# Evaluation of Symmetrical Exercises in Scoliosis by Using Thermal Scanning
## 4 Discussion  
The efficiency of physical exercises in the case of scoliosis is still being studied by specialists in the field. Orthopedists and physiotherapists have not yet agreed on the influence of exercise on children diagnosed with scoliosis. There are still orthopedists who say that a person with scoliosis should be clinically monitored, and surgery can be performed at the right time. In their conception, physical exercises have only a minor role, in maintaining muscle tone in the back. On the other hand, studies conducted by  
Figure 8: Subject with scoliosis 1 (**a**) image taken at the beginning of the experiment 1; (**b**) image taken at the end of the experiment 1; (**c**) image taken at the end of the experiment 2. Figure 10: Subject with scoliosis 3 (**a**) image taken at the beginning of the experiment 1; (**b**) image taken at the end of the experiment 1; (**c**) image taken at the end of the experiment 2. Figure 9: Subject with scoliosis 2 (**a**) image taken at the beginning of the experiment 1; (**b**) image taken at the end of the experiment 1; (**c**) image taken at the the end of the experiment 2.  
physiotherapists in collaboration with orthopedic doctors have been able to show that specific physical exercises can stop the evolution or even reduce the amplitude of the Cobb angle in children with scoliosis [18; 19; 20; 21; 22]. The way the back muscles work in children with scoliosis has long been studied using an electromyogram. Research has shown increased myoelectric activity on the convex side, near the apex of the curve both at static and dynamic while walking or loading [23; 24; 25]. In his study, [PERSON] et al. (2014) [26], points out that in people with scoliosis, myoelectric activity is different not only in the back muscles but also in the lower limbs as an adaptive response to movements performed in different planes. They consider that the asymmetry of tone is a consequence of the attempt to stabilize the trunk in dynamic conditions. In addition, studies on muscle tissue have shown a different distribution of muscle fibers on the convex side and the concave side of the spine. Thus, on the concave side are arranged more type II fibers while on the convex side are predominant type I muscle fibers [27]. Recent studies also show that paraspinal muscles on both the concave and convex sides suffer from atrophy and collagen levels in the tissues are low, similar to degenerative pathologies [28; 29; 30]. Muscle activity during scoliosis-specific exercises was monitored by [PERSON] et al., on patients performing Schroth exercises. They have shown that specific exercises can reduce the difference in activity between the right side and the left side of the back, which demonstrates the importance of physical activity adapted to the condition of each subject [21]. Given the elements observed in studies in the literature, in our research we proposed, as a novelty, to use the thermal imaging camera not only to diagnose scoliosis in children but to observe how the back muscles act during physical activity. Our study analyzed the action of the back muscles during movements performed symmetrically by subjects with scoliosis and by subjects without postural deviations in order to observe if there are differences in the functioning of the back muscles between the two categories of subjects. Three exercises were chosen from the most indicated for mobilizing and toning the back muscles. In the experiment we followed the activation of the back muscles during the dynamic exercises performed from the unloading position of the spine (four-legged position) both in open kinematic chain and in closed kinematic chain using a thermal imaging camera. Following the activity of the muscles in the control group, it was found that the muscles on either side of the back function harmoniously, balanced, in the three exercises studied. In the case of these subjects, it was observed that exercise 1 mainly activates the muscles in the lumbar area, having less action on the upper back muscles.