[Show abstract][Hide abstract] ABSTRACT: Conservative management of idiopathic scoliosis (IS) and other spinal deformities is a real alternative to surgical treatment. Most of adolescent with IS can be managed conservatively with high safety. Many infantile and juvenile cases show also a good immediate response to conservative care, which can be considered a sign of good prognosis. Only patients showing a continue deterioration even treated conservatively with efficient techniques should be considered candidates to surgical correction and stabilization. Rehabilitation (including specific exercises) and bracing are usually involved in conservative care of IS. In this paper we describe our personal approach in conservative scoliosis care regarding rehabilitation. Bracing has been described in a different paper also published in the present book. Specific exercises can change the signs and symptoms in scoliosis patients. Specialists in physiotherapy for spinal deformities teach the patient how to perform a routine of 'curve pattern' specific exercises with the purpose to facilitate the correction of the asymmetric posture and to teach the patient to maintain the corrected posture in daily activities. Principles of correction are based on those developed by the German physiotherapist K. Schroth.
Studies in health technology and informatics 02/2008; 135:208-27.
[Show abstract][Hide abstract] ABSTRACT: Thoracic hypokyphosis with increasing axial rotational instability is claimed to be a primary factor for the initiation of Idiopathic Scoliosis (IS) according to some authors. The objective of this study was to compare the sagittal configuration of the spine in two groups of girls with and without scoliosis in order to determine whether thoracic hypokyphosis and/or lumbar hypolordosis are initiating factors for AIS or not. A group of 207 consecutive non-treated girls diagnosed with IS (12.7 y +/- 1.8) measured with the Formetric system were compared to a control group of 45 non-scoliotic girls of the same age (12.4 y +/- 2). The Cobb angle for the whole scoliosis sample was 26 degrees +/- 13.6 and the angle of axial rotation 12.4 degrees +/- 7.7 (Perdriolle). The patient group was divided into subgroups by their Cobb angle ie G1 (5 degrees -19 degrees, n=79), G2 (20 degrees -34 degrees, n=81), G3 (<or=35 degrees, n=47). The values of the kyphotic angle and lordotic angle were compared. The kyphotic angle was not significantly different in the patients group (48.7 degrees +/- 9.4) compared to the control group (51.5 degrees +/- 10) while the lordotic angle was slightly but significantly lower in the patient group (39.3 degrees +/- 9.4) than in control (42.3 degrees +/- 8.8); however, the lordotic angle in G1 (40.5 degrees +/- 8.3) was not lower than that of the controls. Non-scoliotic girls and those with a mild scoliotic curve had the same angle of thoracic kyphosis and lumbar lordosis. Both angles tended to decrease in progressive curves. Neither thoracic hypokyphosis or lumbar hypolordosis are considered to be initiating factors for scoliosis but are factors in its progression.
Studies in health technology and informatics 01/2006; 123:90-4.
[Show abstract][Hide abstract] ABSTRACT: This paper reports a retrospective series which includes 105 idiopathic scoliotic patients treated with a Chêneau brace. With an average age of 12.5 years old and a mean Risser sign of 0.9, the initial major Cobb angle was 36.8 degrees corrected to 25.9 degrees in the brace (31.1% of the primary correction), and the major torsion angle was 16.8 degrees corrected to 12.9 degrees in the brace (22.2% of the primary correction). 37 patients have finished the treatment with a mean follow-up of 16.8 months. For this group, the initial Cobb and torsion angles were not significantly changed (36.4 degrees Cobb to 34.1 degrees Cobb at follow-up, and 16.9 degrees Perdriolle to 15.7 degrees Perdriolle at follow-up). The proportion of patients without progression greater than 5 degrees Cobb (n=20) and with an improved final Cobb angle (n=10) was greater than failures (n=7). However, due to the catastrophic nature of some progressions which generally coincide with a high Cobb angle right from the start, with low primary correction, and with non-compliance, the final Cobb angle showed a slight tendency to decrease but without reaching high significance. These preliminary results demonstrate that the Chêneau brace can effectively prevent the progression of Cobb and torsion angles, even in cases of bad prognosis.
Studies in health technology and informatics 02/2002; 88:241-5.