# Relevance of Surface Electromyography Assessment and Sleep Impairment in Scoliosis: A Pilot Study
## 4 Discussion  
Indeed, several studies have demonstrated the effectiveness of scoliosis pattern-specific exercises in improving or stabilizing scoliotic curves in patients with adolescent idiopathic scoliosis (AIS). These targeted exercises, designed to address the specific curvature patterns observed in individual patients, have shown promising results in terms of curve reduction and better postural alignment. Implementing such exercise programs, along with other forms of conservative treatments, can be beneficial in managing and optimizing the outcome of AIS. However, it is essential to consider individual variations and seek professional guidance to tailor exercises to each patient's unique condition [24; 25; 26]. Due to the possibility of improper postures leading to the progression of spinal curvatures, certain scoliosis treatment programs have integrated postural training, but there are no evidence-based studies about the combined therapeutic intervention Schroth and GPR. This emphasizes the importance of tailored exercise programs and professional supervision to ensure safe and effective approaches for scoliosis patients, taking into account individual needs and potential risks associated with specific activities. However, this should not discourage patients to move. It is essential for individuals, including those with scoliosis, to follow their athletic passions and engage in physical activity in general. This observation is also evident in our study, where the decline in the Baecke Questionnaire score, which is relatively low, may be attributed to the way that the participation in other physical activities related to sports or leisure activities is perceived by the patients and their parents. There are controversies regarding the safety and involvement of children diagnosed with scoliosis in sports activities. These concerns might influence their engagement in physical activities, leading to lower scores on the Baecke Questionnaire, according to our result. \begin{table}
\begin{tabular}{p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt}} \hline \hline
**Dependent Variables** & **Explanatory Variables** & **Lambda** & **F Observed** & **F Critical Value** & \(p\)**-Value** \\ \hline Flexion Symmetry Index & Epworth categories & 0.465 & 0.906 & 2.341 & 0.537 \\ Orthostatic position symmetry index & & & & & \\ \hline \hline \end{tabular}
\end{table} 
Table 16: Parameter values of the Wilks’ Lambda test, T1 moment. \begin{table}
\begin{tabular}{p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt}} \hline \hline
**Dependent Variables** & **Explanatory Variables** & **Lambda** & **F Observed** & **F Critical Value** & \(p\)**-Value** \\ \hline Flexion Symmetry Index & Epworth categories & 0.403 & 1.108 & 2.341 & 0.397 \\ \hline \hline \end{tabular}
\end{table} 
Table 17: Parameter values of the Wilks’ Lambda test, T2 moment. Currently, physical activity surveys are the most practical method for assessing activity levels in large epidemiological studies exploring the health consequences of inactivity. The Baecke Questionnaire was selected due to its brevity, ease of completion, and established validity and repeatability across various populations [27]. Taking all of the above into consideration, we approached only the first section of the questionnaire, regarding physical activity. Furthermore, in this study, by combining elements from two very discussed treatment programs in the literature, we gain perspective on a complex approach to treatment for AIS. Conservative methods, which rely on exercise approaches like Schroth exercises [28] or global postural reeducation (GPR) [13], can be beneficial and seem to cause fewer adverse effects as they enable patients to move freely without constraints. Notably, GPR utilizes active muscle stretching postures, motor control, and sensory integration exercises. The reduction in scoliotic curves after GPR treatment has been observed during GPR active and assisted self-correction sessions.