title: The relationship of cumulative motor asymmetries to scoliosis in Rett syndrome.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Occupational Therapist, The Medical Center, Beaver, Pennsylvania, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: McClure
authors.forename: C
authors.initials: C
authors.lastname: Battaglia
authors.forename: R J
authors.initials: RJ
authors.lastname: McClure
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016015:Logistic Models; D015518:Rett Syndrome / Q000150:complications* / Q000503:physiopathology; D012600:Scoliosis / Q000150:complications* / Q000503:physiopathology