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Thread: Can you locate & post the actual article?

  1. #1
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    Can you locate & post the actual article?

    September 2014, Volume 3, Number 5
    Original Research
    Serial Case Reporting Yoga for Idiopathic and Degenerative Scoliosis
    Loren M. Fishman, MD; Erik J. Groessl, PhD; Karen J. Sherman, PhD, MPH

    Affiliations: Columbia College of Physicians and Surgeons New York (Dr Fishman), United States
    University of California San Diego, VA San Diego Healthcare System (Dr Groessl), United States
    Karen J. Sherman, PhD, MPH, Group Health Research Institute, Seattle, Washington, United States
    Correspondence: lorenmartinfishman@gmail.com
    Citation: Global Adv Health Med. 2014;3(5):16-21

    Read More: http://www.gahmj.com/doi/abs/10.7453/gahmj.2013.064


    ABSTRACT
    Background: Non-surgical techniques for treating scoliosis frequently focus on realigning the spine, typically by muscular relaxation or muscular or ligamentous stretching. However, such treatments, which include physical therapeutic, chiropractic, and bracing techniques, are inconsistently supported by current evidence. In this study, we assess the possible benefits of asymmetrical strengthening of truncal muscles on the convex side of the scoliotic curve through a single yoga pose, the side plank pose, in idiopathic and degenerative scoliosis.
    Methods: 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. After 1 week performing the pose with convexity downward for 10 to 20 seconds, they were instructed to maintain the posture once daily for as long as possible on that one side only. A second series of spinal radiographs was taken 3 to 22 months later. Pre- and post-yoga Cobb measurements were compared.
    Results: The mean self-reported practice of the yoga pose was 1.5 minutes per day, 6.1 days per week, for a mean follow-up period of 6.8 months. Among all patients, a significant improvement in the Cobb angle of the primary scoliotic curve of 32.0% was found. Among 19 compliant patients, the mean improvement rose to 40.9%. Improvements did not differ significantly among adolescent idiopathic and degenerative subtypes (49.6% and 38.4%, respectively).
    Conclusions: 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. These results warrant further testing.
    JOURNAL INFORMATION
    ISSN info
    Electronic: 2164-9561
    Print: 2164-957X
    Coden: gahmj
    Disclosure Information
    All GAHMJ authors complete the ICMJE Form for Disclosure of Potential Conflicts of Interest, and unless otherwise indicated, none related to the publication were reported.
    Global Advances in Health and Medicine (GAHMJ), an international, peer reviewed, scholarly medical journal, launched in March 2012, has three areas of primary focus: (1) global convergences in health and medicine, (2) whole systems approaches in healthcare, and (3) high quality case reports. GAHMJ has an international editorial team, including Robert Saper, MD, MPH; Mary Jo Kreitzer, PhD, RN, FAAN; Helmut Kiene, Dr med; Gunver Kienle, Dr med; Michele Mittelman, MPH, RN; Gregory Plotnikoff, MD, MTS, FACP. GAHMJ is published in digital and print formats, with abstracts in Chinese, English, and Spanish.

  2. #2
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    I paid the $25 and downloaded the article here: http://www.gahmj.com/doi/abs/10.7453...rnalCode=gahmj

    Unfortunately, it's against the law to actually post the full article without permission.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
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    Quote Originally Posted by LindaRacine View Post
    I paid the $25 and downloaded the article here: http://www.gahmj.com/doi/abs/10.7453...rnalCode=gahmj

    Unfortunately, it's against the law to actually post the full article without permission.
    How bad is it? :-)
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  4. #4
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    AIS Overview

    Quote Originally Posted by LindaRacine View Post
    I paid the $25 and downloaded the article here: http://www.gahmj.com/doi/abs/10.7453...rnalCode=gahmj

    Unfortunately, it's against the law to actually post the full article without permission.
    Thank goodness you mentioned it is against the law to post the full article without permission as I was just about to do so when I read your note. I was unable to pull the article without paying the $25 dollars, however, I did receive a copy. I am only interested in the AIS patients so here is an overview:

    Total number enrolled in study: 25 patients
    Total Curve Size: 6 ˚ – 120 ˚
    Total Age: 14 - 85
    Total Compliant: 20 “…those who reported performing the side plank pose at least 4 times per week for the entire follow-up period.”
    Total Non-Compliant: 5 “one who did the side plank pose fewer than 4 times weekly”
    Total Mean Time: 1.5 minutes per day
    Total Mean days per week: 6.1 (range 5-7 days)
    AIS Compliant: 7
    AIS Non-Complaint: ?
    AIS Improvement: 49.6%
    Total Time frame: 3- 22 months (mean: 6.8months)
    Stated Weaknesses: Small group, No control group, No detailed notes on adherence to treatment

    I will request further information.

    A Mom

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    How many of the 25 had AIS and were not skeletally mature? For the rest, they are probably looking at doing this forever which at a few minutes a day is probably doable.

    The reason I ask is the authors are making a certain number of noises about how braces are hard on kids.
    Last edited by Pooka1; 12-02-2014 at 10:40 PM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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    Quote Originally Posted by LindaRacine View Post
    I paid the $25 and downloaded the article here: http://www.gahmj.com/doi/abs/10.7453...rnalCode=gahmj

    Unfortunately, it's against the law to actually post the full article without permission.
    I understand copyright infringments but sometimes in these cases they just make me laugh, I remember a while ago I posted on this very forum the whole Schroth book and I was asked to remove the post, this article wants you to fork out 25 bucks only to find out it's all BS of course.. health issues should be provided free or offer some sort of your money back clause what a materialistically stupid world we live in..

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    It's really difficult to evaluate this info without reading the whole publication…But, I have to note, in the description the authors state the subject curves ranged from 6 degrees to 120 degrees. That's a pretty huge spread, and there is certainly no comparing 6 degree curves to anything over, oh, say 50 degrees or so. If someone had a 30% reduction of a 6 degree curve does that prove anything at all about side planks? No, of course it doesn't.
    Gayle, age 50
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    2010 VBS Dr Luhmann Shriners St Louis
    2017 curves stable/skeletely mature

    also mom of Torrey, 12 y/o son, 16* T, stable

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    Quote Originally Posted by leahdragonfly View Post
    It's really difficult to evaluate this info without reading the whole publication…But, I have to note, in the description the authors state the subject curves ranged from 6 degrees to 120 degrees. That's a pretty huge spread, and there is certainly no comparing 6 degree curves to anything over, oh, say 50 degrees or so. If someone had a 30% reduction of a 6 degree curve does that prove anything at all about side planks? No, of course it doesn't.
    Good point, Gayle.

    I have seen the article. There are some major problems with it in terms of data selection. One thing it did very well was show the before and after points on one graph. But they only show 22 trajectories (beginning and end measurements connected by a straight line) when there were 25 subjects and the figure includes the 7 secondary curves. So it should have 32 trajectories, not 22. Now only 20 of 25 did the pose. Did they drop the non-compliant off the graph? I think the procedure is to include the non-compliant as having failed the treatment.

    12 of the 22 trajectories shown started at 30* or less. Some of these curves INCREASED over time. I suspect they are AIS in growing kids.
    10 started out with curves larger and sometimes much larger than 30*. They all decreased.
    The 6* curve when down to about 3* which would be a 50% decrease. LOL.
    There were 7 AIS patients and they have much smaller curves (mean = 22.8*) than the degenerative crowd (50.4*). The sd was large for both groups indicating a lot of variation in the results. The smaller curves dropping a little bit produced large percent decreases which makes this look better than it really is as far as I can tell.

    I question the quality of the review. Maybe this is not a peer-reviewed journal?

    The main issue of course is how long will the reductions last?
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  9. #9
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    Quote Originally Posted by Alistair View Post
    I understand copyright infringments but sometimes in these cases they just make me laugh, I remember a while ago I posted on this very forum the whole Schroth book and I was asked to remove the post, this article wants you to fork out 25 bucks only to find out it's all BS of course.. health issues should be provided free or offer some sort of your money back clause what a materialistically stupid world we live in..
    I think anyone can go into a medical library and read the article for free.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  10. #10
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    Sometimes articles can be found on other websites. I found the BrAIST article on some other website for example. This one, though much less weighty, is hard to find.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  11. #11
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    more info

    The information I received is that they only graphed/ reported the compliant cases, which explains the disconnect between the numbers reported.

    Sorry, I disagree about the positive comment about the graph. Without additional information (i.e. age, maturation, comorbidity, size, direction & placement of curve), I don't believe the graph presents the information accurately. As was stated earlier, (b/c of the wide range of curve size, type of scoliosis: AIS & degenerative scoliosis, fairly even split between left & right curves, maturation level, curve placement: T, TL, & L, and small size of the study) mixing the data presents skewed results. In this case, combined results should be viewed very cautiously.

    Several of us checked into it and yes, it is a peer-reviewed publication. By now, we have all read plenty of articles that are poorly written. Maybe authors need to hire grammar school teachers to make the first edit BEFORE it goes through the peer review process. WARNING: Authors should bring the teachers in when writing the proposal or they may not collect enough pertinent data to write the paper....

    I was told the adults who stop the side plank pose lose the reduction within a period of 4-5 months; similar to that noted by McIntire when looking at CTR; however, this information is antidotal. They are informally looking at adolescents and may consider research in that area. --I am not saying they are going to do this, just that it is a point of interest.

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    Quote Originally Posted by AMom View Post
    The information I received is that they only graphed/ reported the compliant cases, which explains the disconnect between the numbers reported.

    Sorry, I disagree about the positive comment about the graph. Without additional information (i.e. age, maturation, comorbidity, size, direction & placement of curve), I don't believe the graph presents the information accurately. As was stated earlier, (b/c of the wide range of curve size, type of scoliosis: AIS & degenerative scoliosis, fairly even split between left & right curves, maturation level, curve placement: T, TL, & L, and small size of the study) mixing the data presents skewed results. In this case, combined results should be viewed very cautiously.
    These are great points and I agree with most of them. I am just saying I have NEVER see the individual before and after points plotted in any other article. If I digitize the figure, I can get their dataset (compliant patients only) and play around with it to show other ways that the data could have been presented. There is no other article I have come across where I can get their entire dataset (for the complaint patients at least).

    I was told the adults who stop the side plank pose lose the reduction within a period of 4-5 months; similar to that noted by McIntire when looking at CTR; however, this information is antidotal. They are informally looking at adolescents and may consider research in that area. --I am not saying they are going to do this, just that it is a point of interest.
    I think a requirement to publish PT treatments should be that they show the exercises overcame and corrected the anterior overgrowth of the spine. Absent that, it is just screwing around in the short term.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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    By the way, if we knew all the before and after measurements, especially for the dose response curve in the Weinstein/Dolan paper, I think we might come away with a different impression of the efficacy of bracing that they claim.

    Recall that a 49* curve with up to 25% of growth remaining was scored a bracing "success" in the BrAIST study. And we still don't even know the average of the after measurements, not to mention the individual trajectories.

    I am losing hope they will ever publish the ending measurements. If they don't then there is some reason.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  14. #14
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    Pre- & Post- data

    Pooka1,

    I've seen other articles that include the Pre- and Post- individual results, however graphing them becomes pretty messy visually when there are a lot of cases so I can readily understand why this type of graph is seldom used. For instance, in this small study, if I had graphed them, I could have separated the AIS only from the AIS and degenerative curves and then included the non-compliant cases within each category. To make it easier to read, I would have color coded the compliant and non-compliant cases. I would only have included the major and double major curves, but to clarify, I would have used a textured line for the double majors. Or better yet, I could have used positive and negative points to graph curve progression. Depending on the cases included, I would then group them in a manner that demonstrated certain points. Anyway, it looks as though they used a basic program and probably didn't have a lot of options. I used something similar and quickly graphed the Pre- and Post- data from Mooney's article. I'll send it to you if you want to post it so others can see what we're talking about.

    Even though I believe the non-compliant cases should be listed, the threshold noted, and the willingness to remain complaint discussed, I do not believe the non-complaint cases should be counted as a failure of the EXERCISE any more than those who see a surgeon, but do not choose the operation. Non-compliance is not the same as efficacy of treatment.

    A Mom

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    Quote Originally Posted by AMom View Post
    Anyway, it looks as though they used a basic program and probably didn't have a lot of options. I used something similar and quickly graphed the Pre- and Post- data from Mooney's article. I'll send it to you if you want to post it so others can see what we're talking about.
    That is Excel and lots can be done with the graphing including what you suggested. They forgot to include the symbols on one of the lines (not the mean line).

    In re showing data, Weinstein/Dolan had 100 points of progression or regression. Every one of those could be clearly shown on one graph instead showing the averages. They could have used a box plot which shows median, quartiles, 10 and 90 percentiles and all outliers. There is a reason box plots are used instead of medians and sds.

    Even though I believe the non-compliant cases should be listed, the threshold noted, and the willingness to remain complaint discussed, I do not believe the non-complaint cases should be counted as a failure of the EXERCISE any more than those who see a surgeon, but do not choose the operation. Non-compliance is not the same as efficacy of treatment.

    A Mom
    I think if you have people agreeing to try a treatment and some are not compliant, that goes into the overall efficacy of the treatment. That is, there is some chance some percentage of patients will try and fail to carry on with the treatment for whatever reason. That is relevant to the efficacy. I think that is why you count all people enrolled who agreed to try the treatment, even the one who eventually were not compliant.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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