The Relationship between the Angle of Curvature of the Spine and SEMG Amplitude of the Erector Spinae in Young School-Children

Round 1

Reviewer 1 Report

The authors report a very interesting study on the relationship between the angle of curvature of the spine and the SEMG amplitude of the erector spinae muscle in a cohort of young children. They observed the highest amplitude of the SEMG in patients with scoliosis, and a significant correlation between the angle of the spine curvature and the SEMG amplitude. The topic is very interesting, the paper is well written. Methodology is correct, and conclusions are supported by results. In my opinion the paper may be accepted for publication as it currently is. 

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Author Response

    Thank you very much for your insightful comments and recommendations.

                                                                                                                 Jacek Wilczyński

 

Reviewer 2 Report

Interesting study

Define early on what SEMG is: Abbreviation in full but also what it is.

Define dystonia and spasticity and explain why they used the term dystonia to describe the paraspinal muscles in scoliosis.

Explain the bone canal in line 54.

What's flbrylation? same as fibrillation?

Author Response

 

Thank you very much for your insightful comments and recommendations.

 

Point 1: Define early on what SEMG is: Abbreviation in full but also what it is.

 

 

Response 1: The term SEMG has been clarified and its definition has been given. The following sentence has been added: “EMG measurements can be performed using intramuscular or surface injection electromyography. The advantages of surface electromyography include the possibility of performing any functional movements by the examined person during the measurement, easy assessment of muscle activity, non-invasiveness, painlessness, the possibility of selective assessment of various muscle groups at the same time and high sensitivity to changes in muscle activity”. The description of the SEMG term can be found in the article from lines 84 to 110. In the ‘Material and Methods section’, there is an in-detail description of the SEMG implementation.

                                                                                            

Point 2: Define dystonia and spasticity and explain why they used the term dystonia to describe the paraspinal muscles in scoliosis.

 

Response 2: The term - dystonia - used in the article is related to uneven tension of the erector spinae (Greek: dys tonus) (Eng: disordered tonicity of muscle). In this case, it concerns the uneven tension of the erector spinae on both sides of the spine and at its various levels. The term used in this way has nothing to do with the neurological disease which is dystonia (Dystonia is a neurological movement disorder syndrome in which sustained or repetitive muscle contractions result in twisting and repetitive movements or abnormal fixed postures. The movements may resemble a tremor. Dystonia is often intensified or exacerbated by physical activity, and symptoms may progress into adjacent muscles). The term – dystonia – used in the article also does not have anything to do with a different neurological symptom – spasticity (Spasticity (from Greek spasmos-, meaning 'drawing, pulling') is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity, and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles).

 

According to the Reviewer’s suggestions, the term dystonia has been replaced in the whole text with a different phrase: unequal tension of the erector spinae.

 

Point 3: Explain the bone canal in line 54.

 

Response 3: The phrase bone canal has been replaced by the anatomical term - groove.

The main mass of the erector spinae muscle lies in the groove restricted by spinal processes of the vertebrae on one side and the arch lamellae, the transverse processes and the vertebral segments of the ribs on the other side [8]. The shape of this groove varies on the convex and concave sides of the curve, hence, the muscle system on both sides is different.

 

Point 4: What's flbrylation? same as fibrillation?

 

Response 4: Should be fibrillation. The term fibrillation is used in the EMG description. The EMG examination is performed using needle electrodes, at rest and during muscle contraction. The measured potential fluctuations are visible on the monitor, they can also be converted to an acoustic signal, heard through a speaker. During rest, no bioelectrical activity (electrical silence) is found in the muscle. The appearance of spontaneous activity at that time is a pathology. When the needle electrode is inserted into the relaxed muscle, a few positive sharp waves or fibrillations are recorded. Longer-term spontaneous activity is also an abnormal phenomenon. The following forms of spontaneous activity are distinguished:

-fibrillation potentials, positive acute waves,

-fasciculation,

-repeated discharges of wave complexes.

Spontaneous activity occurs 2-3 weeks after neurogenic peripheral damage. Fibrillation potentials and positive acute waves correspond to discharges of individual muscle fibres, fasciculations correspond to spontaneous discharges of motor units, and repeated discharge of wave complexes are the expression of discharges of muscle fibre groups. The fibrillation potentials and positive acute waves do not find any equivalent in any visible muscle movements, with fasciculations and repeated discharges of the wave complexes, muscle vibrations and myotonic reactions are visible.

 

 

 

Jacek Wilczyński

Author Response File: Author Response.pdf