Treatment: PT using MedX per Mooney & later, McIntire research

[AMom]

On Topic!

I've moved the discussion so as not to crowd out the torso rotation focus in here. See here:
http://www.scoliosis.org/forum/showt...345#post136345

Tom,

Thanks for your consideration, but this topic is directly related to PT and therefore still "on topic." I am learning quite a bit, but simply haven't had time to comment.

A Mom

[TAMZTOM]

Tom,

Thanks for your consideration, but this topic is directly related to PT and therefore still "on topic." I am learning quite a bit, but simply haven't had time to comment.

A Mom

I am none too bright, AMon. Excuse in advance further obtuseness. In recompense, just read this article on asymmetric vs symmetric exercise. It refers to both K_McI's torso rotation research and the earlier stuff from Mooney. You've probably read it before, been there done that, but, for slow moving creatures like meself, it pays to hammer myself unconscious every night hoping that something will gell and hit the bell.
http://f1.grp.yahoofs.com/v1/sF5WT-w...%20in%20IS.pdf

[AMom]

asymmetric vs symmetric exercise

http://f1.grp.yahoofs.com/v1/sF5WT-w...%20in%20IS.pdf

Tom,

I've had problems opening docs in the past, but this time it comes up, "Error 404, Document Not Found." Will you please give me the title?

Thanks,

A Mom

[TAMZTOM]

Will you please give me the title?

Emailed it to you. Just reading through it again and tried a search through this thread for Kevin_McI's comments on EMG measurement, viz., how difficult it was to assess the EMG accuracy (I think). Can't find it.

From the article:

Specifically, the asymmetric front press and bent-over barbell row increase EMG amplitudes in the lumbar concavity, and the roman chair and bent-over barbell row target the thoracic concavity.

Recall that the signal from Type 1 and Type 11 fibres may render the readings imprecise if we're specifically trying to promote Type 1 (e.g., Type 11 over-activity could confound the EMG?). So wondering if this research was less precise (than Kevin) by not distinguishing between the fibres?

[AMom]

Questions before comments

Emailed it to you. Just reading through it again and tried a search through this thread for Kevin_McI's comments on EMG measurement, viz., how difficult it was to assess the EMG accuracy (I think). Can't find it.

From the article:

Specifically, the asymmetric front press and bent-over barbell row increase EMG amplitudes in the lumbar concavity, and the roman chair and bent-over barbell row target the thoracic concavity.

Recall that the signal from Type 1 and Type 11 fibres may render the readings imprecise if we're specifically trying to promote Type 1 (e.g., Type 11 over-activity could confound the EMG?). So wondering if this research was less precise (than Kevin) by not distinguishing between the fibres?

Thank you, I received and skimmed the document. In addition to your question above (regarding Type I & Type II muscles), I think there have been general questions regarding the accuracy of EMG readings of deeper (vs. surface) muscles—and since that is what this study looked at, I need to have those answers before I can decide how much confidence to place in their results. If anyone knows the answer, please respond.

I’ve noticed other studies focus on the apex of the curve as well; can you tell me why they ignore the muscles above and below the apex?

Also, can you explain their reasoning for not recording data from fatigued muscles? I don't know much about EMG's, maybe fatigued muscles flood the system...?

[Kevin_Mc]

Emailed it to you. Just reading through it again and tried a search through this thread for Kevin_McI's comments on EMG measurement, viz., how difficult it was to assess the EMG accuracy (I think). Can't find it.

From the article:

Specifically, the asymmetric front press and bent-over barbell row increase EMG amplitudes in the lumbar concavity, and the roman chair and bent-over barbell row target the thoracic concavity.

Recall that the signal from Type 1 and Type 11 fibres may render the readings imprecise if we're specifically trying to promote Type 1 (e.g., Type 11 over-activity could confound the EMG?). So wondering if this research was less precise (than Kevin) by not distinguishing between the fibres?

I thought I had this article on my computer or at least had read it. I thought I remember that from Dingo a few months ago. ??

At any rate, I am doubtful that surface EMG is able to differentiate between type I and II fibers. I have a good friend who does a lot of EMG work. I'll email him to confirm this. The increased concave activity is interesting in this article's abstract though. Would you mind emailing it to me as well?

Thank you, I received and skimmed the document. In addition to your question above (regarding Type I & Type II muscles), I think there have been general questions regarding the accuracy of EMG readings of deeper (vs. surface) muscles—and since that is what this study looked at, I need to have those answers before I can decide how much confidence to place in their results. If anyone knows the answer, please respond.

I’ve noticed other studies focus on the apex of the curve as well; can you tell me why they ignore the muscles above and below the apex?

Also, can you explain their reasoning for not recording data from fatigued muscles? I don't know much about EMG's, maybe fatigued muscles flood the system...?

You're correct. Deeper muscles with surface EMG is very unreliable. I've read a handful of reports where they try to figure out different filter algorithms and whatnot to say "This activity is the multifidus". But I think this has been argued down in the literature. The only way to confirm would be a surface EMG along with fine wire EMG inserted into the muscle of interest. But even then, the amount of signal you get from one muscle fiber (fine wire) compared to what you get from several layers of muscles (surface) would be very difficult to piece apart. You'd get correlation for sure but it's doubtful it would be repeatable. Or at least, I would be very skeptical of their results if they were suggesting specific deep muscles were activated over other deep muscles.

[TAMZTOM]

I thought I had this article on my computer or at least had read it. I thought I remember that from Dingo a few months ago. ??
At any rate, I am doubtful that surface EMG is able to differentiate between type I and II fibers. I have a good friend who does a lot of EMG work. I'll email him to confirm this. The increased concave activity is interesting in this article's abstract though. Would you mind emailing it to me as well?

Didn't get it from Dingo. I've read some of his posts, very diligent and knowledgeable. Emailing it to you now.
Re. the increased concave activity recorded, I think that may relate to a comment you made somewhere else re. the recruitment of Type 11 fibres from the concavity located muscles to supplement the Type 1 deficit. (I don't even know if this is possible?)

[AMom]

Treatment: PT using MedX per Mooney & later, McIntire research, 1 year later

In preparation for her third x-ray (since she began CTR), I am writing up an overview of the last 13 months of PT (it will be 14 months at the time the next x-ray is taken.) Here are a few interesting notes I’ve found with regard to frequency and intensity/ weight.

1. Research suggests working out the paraspinal muscles 1x week is good, 2x week is better, and 3x per week is only infinitesimally better, but isn’t worth the slight benefit because patients usually experience back pain at this frequency which will cause them to stop the workout altogether.

2. Research also suggests workouts build bone mass and there is a positive correlation between the density of 10yro – 20 something’s and the bone density of women in later life. (?, I will have to go back to check and insert the specific age range sited)

3. The studies I’ve found discuss core torso rotation 2x per week until the patient plateaus and then reducing the workout to 1x per week.

4. Nothing in writing/ nothing published. Conversations with clinics and gym personnel using this workout with adolescent girls with scoliosis say the most they can get the clients to come in on a regular basis is 1x per week, though some may start at 2x per week, they quickly reduce to 1x per week. The agencies all state they would prefer to stay at 2x per week until the patient/ client plateaus (to obtain better results), and then reduce the workout, but it frequently isn’t possible for the families. They are not tracking results, but their overall IMPRESSION reported is they are similar, but not quite as good as Mooney’s original project. One clinic said they were not getting as favorable results, but declined to discuss type of curves, maturation, PT consistency or a rough number of children treated. One gym said they were getting better results than Mooney, but also declined to discuss general details. No one wanted to discuss what consitituted "less favorable" or "better" results.
–It get the idea they are each working with fairly small numbers of children. Interestingly, boys are frequently mentioned as being part of the clientele. Ages mentioned range from 8 to 16 with 8-12yro being referenced most often.
--Wish I had hard facts/ numbers to offer, but I have been unsucessful in gathering more than general information.

5. Per my records, there was no change in results between the beginning of my daughter’s workout, (very low weight lifted) and the end of her workout (high weight lifted.) Her curve neither increased, nor decreased when the weight changed. (Though the weight increased, the intensity was fairly consistent.) She worked out 3x per week.
--We will see if there is a change at the next x-ray since she is now lifting close to half her body weight. (There are several other variables in play, so any changes cannot be solely attributed to the weight increase.)

As I continue putting together the year-end-report, I will share any other comparisons that arise.

Frequency: Number of workouts per week
Intensity/ Weight: “To fatigue” @ 1/3 (or higher) of body weight

[AMom]

Does seat height impact output during CTR?

Spoke with a family who tried raising the seat during CTR on the Cybex. They found their child was unable to complete the same number of repetitions using the same amount of weight. They reported:

Lower (regular) Seat Height: 15 reps @ 20lbs (struggling at the 10th rep)
Higher Seat Height: 15 reps @ 10lbs (struggling at the 10th rep)

This is the second person to note this occurrence (that I am aware of), but it shows it is not always an "easier workout when the seat is higher" as some of the clinics and gyms thought. (I realize they thought that because they noted the change when seating was lowered due to client growth.) This demonstrates that the loss in output may also occur when the seat is raised. If you are doing CTR, will you let me know what happens if you raise or lower your seat ± one inch?

Thanks,

A Mom

[AMom]

PT/ Core Torso Rotation per Mooney & McIntire

I am glad to have the opportunity to speak with ALL of you folks who have contributed to these conversations, but I am wondering why the people who are using equipment to TRY core torso rotation during the "watch & wait" period have not responded to this thread. It has been three months and not one family, trainer, or therapist has replied.

Positive or negative, I really want to hear your results. What made you consider this type of PT? What did you try that did/ did not work? Why did you walk away after you started PT? I know our ortho discouraged PT because it wouldn't help the curve, but he okayed it for general fitness--did you decide it wasn't worth the time and expense without a guaranteed outcome? (There are no guarantees) If you are nervous about writing on a public forum, would you consider sending me a private message? If you are a PT or trainer and don't feel this is the place for your comments, will you PM me or suggest another site where it would be appropriate?

Since I know there are others trying it, maybe I am on the wrong forum or it could just be me (dry, boring, not well enough informed to speak with).

It may be time to widen the audience. Where else could I go to talk with others who are trying core torso rotation?

Thanks in advance for your advice!

A Mom

[Pooka1]

I am glad to have the opportunity to speak with ALL of you folks who have contributed to these conversations, but I am wondering why the people who are using equipment to TRY core torso rotation during the "watch & wait" period have not responded to this thread. It has been three months and not one family, trainer, or therapist has replied.

To my knowledge, only you, the other woman, Dingo, and now Tamztom are trying it. That's four. If more are trying it I don't think they posted about doing so.

Since I know there are others trying it, maybe I am on the wrong forum or it could just be me (dry, boring, not well enough informed to speak with).

You might call the trainer guy who (repeatedly) refuses to stop listing the wrong credentials for McIntire. But he's just a trainer and likely hasn't seen any radiographs nor would he understand them. Scoliosis is a way for him to make money. Trainers in general will be of no help as they have no relevant training in scoliosis or torso rotation to treat same.

Where else could I go to talk with others who are trying core torso rotation?

With only Mooney and McIntire's work out there with a total of 35 patients and no long term follow-up, I doubt there are cadres of folks doing torso rotation so I am not sure how you will find any. But I hope you do.

[Pooka1]

Oh hey there was another person, "Turtle" or something but her child only had about a 10* curve so it doesn't count towards assessing torso rotation efficacy.

[AMom]

PT/ Core Torso Rotation per Mooney & McIntire

Anna's Mom, Dingo, and I are using CTR on Cybex, Cybex, & MedX equipment.

Tamztom is doing it freestanding, but this means he is unable to focus on the paraspinal muscles. I am not saying the workout won't build other muscle groups, but I do not believe that CTR will have an effect on curve progression if all muscle groups are able to engage. (Dr. McIntire can correct me here, but it is my opinion the larger muscles will take over the task if they aren't eliminated from the workout.)

I haven't come across Turtle.

Even though trainers don't have an education in scoliosis or research, they are likely to come across small numbers of girls in gyms (larger numbers than I will ever see). If they are willing to talk with me, I could give them a flyer to share with their clients. Then, if their clients contact me we could discuss x-ray results, ages, gender, and possibly the intensity, duration, & frequency of the workouts. This isn't research, simply a gathering of antidotes for deep background. And, if we are going to be honest about educations, trainers frequently have a bachelors degree in kinesiology or related fields, which is better suited to this discussion than my background.

I would only share generic info here if folks gave me permission to do so. Or, they might be willing to write their own stories.

Another mom just put me in contact with Curvy Girls, they are a smaller organization than NSF, seem friendly, mostly offering support for young girls. If I can link up with several more web sites or gyms in this manner, it is possible I might be able to locate others who are using CTR equipment and are willing to talk with me. (Thanks for sharing the idea! I've already sent an email and gotten an initial response.) --This is exactly what I hoped would happen.

Anyone else?

A Mom

[Pooka1]

I haven't come across Turtle.

Sorry I didn't remember that correctly. It's Turtlelover... here are her posts:

http://www.scoliosis.org/forum/searc...earchid=500327

[djjane]

Hi Amom,

I am here. We've used Cybex for several weeks. Then found the MedX torso rotation machine in a small fitness center. But only have been there for two weeks.

We are using the 24 lb settings right now. Also using the MedX back extension machine there. We go there twice a week. Then we go to our regular gym using Cybex for CTR twice a week.

Thanks.