledgments

The authors are thankful to Dräger Medical Belgium NV for providing them with instruments for EIT measurements. They are also grateful to L. Fauvy and F. Mols for their explanation of the Schroth method and to R. Guillaume for his help. Finally, the authors thanks Prof. C. Bugli from the Support en Méthodologie et Calcul Statistique platform (SMCS, Belgium).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

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Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.