Marjorie K. McClure, Carmela Battaglia, Richard J. McClure; The Relationship of Cumulative Motor Asymmetries to Scoliosis in Rett Syndrome. Am J Occup Ther 1998;52(3):196-204. doi: 10.5014/ajot.52.3.196.
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Objectives. Interrelationships between Rett syndrome scoliosis and symmetric and asymmetric motor pull, ambulation, and advancement of age were investigated in order to provide a treatment rationale for slowing the progression of scoliosis.
Method. Questionnaires (N =262) completed by International Rett Syndrome Association families were analyzed with logistic regression, odds ratio, Kruskal-Wallis one-way, and Fisher's exact test analyses.
Results. Rett syndrome scoliosis was found to be significantly related to orthopedic risk factors of asymmetric movements and positions (odds ratio =4.5, p <.001). The odds ratio for asymmetric upper body positioning (4.4), nonambulation (3.1), and age advancement (14.1) indicated that each was a significant predictor of scoliosis by logistic regression analysis. Univariate Kruskal-Wallis one-way analysis identified a significant relationship between scoliosis and asymmetric higher shoulder positioning (p < .001) and bodyside movements (p =.03). Hemisyndrome aspects of Rett syndrome were identified as the increased prevalence of symptoms in either right or left bodyside.
Conclusion. A significant relationship was found between the prevalence of Rett syndrome scoliosis and orthopedic risk factors. These findings suggest a treatment approach for Rett syndrome scoliosis that focuses on balancing bilateral muscular pull.
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