Electromyography of scoliotic patients treated with a brace

Abstract

When a brace is used to correct spinal deviation, patients may seek to ease the discomfort from the pressure exerted by the orthosis by actively recruiting specific trunk muscles. The effect of bracing on trunk electromyography (EMG) has been reported in only one study where a limited number of electrodes were placed mainly in the thoracic region. Our hypothesis was that a multi-electrode mapping of the activity of the thoracic, lumbar, and abdominal trunk muscles would provide a more representative picture of the muscular reaction in response to bracing. With a larger number of EMG measuring sites, the presence of any brace-induced trunk muscle activity should be detected. Therefore, EMG signals of 11 adolescent idiopathic scoliosis patients who had been undergoing Boston brace treatment for 0.7-3 years were collected during four isometric tasks to evaluate the response of trunk muscles in the minutes following the application of the brace. Twenty-two pairs of bipolar electrodes were used to measure the EMG signals of the main superficial trunk muscles during four isometric tasks. EMG signals of trunk muscles were compared in braced and unbraced conditions. Brace-induced increases in EMG activity were significant in 43% of the individual measurements and in three of the four tasks for the group mean values. Increases were greater in the lumbar area, especially on the convex side of the secondary (lumbar) curve. These results thus suggest that immediately following the application of the brace, significant muscular responses can be observed in some patients.