Side Planks

[Pooka1]

Is there no way to know if a study like this is absolutly true or a deliberated fraude? There's no place here to grey zones. They are talking about objective measurements (with enormous differences), not simple conclusions about what could happen or not.
If it's a perfect fraude, is something so simple to do? Why I should to think that? Because I thought as impossible to get a very much significant reduction in a giant curve? What the hell I know in order to be important what I believe or not? WHAT THE HELL KNOWS SOMEONE? If someone really have enough knowledge, tell me please, we have a lot to talk.. I have a lot of questions to do.

Those reductions might have been measured correctly. We won't know until someone tries to replicate the study. Only a fraction of very good studies are able to be replicating with the same results and this one doesn't fall into the category of "good" in my opinion. For example there is an obvious problem with the number of trajectories shown not matching the text. There was plenty of data selection which might have disqualified it from publication.

The reductions don't hold if they stop. That means the curves are not being fixed in any sense but held by recruiting certain muscles. Also, there is still no evidence this stops progression because there is no long term even among the people who continue the PT. It might hold curves but we don't know. The issue with degenerative (most of their cases) is pain not curvature though and I don't recall them discussing that but maybe they did.

[jrnyc]

hey Sharon
so...they are playing with numbers, are they...
you are so right...
50% if your curve is 10 is fantastic...
curve of 20 degrees still great...
get to the big ones...then what....???

pretty ridiculous to do the study with really small curves, like
6 degrees....
let's see them do it with some real curves...not ones under
10 degrees....not the ones that doctors tell most adults are not to worry about

jess

[flerc]

Those reductions might have been measured correctly. We won't know until someone tries to replicate the study. Only a fraction of very good studies are able to be replicating with the same results and this one doesn't fall into the category of "good" in my opinion. For example there is an obvious problem with the number of trajectories shown not matching the text. There was plenty of data selection which might have disqualified it from publication.

Is there no way really to know it until a new study? It should be possible for some people to access those x-rays.. if it would be a deliberate fraude in order to promote Yoga (something extremely stupid.. what could happen when everyone realize it was a fraude?) those x-rays could clearly show it.. also if it's true.
This is the only point important for me by now. I understand and certainly I may agree in everything else what you are saying , but if those measurements are forged, it has not any sense to talk about nothing of this and if they are right, nothing else may discredit this discovery. They could have not idea about what scoliosis is, nothing about medicine, statistics.. nothing! and the study itself may be unacceptable in every other sense but x-rays will not change for that, so any considerations like those may only support the idea of a fraud but cannot prove it, so we need to be sure about those x-rays and it's something too much important to be waiting for another study..

[Pooka1]

Is there no way really to know it until a new study? It should be possible for some people to access those x-rays.. if it would be a deliberate fraude in order to promote Yoga (something extremely stupid.. what could happen when everyone realize it was a fraude?) those x-rays could clearly show it.. also if it's true.
This is the only point important for me by now. I understand and certainly I may agree in everything else what you are saying , but if those measurements are forged, it has not any sense to talk about nothing of this and if they are right, nothing else may discredit this discovery. They could have not idea about what scoliosis is, nothing about medicine, statistics.. nothing! and the study itself may be unacceptable in every other sense but x-rays will not change for that, so any considerations like those may only support the idea of a fraud but cannot prove it, so we need to be sure about those x-rays and it's something too much important to be waiting for another study..

No I was unclear.

I think the measurements are probably as good as it gets because although the authors measured them, they made sure they agreed with the orthopedic surgeon or radiologist measurements. I just hope they scrupulously avoided using chiro measurements at all points and didn't lump in chiro measurements with orthopedic surgeon and radiologist measurements.

There is a potential problem if more people did the yoga than are reported because this a retrospective of 25 consecutive cases. They selected a set of 25 consecutive cases on some basis that they don't say what it is. Was this set the ENTIRE set of all people trying the side plank or what is cases 4-29 or was it cases 18-43 or cases 100-125? Maybe it was the set that had the largest reductions. Who knows.

Repeating the study by others would reveal if these particular 25 consecutive cases are unusual in terms of degree of reduction achieved.

[AMom]

participants

Pooka1,

I believe that they only included those who followed protocols at a certain level, I do not believe they included everyone who was given these instructions. I do wonder if they also included those who were given a group of yoga exercises, I am NOT saying they did that, just that I wondered if they realized that that should not occur. Choosing only those based on results was not mentioned.

A Mom

[Pooka1]

Pooka1,

I believe that they only included those who followed protocols at a certain level, I do not believe they included everyone who was given these instructions. I do wonder if they also included those who were given a group of yoga exercises, I am NOT saying they did that, just that I wondered if they realized that that should not occur. Choosing only those based on results was not mentioned.

A Mom

Yes the 25 they included in the beginning had 19 compliant and 7 non-compliant. But I am saying that consecutive set of 25 cases might not be the entire set. Maybe 50 is the entire set and they picked the 25 consecutive cases somewhere within that 50 that had the highest reductions.

[Alistair]

Yes the 25 they included in the beginning had 19 compliant and 7 non-compliant.

That surely makes it 26, no? In the end compliance amongst idiopathic scoliosis was 7 and 12 amongst degenerative.

[Pooka1]

That surely makes it 26, no? In the end compliance amongst idiopathic scoliosis was 7 and 12 amongst degenerative.

Yes there is something wrong with my numbers. I'll check later.

[flerc]

Maybe 50 is the entire set and they picked the 25 consecutive cases somewhere within that 50 that had the highest reductions.

If it would be the case, then something would be really bad in this article: http://www.gahmj.com/doi/abs/10.7453/gahmj.2013.064
'Twenty-five patients with idiopathic or degenerative scoliosis and primary curves measuring 6 to 120 degrees by the Cobb method had spinal radiographs and were then taught the side plank pose'.
They are saying twenty-five, if there were 50 patiens, it would be also true what they says about those 25 patients, but obviously they would have said this in a confusing way non acceptable to a summary.

[Pooka1]

If it would be the case, then something would be really bad in this article: http://www.gahmj.com/doi/abs/10.7453/gahmj.2013.064
'Twenty-five patients with idiopathic or degenerative scoliosis and primary curves measuring 6 to 120 degrees by the Cobb method had spinal radiographs and were then taught the side plank pose'.
They are saying twenty-five, if there were 50 patiens, it would be also true what they says about those 25 patients, but obviously they would have said this in a confusing way non acceptable to a summary.

All cases were chosen retrospectively. So they had the data in hand for the entire set if it was larger than 25. The question is were ONLY and EXACTLY 25 patients imaged and taught the side plank pose? Maybe or maybe not. If not then how did they select which consecutive set of 25 out of the larger set to use? Note this is consecutive cases so any set is probably going to include some non-compliant cases. Maybe this consecutive set of 25 had the least number of non-compliant cases. Who knows.

What follows is my understanding of what they wrote.... in some cases it differs from what they wrote (for example, what is surgical range?). The article was completely unclear on critical factors as AMom alluded to.

12 right curves - most but not all of these are probably T AIS curves.
13 left curves - most of these are probably the degenerative L and TL curves.

Of the 22 trajectories... starting point was:
8 curves in surgical range (>50*)
3 in bracing range (>25* and <40*)
11 less than bracing range (<25*)

25 primary and 7 secondary curves. Therefore they studied 32 curves. Yet Figure 4 mysteriously shows only 22 trajectories.

The 22 trajectories must be all the curves among the 20 compliant cases. So this is mostly primary and some secondary. Some secondary may be compensatory... hard to say.

The largest curves exhibited the most reduction in absolute terms (degrees) in general. I am guessing some of these are the compensatory secondary curves.

[flerc]

I should to buy the full text.. If were more than 25 participants and in some case were not a significant reduction, then what the conclusion says is definetely wrong: 'Asymmetrically strengthening the convex side of the primary curve with daily practice of the side plank pose held for as long as possible for an average of 6.8 months significantly reduced the angle of primary scoliotic curves.' By default they are referring to the entire set of participants, if not they should to say in how many cases it worked. So what conclusion is saying would not be uncomplete or not enough clear, it would be definitely wrong.
I have never heard before about this scholarly medical journal 'Global Advances in Health and Medicine... is a member of the Committee for Publication Ethics and abides by its Code of Conduct and adheres to its Best Practice Guidelines. Some editors belong to: the Council of Scientific Editors, the World Association of Medical Editors, and the American Association of Medical Writers.' but if they were posting so wrong conclusions, could not be something serious.

[Pooka1]

Four of the smaller curves INCREASED over time.

About seven of the smaller curves decreased slightly or somewhat.

The largest absolute decreases were among the largest curves. Six of the curves in surgical range were below surgical range post-yoga. Obviously if that were uniform and the reductions held, there would be no more surgery for curvature. There may be surgery for pain. Pain is not addressed.

Table 2 indicates 20 compliant patients yet Table 3 indicates 19 compliant patients. The text indicates 19 compliant patients. Amazing.

[Pooka1]

If the 22 curves on the figure are from the 19 (or 20) compliant patients then that means there were 10 curves among the 5 or 6 non-compliant patients. I bet most of the non-compliant people had double majors and it was just too difficult to do the thing with the band on your foot at the same time as the plank.

If this is right then the vast majority of compliant patients only had single curves. It may be that this is just not going to be useful for people with double (or triple) curves. That is the second most prevalent curve pattern in AIS. If true then it needs to be mentioned.

[jrnyc]

oh my goodness...
i tried to read some of this, and my head is spinning...
it reminds me of the infamous math problem...
you know the one that starts something like this....
"if John leaves Newark at 2 pm on Thursday driving
50 miles an hour, and Steve leaves New York at 4 p.m.
on Wednesday driving 60 miles an hour......"

and at that point, 99% of people listening or reading that
problem...STOP reading or listening.... and skip the problem!!

i am not a "math person" and the numbers are starting to make me dizzy...
i gotta think, though...if the "side planks" thing has to be dissected like this...
if the numbers must be examined like this...i am NOT impressed!
because if this were a worthwhile study, it all would be clear, and no
guessing would be needed.
everyone knows good studies need bigger numbers and need to be REPEATED
to prove anything...

jess....
(getting a headache)

[Pooka1]

LOL Jess!

I agree that the article should have been clearer and presented the material in a more useful fashion. They lump and split in non-optimal ways in my opinion. I think it is because spine orthopedics is not their field.

What I have tried to do is deduce what must or is likely the case from what they did present.

But the bottom line is you are right that this study is too small to conclude much and that it needs to be repeated, preferably by someone like Dr. McIntire who is versed in scoliosis orthopedics.