PMC10130685_01
At initial presentation, coronal radiograph shows right pelvic drop, right hip contracture with abduction and a right thoracolumbar curvature with a 20  Cobb angle between T10 and L5. Lateral view reveals reverse cervical lordosis with anteroflexion deformity (white arrow), -28  McGregor slop, mild subluxation of C4 relative to C5 (red arrow), osteophytes in the lower cervical and lumbar spine, and interspace narrowing of the C3/C4, C5/6, C6/C7, C7/T1, and L4/5 levels. McGregor's line is a hypothetical line drawn between the hard palate and the most caudal point of the occipital curve.
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A coronal view revealed right pelvic drop, right hip contracture with abduction, and a long thoracolumbar curve (T10-L5 Cobb angle of 20 ) with a right convexity as compensatory changes for pelvic obliquity (Figure 1).
Comparison of pre- and post-intervention sEMG. Handheld electrodes are used to measure paraspinal muscle groups. In a schematic representation, myoelectric activity at each paraspinal level is recorded and represented by different colored bars. EP stress score is the sum of all muscle activity on the spine measured in microvolts. (A) sEMG revealed substantial levels of muscular tension at all spinal segments during the initial presentation. Intense neck activity indicated the significant effort required in the nuchal muscle to prevent the head (chin) from falling onto the chest. (B) The sEMG signal of most muscle groups normalized and was favorably linked with symptom alleviation following 40 months of treatment. The less myoelectric activity in the lumbar region is due to asymmetric paralysis of the quadratus lumborum following initial polio infection. sEMG, surface electromyography; EP, electrophysiological.
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Static surface electromyography (sEMG) was conducted using MyoVision  4000 (Precision Biometrics/MyoVision, San Carlos, CA, USA) revealed intense myoelectric activity of bilateral paraspinal muscles throughout the spine (Figure 2). Comparing to pre-intervention sEMG, paraspinal myoelectric activity returned to normal after intervention at the majority of spinal levels (Figure 2).
Exemplification of a core strengthening workout. The demonstrator is placed in the robotic device (AllCore360  Core Training System , AllCore360 , GA, USA), which slowly rotates at varied angles of inclination. At the same time, the demonstrator contracts the core muscles isometrically to maintain a neutral, seated posture while clutching a big ring in the hands and a ball between the knees. The device and its usage are depicted in this exercise demonstration.
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Training System , AllCore360, GA, USA) for the workout. The device is designed to allow for increasing the strength of the core muscles by progressively contracting the trunk muscles while the chair slowly rotates at various angles and the patient keeps his spine in a neutral position (Figure 3).
Comparing the result of 40-month treatment in the same patient shown in Figure 1. Repeat radiographs taken 40 months after the first one show patient's head ptosis has been corrected, the McGregor slop returns to 9 , and the majority of other radiographic parameters have improved. The coronal Cobb angle of the main thoracolumbar curve is 16  and pelvic obliquity angle is 12 .
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Repeated radiographs revealed improved head posture, relatively restored normal pelvic obliquity, and lumbar scoliosis reduced to a T10-L5 Cobb angle of 16  (Figure 4).