{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:53:06Z","timestamp":1791319986797,"version":"4.3.1"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T00:00:00Z","timestamp":1674777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Adolescent idiopathic scoliosis (AIS) disrupts spinal alignment and increases the intrinsic demand for active stabilization to maintain postural stability. Understanding the paraspinal muscle fatigability and its effects on spinal alignment and kinematics informs the importance of paraspinal muscle endurance for postural stability. This study aims to investigate the effects of fatigue of thoracic erector spinae on the spinal muscle activity and spinal kinematics in individuals with scoliosis. Spinal muscle activity, posture and mobility measured by electromyography and surface tomography were compared between 15 participants with scoliosis and 15 age- and gender-matched healthy controls during unilateral shoulder flexion and abduction with and without holding a 2-kg weight and performed before and after a fatigue task (prone isometric chest raise). No between-groups difference was found for the spinal extensor endurance. Erector spinae activity at the convex side of AIS group was significantly higher than that at their concave side and than that of healthy controls during shoulder elevations, regardless of the fatigue status. Significant decreases in translational and rotational mobility were found at convex side of AIS group during weighted abduction tasks after fatigue. In contrast, a significant increase in rotational mobility was demonstrated at convex side of AIS participants during weighted flexion tasks after fatigue. Our results revealed a comparable level of spinal extensor endurance between individuals with or without AIS. The increase in muscle activation post-fatigue provides no additional active postural stability but may increase the risk of back pain over the convex side in individuals with scoliosis. Findings highlight imbalances in muscles and the potential implications in optimising neuromuscular activation and endurance capacity in the rehabilitation for AIS patients. Future research is needed to investigate if endurance training of the convex-sided back extensors could optimize the impaired neuromuscular control in the AIS patients.<\/jats:p>","DOI":"10.1371\/journal.pone.0281001","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T13:34:51Z","timestamp":1674826491000},"page":"e0281001","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":14,"title":["Effect of muscle fatigue of the thoracic erector spinae on neuromuscular control when performing the upper extremity functional tasks in people with adolescent idiopathic scoliosis"],"prefix":"10.1371","volume":"18","author":[{"given":"Ray Y. H.","family":"Chan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiden C. F.","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy S. K.","family":"Cheung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny C. L.","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruby W. Y.","family":"Kwok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9894-2367","authenticated-orcid":true,"given":"Allan C. L.","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2232-9814","authenticated-orcid":true,"given":"Sharon M. H.","family":"Tsang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,1,27]]},"reference":[{"issue":"1","key":"pone.0281001.ref001","doi-asserted-by":"crossref","first-page":"15030","DOI":"10.1038\/nrdp.2015.30","article-title":"Adolescent idiopathic scoliosis","volume":"1","author":"JC Cheng","year":"2015","journal-title":"Nature Reviews Disease Primers"},{"issue":"9623","key":"pone.0281001.ref002","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1016\/S0140-6736(08)60658-3","article-title":"Adolescent idiopathic scoliosis","volume":"371","author":"SL Weinstein","year":"2008","journal-title":"The Lancet"},{"key":"pone.0281001.ref003","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.2147\/RMHP.S302360","article-title":"Relationship Between Electromyographic Frequency of the Erector Spinae and Location, Direction, and Number of Spinal Curvatures in Children with Scoliotic Changes","volume":"14","author":"J Wilczy\u0144ski","year":"2021","journal-title":"Risk Manag Healthc Policy"},{"issue":"5","key":"pone.0281001.ref004","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.jelekin.2014.05.014","article-title":"Electromyographic responses of erector spinae and lower limb\u2019s muscles to dynamic postural perturbations in patients with adolescent idiopathic scoliosis","volume":"24","author":"N Farahpour","year":"2014","journal-title":"Journal of Electromyography and Kinesiology"},{"issue":"10","key":"pone.0281001.ref005","doi-asserted-by":"crossref","first-page":"3146","DOI":"10.1007\/s00586-016-4628-8","article-title":"Electrophysiological and histological changes of paraspinal muscles in adolescent idiopathic scoliosis","volume":"25","author":"I Stetkarova","year":"2016","journal-title":"European Spine Journal"},{"key":"pone.0281001.ref006","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.clinbiomech.2019.03.013","article-title":"Asymmetric biomechanical characteristics of the paravertebral muscle in adolescent idiopathic scoliosis","volume":"65","author":"Y Liu","year":"2019","journal-title":"Clinical Biomechanics"},{"issue":"1","key":"pone.0281001.ref007","doi-asserted-by":"crossref","first-page":"17582","DOI":"10.1038\/s41598-021-96882-8","article-title":"Asymmetrical activation and asymmetrical weakness as two different mechanisms of adolescent idiopathic scoliosis","volume":"11","author":"Y Park","year":"2021","journal-title":"Scientific Reports"},{"issue":"3","key":"pone.0281001.ref008","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1097\/01241398-198505000-00013","article-title":"An evaluation of muscle pathology in idiopathic scoliosis","volume":"5","author":"WJ Gonyea","year":"1985","journal-title":"J Pediatr Orthop"},{"issue":"6","key":"pone.0281001.ref009","doi-asserted-by":"crossref","first-page":"389","DOI":"10.2519\/jospt.1998.27.6.389","article-title":"Relationship Between Muscle Fiber Composition and Functional Capacity of Back Muscles in Healthy Subjects and Patients With Back Pain","volume":"27","author":"JK-F Ng","year":"1998","journal-title":"Journal of Orthopaedic & Sports Physical Therapy"},{"issue":"4","key":"pone.0281001.ref010","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s005860050077","article-title":"Paraspinal muscle fibre type alterations associated with scoliosis: an old problem revisited with new evidence","volume":"7","author":"AF Mannion","year":"1998","journal-title":"European Spine Journal"},{"issue":"2","key":"pone.0281001.ref011","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/PEP.0000000000000131","article-title":"Ultrasonographic Measurements of Paraspinal Muscle Thickness in Adolescent Idiopathic Scoliosis: A Comparison and Reliability Study","volume":"27","author":"KA Zapata","year":"2015","journal-title":"Pediatric Physical Therapy"},{"issue":"2","key":"pone.0281001.ref012","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/S0966-6362(99)00055-7","article-title":"Three dimensional preparatory trunk motion precedes asymmetrical upper limb movement","volume":"11","author":"PW Hodges","year":"2000","journal-title":"Gait & Posture"},{"issue":"1","key":"pone.0281001.ref013","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.jelekin.2007.06.015","article-title":"Anticipatory postural adjustments to arm movement reveal complex control of paraspinal muscles in the thorax","volume":"19","author":"L-J Lee","year":"2009","journal-title":"Journal of Electromyography and Kinesiology"},{"issue":"10","key":"pone.0281001.ref014","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1097\/01.brs.0000261562.48888.e3","article-title":"Reliability and concurrent validity of the adapted Chinese version of Scoliosis Research Society-22 (SRS-22) questionnaire","volume":"32","author":"KM Cheung","year":"2007","journal-title":"Spine (Phila Pa 1976)"},{"issue":"3","key":"pone.0281001.ref015","first-page":"328","article-title":"ACSM\u2019s Guidelines for Exercise Testing and Prescription 9th Ed. 2014","volume":"58","author":"B. Ferguson","year":"2014","journal-title":"J Can Chiropr Assoc"},{"issue":"5","key":"pone.0281001.ref016","doi-asserted-by":"crossref","first-page":"E334","DOI":"10.1097\/BRS.0b013e3181f516cd","article-title":"Electromyographic Analysis of Paravertebral Muscles in Patients with Idiopathic Scoliosis","volume":"36","author":"AS de Oliveira","year":"2011","journal-title":"Spine"},{"key":"pone.0281001.ref017","doi-asserted-by":"crossref","first-page":"1796247","DOI":"10.1155\/2020\/1796247","article-title":"Reliability of the DIERS Formetric 4D Spine Shape Parameters in Adults without Postural Deformities","volume":"2020","author":"BF Degenhardt","year":"2020","journal-title":"BioMed Research International"},{"key":"pone.0281001.ref018","doi-asserted-by":"crossref","first-page":"721829","DOI":"10.1155\/2014\/721829","article-title":"Evaluating the Reproducibility of Motion Analysis Scanning of the Spine during Walking","volume":"2014","author":"A Gipsman","year":"2014","journal-title":"Advances in Medicine"},{"key":"pone.0281001.ref019","volume-title":"European recommendations for surface electromyography: results of the SENIAM project","author":"Commission of the European Communities B, Health Research P, project S","year":"1999","edition":"2"},{"issue":"2","key":"pone.0281001.ref020","doi-asserted-by":"crossref","first-page":"e0211800","DOI":"10.1371\/journal.pone.0211800","article-title":"Patterns of muscle coordination during dynamic glenohumeral joint elevation: An EMG study","volume":"14","author":"DH Hawkes","year":"2019","journal-title":"PLOS ONE"},{"issue":"2","key":"pone.0281001.ref021","doi-asserted-by":"crossref","first-page":"160","DOI":"10.4085\/1062-6050-44.2.160","article-title":"A clinical method for identifying scapular dyskinesis, part 1: reliability","volume":"44","author":"P McClure","year":"2009","journal-title":"J Athl Train"},{"issue":"9","key":"pone.0281001.ref022","doi-asserted-by":"crossref","first-page":"3088","DOI":"10.3390\/ijerph17093088","article-title":"A Meta-Analysis of the Reliability of Four Field-Based Trunk Extension Endurance Tests","volume":"17","author":"MT Mart\u00ednez-Romero","year":"2020","journal-title":"International Journal of Environmental Research and Public Health"},{"issue":"1","key":"pone.0281001.ref023","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1186\/s12891-021-04189-6","article-title":"Associations between curve severity and revised Scoliosis Research Society-22 and scoliosis Japanese Questionnaire-27 scores in female patients with adolescent idiopathic scoliosis: a multicenter, cross-sectional study","volume":"22","author":"T Doi","year":"2021","journal-title":"BMC Musculoskeletal Disorders"},{"key":"pone.0281001.ref024","unstructured":"Abdul-latif AA, Cosic I, Kumar DK, Polus B, Costa CD, editors. Power changes of EEG signals associated with muscle fatigue: the root mean square analysis of EEG bands. Proceedings of the 2004 Intelligent Sensors, Sensor Networks and Information Processing Conference, 2004; 2004 14\u201317 Dec. 2004."},{"issue":"11","key":"pone.0281001.ref025","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1097\/00007632-199405310-00006","article-title":"Electromyographic median frequency changes during isometric contraction of the back extensors to fatigue","volume":"19","author":"AF Mannion","year":"1994","journal-title":"Spine"},{"key":"pone.0281001.ref026","volume-title":"Clinically oriented anatomy","author":"KL Moore","year":"2018"},{"issue":"9","key":"pone.0281001.ref027","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1002\/mus.880100906","article-title":"Effects of fatiguing exercise on high-energy phosphates, force, and EMG: Evidence for three phases of recovery","volume":"10","author":"RG Miller","year":"1987","journal-title":"Muscle & Nerve"},{"issue":"2","key":"pone.0281001.ref028","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s00421-007-0577-6","article-title":"Relationship between erector spinae muscle oxygenation via in vivo near infrared spectroscopy and static endurance time in healthy males","volume":"102","author":"RT Kell","year":"2008","journal-title":"European Journal of Applied Physiology"},{"issue":"2","key":"pone.0281001.ref029","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s007760300031","article-title":"Oxygen dynamics at paraspinal muscles during exertion using nearinfrared spectroscopy in patients with degenerative lumbar scoliosis","volume":"8","author":"M Miyake","year":"2003","journal-title":"Journal of Orthopaedic Science"},{"key":"pone.0281001.ref030","doi-asserted-by":"crossref","first-page":"9758273","DOI":"10.1155\/2019\/9758273","article-title":"Differences in Nonspecific Low Back Pain between Young Adult Females with and without Lumbar Scoliosis","volume":"2019","author":"W Yuan","year":"2019","journal-title":"Pain Research and Management"},{"issue":"6","key":"pone.0281001.ref031","doi-asserted-by":"crossref","first-page":"370","DOI":"10.2519\/jospt.2019.7917","article-title":"Motor Control Changes in Low Back Pain: Divergence in Presentations and Mechanisms","volume":"49","author":"JHv Die\u00ebn","year":"2019","journal-title":"Journal of Orthopaedic & Sports Physical Therapy"},{"issue":"10","key":"pone.0281001.ref032","article-title":"Muscle fatigue: general understanding and treatment","volume":"49","author":"J-j Wan","year":"2017","journal-title":"Experimental & Molecular Medicine"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0281001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T13:35:29Z","timestamp":1674826529000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0281001"}},"subtitle":[],"editor":[{"given":"Emiliano","family":"C\u00e8","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,1,27]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0281001","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,27]]}}}