Article

Preliminary results and worst-case analysis of inpatient scoliosis rehabilitation

January 1997
Pediatric Rehabilitation 1(1):35-40

Source
PubMed

Authors:

Schroth Best Practice Academy

The purpose of this study was to assess the effectiveness of a scoliosis-specific rehabilitation programme as it is carried out in the Katharina Schroth Spinal Deformities Rehabilitation Center. Physiotherapy in the treatment of scoliosis patients is still regarded as ineffective since the study by the American Orthopedic Association in 1941, which showed that general exercises could not influence the natural history of scoliosis. However, specific exercise programmes were not known in the USA at that time. This preliminary study started in 1989 with the following inclusion criteria: (1) diagnosis of idiopathic scoliosis; (2) risser sign < 4; (3) no treatment other than physiotherapy; (4) first control after 1-3 years during repeated in patient treatment; (5) standing AP radiograph taken not more than 6 months before the first in patient treatment. A total of 181 scoliosis patients, with an average age of 12.7 years and an average angle of curvature of 27% according to Cobb, were included in this study. The average risser sign was 1.4, the average follow-up 33 months. The Cobb angle of the major curve was measured in a standardized way. The results of our preliminary study were compared to natural history as known from literature. For the worst-case analysis additionally a questionnaire was sent to the non-repeaters treated at our centre at the same time (1989 and 1990) as the patient sample described above, taking into account the same inclusion criteria for this patient sample except point 4. Results showed that progression as usually defined (increase in curvature of 5 degrees or more per year) has not been found in the preliminary study. The patient sample of this study was divided into different age groups and different groups of curve magnitude, for comparison with other studies. Additional to the patient sample of the preliminary study, 116 of the patients from the years 1989 and 1990 fulfilled the inclusion criteria of the preliminary study with the exception of point 4. These patients formed the questionnaire sample for the worst-case analysis showing that the progression rate of the 181 patients from the preliminary study and the 116 patients of the questionnaire sample together was still better than natural history even if all drop-outs were considered to be failures. The fact that there was no relative progression in our patients sample treated solely by physiotherapy (preliminary study), seems to show the effectiveness of the inpatient rehabilitation programme even in cases with a bad prognosis, severe angles of curvature and unfavourable curvature patterns. A worst-case analysis does not prevent this conclusion, even if all dropouts from the non-repeaters group were considered as failures.

BIOENGINEERING OF THE SCOLIOSIS (in Serbian) Bioinženjering skolioze

Book

Full-text available

Mar 2016

Bioengineering of the Scoliosis systematically describes complex issues of development, diagnostics and monitoring of adolescent spinal deformities, aiming at scoliosis. It is the result of joint research results of the teams from University of Kragujevac, Serbia (Faculty of Engineering, Faculty of Technical Sciences in Cacak and Faculty of Medical Sciences) and Clinical Centre Kragujevac, Serbia (Clinic for Orthopedics and Centre for Physical Medicine and Rehabilitation. Research work is conducted within two national projects supported by Ministry of Education, Science, and Technological Development of Republic Serbia: TR-12002 Ontological Modeling in Bioengineering, and III-41007 Application of Biomedical Engineering in Preclinical and Clinical Practice. Bioengineering of the Scoliosis contains seven chapters: (1) Anatomy of Spinal Column, (2) Spinal Orthoses, (3) 3D Modeling and Reconstruction of the Spine (4) Digital Mock-Up of the Spine, (5) Classification of Spinal Deformities, (6) Ontology of the Scoliosis, and (7) Information System for Visual Diagnostics and Monitoring of the Scoliosis.

Additional file 3

Data

Full-text available

Jan 2012

Description of the basic principles used within the Scoliologic™ Best Practice program (Chapter IV from the 4th edition of [15]with kind permission by Dr. HR Weiss).

2012-sosort scoliosis guideline

Data

Full-text available

Dec 2015

2011 SOSORT Guidelines: Orthopaedic and Rehabilitation Treatment of Idiopathic Scoliosis During Growth

Article

Full-text available

Jan 2012
Scoliosis

The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), that produced its first Guidelines in 2005, felt the need to revise them and increase their scientific quality. The aim is to offer to all professionals and their patients an evidence-based updated review of the actual evidence on conservative treatment of idiopathic scoliosis (CTIS). All types of professionals (specialty physicians, and allied health professionals) engaged in CTIS have been involved together with a methodologist and a patient representative. A review of all the relevant literature and of the existing Guidelines have been performed. Documents, recommendations, and practical approach flow charts have been developed according to a Delphi procedure. A methodological and practical review has been made, and a final Consensus Session was held during the 2011 Barcelona SOSORT Meeting. The contents of the document are: methodology; generalities on idiopathic scoliosis; approach to CTIS in different patients, with practical flow-charts; literature review and recommendations on assessment, bracing, physiotherapy, Physiotherapeutic Specific Exercises (PSE) and other CTIS. Sixty-five recommendations have been given, divided in the following topics: Bracing (20 recommendations), PSE to prevent scoliosis progression during growth (8), PSE during brace treatment and surgical therapy (5), Other conservative treatments (3), Respiratory function and exercises (3), Sports activities (6), Assessment (20). No recommendations reached a Strength of Evidence level I; 2 were level II; 7 level III; and 20 level IV; through the Consensus procedure 26 reached level V and 10 level VI. The Strength of Recommendations was Grade A for 13, B for 49 and C for 3; none had grade D. These Guidelines have been a big effort of SOSORT to paint the actual situation of CTIS, starting from the evidence, and filling all the gray areas using a scientific method. According to results, it is possible to understand the lack of research in general on CTIS. SOSORT invites researchers to join, and clinicians to develop good research strategies to allow in the future to support or refute these recommendations according to new and stronger evidence.

Incidence of curvature progression in idiopathic scoliosis patients treated with scoliosis inpatient rehabilitation (SIR): An age- and sex-matched controlled study

Article

Full-text available

Jul 2009
Pediatr Rehabil

The goal of this study is to test the hypothesis that physiotherapy-based intervention can reduce incidence of progression in children with IS. Two independent patient groups matched by age and sex at diagnosis were analysed using the outcome parameter, incidence of progression (> or =5 degrees ). One group was untreated and the other received scoliosis in-patient rehabilitation (SIR). Incidence of progression in groups of untreated patients ranged from 1.5-fold (71.2% vs 46.7%) to 2.9-fold (55.8% vs 19.2%) higher than in groups of patients treated with SIR, even when SIR-treated groups included patients with more severe curvatures. Statistically, the differences were highly significant. Efforts to test the hypothesis that physical therapies addressing postural imbalance can be used effectively in the treatment of IS have been limited. The results of this study are consistent with the possibility that a supervized programme of exercise-based therapies can reduce incidence of progression in children with IS.

Physical exercises as a treatment for adolescent idiopathic scoliosis. A systematic review

Article

Full-text available

Jul 2003
Pediatr Rehabil

Our purpose was, through an extensive and systematic review of the literature, to verify the effectiveness of physical exercises in the treatment of adolescent idiopathic scoliosis. We performed a search of different databases (Medline, Cochrane Library, Embase, Cinhal), and a hand-search of the non-indexed pertinent literature, and found 11 papers: none of the studies was randomized, six were prospective, seven were controlled, and two compared their results to historical controls; one paper had both a prospective design and a concurrent control group. The methodological quality of the retrieved studies was reviewed and found to be very poor. With one exception, the published studies demonstrated the efficacy of physical exercises in reducing both the rate of progression or the magnitude of the Cobb angle at the end of treatment. However, being of poor quality, the literature failed to provide solid evidence for or against the efficacy of physical exercises in the treatment of adolescent idiopathic scoliosis. Nevertheless, considering that exercises could also be proposed on the basis that benefits rather than to avoid progression have been shown in the literature, and that the results contained in published studies here reviewed suggest an effect on the primary goal of preventing progression, there is a basis for discussion of this option with patients and their families, which in turn allows decisions to be made according to their preferences.

Curvature progression in patients treated with scoliosis in-patient rehabilitation - A sex and age matched controlled study

Article

Full-text available

Jan 2002
Stud Health Tech Informat

The aim of this study is to test the hypothesis that physiotherapy-based intervention can reduce incidence of progression in children with IS because progression of spinal curvature in patients with idiopathic scoliosis (IS) is of paramount concern in treatment strategies. Follow-up of the outcome of two prospective studies using the outcome parameter, incidence of progression (> or = 5 degrees), in treated and untreated patient groups matched by age, sex, and degree of curvature at diagnosis. A six-week scoliosis in-patient rehabilitation (SIR) program offering patient-specific physiotherapy including intensive therapist-assisted exercise in diagnosis-matched groups. A followup home therapy regime is designed for each patient. Incidence of progression in groups of untreated patients ranged from 1.5-fold (71.2% vs 46.7%) to 2.9-fold (55.8% vs 19.2%) higher than in groups of patients treated with SIR, even when SIR-treated groups included patients with more severe curvatures. Statistically, the differences were highly significant. Postural imbalance is a component of spinal curvature and can be a causative mechanism. However, efforts to test the hypothesis that physical therapies addressing postural imbalance can be used effectively in the treatment of IS have been limited. The results of this study indicate that a supervised program of exercise-based therapies can reduce incidence of progression in children with IS.

SOSORT GUIDELINES 2016 final

Data

Full-text available

Feb 2018

2016 SOSORT guidelines: Orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth

Article

Full-text available

Jan 2018

Background The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) produced its first guidelines in 2005 and renewed them in 2011. Recently published high-quality clinical trials on the effect of conservative treatment approaches (braces and exercises) for idiopathic scoliosis prompted us to update the last guidelines’ version. The objective was to align the guidelines with the new scientific evidence to assure faster knowledge transfer into clinical practice of conservative treatment for idiopathic scoliosis (CTIS). Methods Physicians, researchers and allied health practitioners working in the area of CTIS were involved in the development of the 2016 guidelines. Multiple literature reviews reviewing the evidence on CTIS (assessment, bracing, physiotherapy, physiotherapeutic scoliosis-specific exercises (PSSE) and other CTIS) were conducted. Documents, recommendations and practical approach flow charts were developed using a Delphi procedure. The process was completed with the Consensus Session held during the first combined SOSORT/IRSSD Meeting held in Banff, Canada, in May 2016. Results The contents of the new 2016 guidelines include the following: background on idiopathic scoliosis, description of CTIS approaches for various populations with flow-charts for clinical practice, as well as literature reviews and recommendations on assessment, bracing, PSSE and other CTIS. The present guidelines include a total of 68 recommendations divided into following topics: bracing (n = 25), PSSE to prevent scoliosis progression during growth (n = 12), PSSE during brace treatment and surgical therapy (n = 6), other conservative treatments (n = 2), respiratory function and exercises (n = 3), general sport activities (n = 6); and assessment (n = 14). According to the agreed strength and level of evidence rating scale, there were 2 recommendations on bracing and 1 recommendation on PSSE that reached level of recommendation “I” and level of evidence “II”. Three recommendations reached strength of recommendation A based on the level of evidence I (2 for bracing and one for assessment); 39 recommendations reached strength of recommendation B (20 for bracing, 13 for PSSE, and 6 for assessment).The number of paper for each level of evidence for each treatment is shown in Table 8. Conclusion The 2016 SOSORT guidelines were developed based on the current evidence on CTIS. Over the last 5 years, high-quality evidence has started to emerge, particularly in the areas of efficacy of bracing (one large multicentre trial) and PSSE (three single-centre randomized controlled trials). Several grade A recommendations were presented. Despite the growing high-quality evidence, the heterogeneity of the study protocols limits generalizability of the recommendations. There is a need for standardization of research methods of conservative treatment effectiveness, as recognized by SOSORT and the Scoliosis Research Society (SRS) non-operative management Committee. Electronic supplementary material The online version of this article (10.1186/s13013-017-0145-8) contains supplementary material, which is available to authorized users.

Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial

Article

Full-text available

Feb 2014
EUR SPINE J

To evaluate the effect of a programme of active self-correction and task-oriented exercises on spinal deformities and health-related quality of life (HRQL) in patients with mild adolescent idiopathic scoliosis (AIS) (Cobb angle <25°). This was a parallel-group, randomised, superiority-controlled study in which 110 patients were randomly assigned to a rehabilitation programme consisting of active self-correction, task-oriented spinal exercises and education (experimental group, 55 subjects) or traditional spinal exercises (control group, 55 subjects). Before treatment, at the end of treatment (analysis at skeletal maturity), and 12 months later (follow-up), all of the patients underwent radiological deformity (Cobb angle), surface deformity (angle of trunk rotation) and HRQL evaluations (SRS-22 questionnaire). A linear mixed model for repeated measures was used for each outcome measure. There were main effects of time (p < 0.001), group (p < 0.001) and time by group interaction (p < 0.001) on radiological deformity: training in the experimental group led to a significant improvement (decrease in Cobb angle of >5°), whereas the control group remained stable. Analysis of all of the secondary outcome measures revealed significant effects of time, group and time by group interaction in favour of the experimental group. The programme of active self-correction and task-oriented exercises was superior to traditional exercises in reducing spinal deformities and enhancing the HRQL in patients with mild AIS. The effects lasted for at least 1 year after the intervention ended.

Optimal management of idiopathic scoliosis in adolescence

Article

Full-text available

Jul 2013

Idiopathic scoliosis is a three-dimensional deformity of the growing spine, affecting 2%–3% of adolescents. Although benign in the majority of patients, the natural course of the disease may result in significant disturbance of body morphology, reduced thoracic volume, impaired respiration, increased rates of back pain, and serious esthetic concerns. Risk of deterioration is highest during the pubertal growth spurt and increases the risk of pathologic spinal curvature, increasing angular value, trunk imbalance, and thoracic deformity. Early clinical detection of scoliosis relies on careful examination of trunk shape and is subject to screening programs in some regions. Treatment options are physiotherapy, corrective bracing, or surgery for mild, moderate, or severe scoliosis, respectively, with both the actual degree of deformity and prognosis being taken into account. Physiotherapy used in mild idiopathic scoliosis comprises general training of the trunk musculature and physical capacity, while specific physiotherapeutic techniques aim to address the spinal curvature itself, attempting to achieve self-correction with active trunk movements developed in a three-dimensional space by an instructed adolescent under visual and proprioceptive control. Moderate but progressive idiopathic scoliosis in skeletally immature adolescents can be successfully halted using a corrective brace which has to be worn full time for several months or until skeletal maturity, and is able to prevent more severe deformity and avoid the need for surgical treatment. Surgery is the treatment of choice for severe idiopathic scoliosis which is rapidly progressive, with early onset, late diagnosis, and neglected or failed conservative treatment. The psychologic impact of idiopathic scoliosis, a chronic disease occurring in the psychologically fragile period of adolescence, is important because of its body distorting character and the onerous treatment required, either conservative or surgical. Optimal management of idiopathic scoliosis requires cooperation within a professional team which includes the entire therapeutic spectrum, extending from simple watchful observation of nonprogressive mild deformities through to early surgery for rapidly deteriorating curvature. Probably most demanding is adequate management with regard to the individual course of the disease in a given patient, while avoiding overtreatment or undertreatment.

Inclusion Criteria for Physical Therapy Intervention Studies on Scoliosis – a Review of the Literature

Article

Full-text available

Jun 2012
Stud Health Tech Informat

Hans-Rudolf Weiss

There is a wide variation of the inclusion criteria found in studies investigating the outcome of conservative scoliosis treatment. While the application of the SRS criteria for studies on bracing seem useful, there are no inclusion criteria for the investigation of physiotherapy alone. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT). A PubMed and (incomplete) hand search for outcome papers on PT has been performed in order to detect study designs and inclusion criteria used. Real outcome papers (start of treatment in immature samples / end results after the end of growth) have not been found. Some papers investigated mid-term effects of exercises, most were retrospective, few prospective and many included patient samples with questionable treatment indications. No paper has been found with patients of risk for being progressive followed from premenarchial status until skeletal maturity under physiotherapy treatment alone. Claims made to regard physiotherapy as an evidence based method of treatment are not justified scientifically. An agreement of the scientific community on common inclusion criteria for future studies on PT is necessary. We would suggest the following: (1) girls only, (2) age 10 to 13 with the first signs of maturation (Tanner II), (3) Risser 0-2, (4) risk for progression 40 - 60% according to Lonstein and Carlson. There is no outcome paper on PT in scoliosis with a patient sample at risk for being progressive followed from premenarchial status until skeletal maturity. Therefore, only bracing can be regarded as being evidence based in the management of scoliosis patients during growth.

Physical therapy intervention studies on idiopathic scoliosis-review with the focus on inclusion criteria1

Article

Full-text available

Jan 2012
Scoliosis

Hans-Rudolf Weiss

Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT). A PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used. Real outcome papers (start of treatment in immature samples/end results after the end of growth; controlled studies in adults with scoliosis with a follow-up of more than 5 years) have not been found. Some papers investigated mid-term effects of exercises, most were retrospective, few prospective and many included patient samples with questionable treatment indications. There is no outcome paper on PT in scoliosis with a patient sample at risk for being progressive in adults or in adolescents followed from premenarchial status until skeletal maturity. However, papers on bracing are more frequently found and bracing can be regarded as evidence-based in the conservative management and rehabilitation of idiopathic scoliosis in adolescents.

Efficacy of exercise therapy for the treatment of adolescent idiopathic scoliosis: A review of the literature

Article

Full-text available

Nov 2011
EUR SPINE J

Current evidence regarding the use of exercise therapy in the treatment of adolescent idiopathic scoliosis (AIS) was assessed with a review of published literature. An extensive literature search was carried out with commonly used medical databases. A total of 155 papers were identified out of which only 12 papers were deemed to be relevant. There were nine prospective cohort studies, two retrospective studies and one case series. All studies endorsed the role of exercise therapy in AIS but several shortcomings were identified--lack of clarity of patient recruitment and in the method of assessment of curve magnitude, poor record of compliance, and lack of outcome scores. Many studies reported "significant" changes in the Cobb angle after treatment, which were actually of small magnitude and did not take into account the reported inter or intra-observer error rate. All studies had poor statistical analysis and did not report whether the small improvements noted were maintained in the long term. This unbiased literature review has revealed poor quality evidence supporting the use of exercise therapy in the treatment of AIS. Well-designed randomised controlled studies are required to assess the role of exercise therapy in AIS.

Spinal deformities rehabilitation - state of the art review

Article

Full-text available

Dec 2010
Scoliosis

Hans-Rudolf Weiss

Medical rehabilitation aims at an improvement in function, capacity and participation. For the rehabilitation of spinal deformities, the goal is to maintain function and prevent secondary symptoms in the short- and long-term. In patients with scoliosis, predictable signs and symptoms include pain and reduced pulmonary function. A Pub Med review was completed in order to reveal substantial evidence for inpatient rehabilitation as performed in Germany. No evidence has been found in general to support claims for actual inpatient rehabilitation programmes as used today. Nevertheless, as there is some evidence that inpatient rehabilitation may be beneficial to patients with spinal deformities complicated by certain additional conditions, the body of evidence there is for conservative treatment of spinal deformities has been reviewed in order to allow suggestions for outpatient conservative treatment and inpatient rehabilitation. Today, for both children and adolescents, we are able to offer intensive rehabilitation programmes lasting three to five days, which enable the patients to acquire the skills necessary to prevent postures fostering scoliosis in everyday life without missing too much of school teaching subjects at home. The secondary functional impairments adult scoliosis patients might have, as in the opinion of the author, still today require the time of 3-4 weeks in the clinical in-patient setting. Time to address psychosocial as well as somatic limitations, namely chronic pains and cardiorespiratory malfunction is needed to preserve the patients working capability in the long-term. Outpatient treatment/rehabilitation is sufficient for adolescents with spinal deformities.Inpatient rehabilitation is recommended for patients with spinal deformities and pain or severe restrictive ventilation disorder.

Comparative efficacy of six types of scoliosis-specific exercises on adolescent idiopathic scoliosis: a systematic review and network meta-analysis

Article

Full-text available

Dec 2024
BMC MUSCULOSKEL DIS

Background Adolescent idiopathic scoliosis (AIS) stands as the predominant spinal deformity in adolescents, manifesting symptoms including back pain, functional limitations, cosmetic worries, and respiratory dysfunction. At present, six approaches of scoliosis-specific exercises are globally practiced, encompassing Schroth exercise, the Scientific Exercise Approach to Scoliosis (SEAS), the Dobomed, the side shift exercise, active self-correction, and the Functional Individual Therapy of Scoliosis (FITS). However, there is no systematic review and meta-analysis comparing the efficacy of these six types of scoliosis-specific exercises on adolescent idiopathic scoliosis. Objective To evaluate and compare the efficacy of six types of scoliosis-specific exercises on spinal deformity and quality of life in AIS. Materials and methods A systematic search was performed on PubMed, EMBASE, and the Cochrane Library from their inception to September 2023. Two independent auditors screened all studies according to predefined inclusion and exclusion criteria. Clinical trials were compiled to investigate the effects of six exercise interventions on spinal deformity and quality of life in AIS. Results Twenty-four studies were included, with a sample size of 1069 subjects. After meta-analysis, it was shown that SEAS ranked first in reducing Cobb angles (SUCRA: 84.8%); active self-correction and Schroth significantly improved the angles of trunk rotation in AIS (SUCRA: 86.6% and SUCRA: 79.1%, respectively); active self-correction and Schroth showed significant improvements in quality of life (SUCRA: 76.6% and SUCRA: 76.0%, respectively). Conclusion According to the current findings, active self-correction demonstrated superior short-term benefits compared to other exercise interventions in ameliorating spinal deformity and improving quality of life for adolescents with idiopathic scoliosis. Meanwhile, Schroth exhibited long-term effects in improving both spinal deformity and quality of life. Registration information This review was registered on PROSPERO on June 20, 2023 (ID: CRD42023433152).

Schroth Therapy Advancements in Conservative Scoliosis Treatment 3rd edition Special Schroth Best Practice Academy Edition

Book

Full-text available

Apr 2022

This book presents comprehensive and practice-oriented physiotherapy and brace treatment for scoliosis patients. The treatment examples are based on the differentiated findings of the curvature patterns. Their approach follows - albeit in an expanded form - the basic ideas of the scoliosis therapy of Katharina Schroth, the pioneer in this field. The third edition of the book has been thoroughly revised, taking into account the latest literature and the updated and now scientifically evaluated indication guidelines. The basic modules "physio-logic", “Activities of daily living, ADL", "3D made easy" and "Schroth" merge into an evidence-based overall concept, which can be used in a differentiated manner depending on the individual indication. The specific exercises have been simplified without sacrificing effectiveness. In fact, when all the tips and tricks described here are taken into account, clinical overcorrections are even possible in the exercise, which were not even attempted in the past. The “Schroth Best Practice” program (SBP) allows effective rehabilitation including patient training within a few days. Thus, this book is also addressed to all those who attend the course program provided by the Schroth Best Practice Academy and want to start effective treatment of their scoliosis patients after just one week of the course.

Does curve pattern impact on the effects of physiotherapeutic scoliosis specific exercises on Cobb angles of participants with adolescent idiopathic scoliosis: A prospective clinical trial with two years follow-up

Article

Full-text available

Jan 2021
PLOS ONE

Background Current clinical evidence suggests that a well-planned physiotherapeutic scoliosis specific exercise (PSSE) program is effective for scoliosis regression. Objectives We investigated the effect of curve patterns on Cobb angles with PSSE. Methods This was a non-randomized prospective clinical trial that recruited participants with adolescent idiopathic scoliosis between January and June 2017. Participants were grouped by curve pattern into major thoracic and major lumbar groups. An outpatient-based PSSE program was conducted with the following schedule of intensive exercise: ≥ 1 session of supervised PSSE per month and > 30min of home exercise 5 days/week in the first 6 months, after which exercise frequency was reduced to 1 session of supervised PSSE every three months and > 30min of home exercise 5 days/week until 2 years after study initiation. Radiographic Cobb angle progressions were identified at the 1, 1.5 and 2-year follow-ups. A mixed model analysis of variance (ANOVA) was performed to examine the differences in Cobb angles between groups at four testing time points. The two-tailed significance level was set to 0.05. Results In total, 40 participants were recruited, including 22 with major thoracic curves (5 males and 17 females; mean age 13.5±1.8 years; Cobb angle 18–45 degrees) and 18 with major lumbar curves (7 males and 11 females; mean age 12.7±1.7 years; Cobb angle 15–48 degrees). Curve regressions, namely the reduction of Cobb angles between 7 to 10 degrees were noted in 9.1% of participants in the major thoracic group; reductions of 6 to 13 degrees were noted in 33.3% of participants in the major lumbar group at the 2-year follow-up. Repeated measurements revealed a significant time effect (F2.2,79.8 = 4.1, p = 0.02), but no group (F2.2,79.8 = 2.3, p = 0.1) or time × group (F1,37 = 0.97, p = 0.3) effects in reducing Cobb angles after 2 years of PSSE. A logistic regression analysis revealed that no correlation was observed between curve pattern and curve regression or stabilization (OR: 0.2, 95% CI: 0.31–1.1, p = 0.068) at the 2-year follow-up. Conclusion This was the first study to investigate the long-term effects of PSSE in reducing Cobb angles on the basis of major curve location. No significant differences in correction were observed between major thoracic and major lumbar curves. A regression effect and no curve deterioration were noted in both groups at the 2-year follow-up. Trial registration ChiCTR1900028073.

Effects of Three-Dimension Schroth Exercises and Kinesio Taping on General Mobility of Vertebrae, Angle of Trunk Rotation, Muscle Strength and Endurance of Trunk, and Inspiratory and Expiratory Muscle Strength in Children with Idiopathic Scoliosis

Article

Full-text available

Aug 2020

This study aimed to compare the effects of 3-dimension Schroth exercises and Kinesio taping (KT) on several variables in children with idiopathic scoliosis. Female volunteers aged 10-18 years with an angle trunk rotation > 7 degrees participated in the study. The 16 volunteers were divided into 2 groups: 'Three-dimension Schroth exercises' (Con) and 'Kinesio tape with Schroth exercises' (KT). The training program comprised 2 sessions per week with 2 h per session for 6 consecutive weeks. Significant increases of maximal inspiratory pressure (Con; p = 0.046), maximal expiratory pressure (Con; p = 0.046, KT; p = 0.047), and back muscle endurance (Con; p = 0.028, KT; p = 0.028) were recorded. Significant decreases of angle trunk rotation at the thoracic level (Con; p = 0.046, KT; p = 0.017) and the lumbar level (Con; p = 0.042, KT; p = 0.041) were recorded. In conclusion, 3-dimension Schroth exercises and KT with Schroth exercises can increase maximal expiratory pressure, back muscle endurance, and angle of trunk rotation at the thoracic and the lumbar level.

Evaluation de la force des muscles ischio-jambiers et des quadriceps chez les volleyeuses par dynamomètre isocinétique

Article

Full-text available

Jul 2020

valuer la force des muscles ischio-jambier et des quadriceps, quantifier le caractère de dominance déclarée d'un membre par rapport à l'autre et comparer le niveau de force en fonction du poste occupé sur le terrain. 12 sujets de sexe féminin ont été évalués sur dynamomètre Cybex 6000. Les paramètres étudiés : pics de couple des effecteurs et ratios fléchisseurs/extenseurs (F/E) à 2 vitesses angulaires : lente 60 •/s et rapide 180 •/s, en mode concentrique. Le moment maximal par rapport au poids (MFM) et le ratio ischio-jambiers/quadriceps ont été recueillis. Caractéristiques des sujets (moyenne-écart-type) : âge moyen de 24,62±4,27 ans, avec des extrême allant de (19 à 33 ans), une taille moyenne de 175,25±7,54 cm et un poids moyen de 65,12±9,05kg). Le ratio IJ/Q se situait à vitesse lente à (60°/s) entre 62 et 64 %, et à vitesse moyenne (180°/s) entre 56,75 et 57,58%. L'augmentation progressive de la vitesse angulaire de 60•/s à 180 •/s a engendré une diminution significative du MFM (244,675 ±31,08 à 159,75 ± 23,32 N.m) lors du mouvement d'extension et de flexion (248,00 ±34,40 à 161,25 ± 16,20 N.m, pour le genou non dominant (p = 0,05) vs genou non dominant (p=0,05) et une augmentation significative des valeurs de la puissance moyenne lors des mouvements des genoux. Les pic de couple du membre dominant sont supérieurs à ceux du membre non dominant pour les 2 vitesses (60 et à 180°/s). Les ratios F/E moyens sont de 0,5675 et 0,6468 correspondant aux normes acceptables. Globalement, il n'a pas été retrouvé de différence significative entre le membre dominant et le membre non dominant pour les cinq groupes de joueuses (passeuses, liberos, centrales, attaquante réceptionneuses et les pointus) néanmoins les passeuses et les libéros sont celles qui enregistrent les plus faibles déficits. L'utilisation de l'évaluation isocinétique constitue un progrès pour la quantification objective de la force musculaire du genou chez les sportifs. L'entraineur peut ainsi réviser la charge lors des entrainements. Mots clés : isocinétisme, membres inférieurs, pics de couple, ratios, volleyball. Summary. To assess the knee muscles power using isokinetic in a population of women volleyball players. To investigate the relationships between isokinetic peak torque and each player's position in the playground. 12 female subjects were estimated on dynamometer Cybex 6000. The studied parameters: peaks of couple of effectors and ratios flexors / chest expanders (F/E) in 2 angular speeds: slow (60•/s) and medium speed (180•/s), in concentric mode. The maximal moment with the harmstring/quadriceps (MFM) and the ratio were collected. Characteristics of the subjects (average-standard deviation):

Significance of Schroth method in the rehabilitation of children with structural idiopathic scoliosis

Article

Full-text available

Jan 2020

Introduction: Scoliosis is a multifactorial three-dimensional spinal deformation. Adolescent idiopathic structural scoliosis (AIS) is the most common spinal deformity in children. Specific physiotherapeutic exercises are recommended as the first step in the treatment of idiopathic scoliosis. The Schroth method is most often used and consists out of auto-correction in three dimensions, breathing exercises, education and home exercises. Aim: Examination of the efficacy of short-term controlled Schroth exercises in the treatment of adolescents with AIS. Material and methods: A prospective clinically controlled study comprised 23 adolescent patients who were previously treated with "usual" physiotherapy, but without significant success. The initial evaluation included physical examination, anthropometric measurements, scoliometry and spinal radiography. The children were assigned 60 min long individual therapy sessions. All the children had 15 sessions (3 per week, during 5 weeks) in the ambulatory settings, followed by a 30-45 min long daily home exercise program. Angle of trunk rotation (ATR), trunk lateral flexion and respiratory index were analyzed before and after the study. Results: Eighteen children, 16 girls and 2 boys, mean age 13.38 ± 2.17 years, completed the study. Baseline mean Cobb angle of the largest curve was 28°. 61.1% of the children wore a brace. After treatment, ATR was significantly reduced at Th8-12 and L1-5 level, while lateral flexion and respiratory index increased significantly. Conclusion: The Schroth method improved posture and esthetic appearance, as well as breathing and flexibility of the spine in children with AIS.

A procedure to detect abnormal sensorimotor control in adolescents with idiopathic scoliosis

Article

Jun 2017

This work identifies, among adolescents with idiopathic scoliosis, those demonstrating impaired sensorimotor control through a classification procedure comparing the amplitude of their vestibular-evoked postural responses. The sensorimotor control of healthy adolescents (n = 17) and adolescents with idiopathic scoliosis (n = 52) with either mild (Cobb angle ≥ 15° and ≤30°) or severe (Cobb angle >30°) spine deformation was assessed through galvanic vestibular stimulation. A classification procedure sorted out adolescents with idiopathic scoliosis whether the amplitude of their vestibular-evoked postural response was dissimilar or similar to controls. Compared to controls, galvanic vestibular stimulation evoked larger postural response in adolescents with idiopathic scoliosis. Nonetheless, the classification procedure revealed that only 42.5% of all patients showed impaired sensorimotor control. Consequently, identifying patients with sensorimotor control impairment would allow to apply personalized treatments, help clinicians to establish prognosis and hopefully improve the condition of patients with adolescent idiopathic scoliosis.

Idiopatic scoliosis, diagnosis, following and physical therapy treatment

Book

Full-text available

Sep 2004

Elizabeta Leonid Popova Ramova

Skolyozda Sagital Planda Uygulanan Simetrik Mobilizasyon Egzersizlerinin Omurga Esnekliği ve Gövde Rotasyon Açısına Etkisi

Article

Full-text available

Aug 2015

Tuğba Kuru Çolak

Physiotherapy scoliosis-specific exercises – a comprehensive review of seven major schools

Article

Full-text available

Aug 2016

Abstract In recent decades, there has been a call for change among all stakeholders involved in scoliosis management. Parents of children with scoliosis have complained about the so-called “wait and see” approach that far too many doctors use when evaluating children’s scoliosis curves between 10° and 25°. Observation, Physiotherapy Scoliosis Specific Exercises (PSSE) and bracing for idiopathic scoliosis during growth are all therapeutic interventions accepted by the 2011 International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT). The standard features of these interventions are: 1) 3-dimension self-correction; 2) Training activities of daily living (ADL); and 3) Stabilization of the corrected posture. PSSE is part of a scoliosis care model that includes scoliosis specific education, scoliosis specific physical therapy exercises, observation or surveillance, psychological support and intervention, bracing and surgery. The model is oriented to the patient. Diagnosis and patient evaluation is essential in this model looking at a patient-oriented decision according to clinical experience, scientific evidence and patient’s preference. Thus, specific exercises are not considered as an alternative to bracing or surgery but as a therapeutic intervention, which can be used alone or in combination with bracing or surgery according to individual indication. In the PSSE model it is recommended that the physical therapist work as part of a multidisciplinary team including the orthopeadic doctor, the orthotist, and the mental health care provider - all are according to the SOSORT guidelines and Scoliosis Research Society (SRS) philosophy. From clinical experiences, PSSE can temporarily stabilize progressive scoliosis curves during the secondary period of progression, more than a year after passing the peak of growth. In non-progressive scoliosis, the regular practice of PSSE could produce a temporary and significant reduction of the Cobb angle. PSSE can also produce benefits in subjects with scoliosis other than reducing the Cobb angle, like improving back asymmetry, based on 3D self-correction and stabilization of a stable 3D corrected posture, as well as the secondary muscle imbalance and related pain. In more severe cases of thoracic scoliosis, it can also improve breathing function. This paper will discuss in detail seven major scoliosis schools and their approaches to PSSE, including their bracing techniques and scientific evidence. The aim of this paper is to understand and learn about the different international treatment methods so that physical therapists can incorporate the best from each into their own practices, and in that way attempt to improve the conservative management of patients with idiopathic scoliosis. These schools are presented in the historical order in which they were developed. They include the Lyon approach from France, the Katharina Schroth Asklepios approach from Germany, the Scientific Exercise Approach to Scoliosis (SEAS) from Italy, the Barcelona Scoliosis Physical Therapy School approach (BSPTS) from Spain, the Dobomed approach from Poland, the Side Shift approach from the United Kingdom, and the Functional Individual Therapy of Scoliosis approach (FITS) from Poland.

Effect of symmetric mobilization exercises applied sagittale plane on spine flexibility and angle of trunk rotation in scoliosis

Article

Full-text available

Oct 2015

Purpose: Thoracic and lumber flatback has been assumed to be the triggering factor for idiopathic scoliosis. It is belived that rotation and lateral deviation are secondary patterns of deformity in the development of idiopathic scoliosis, and it should be possible to improve scoliosis by forces in sagittal plane. It is suggested that Physio-logic® exercises stabilize the spine posture and correct scoliosis in 3-D. The aim of this study was to assess the effect of symmetric mobilization exercise which was defined in Physio-logic®exercises on spine flexibility and angle of trunk rotation. Methods: Thirty four patients (30 female, 4 male) with adolescent idiopathic scoliosis (AI5) were included in this study. King classification was used to classify of scoliosis types. "Symmetric mobilization" exercise was done 20 repetitions, 15 sessions in supin position under physiotherapist supervision. Spine flexibility was evaluated with forward and lateral bending test and angle of trunk rotation was measured with scoliometer. Evaluations were performed before and after every session. Results: The mean age of patients was 13.5years (range; 10-17). The mean Cobb angle was 31.64° (range; 12°- 60°) and angle of trunk rotation was 9.86° (range; 3°-16°). Statistically significant improvements were observed for all assessed measurements after the treatment (p<0.05). Discussion: Our results showed that spine flexibility can be improved and angle of trunk rotation can be decreased by sagittal forces. Increasing of spine flexibility and decreasing angle of trunk rotation may prevent progression of scoliosis. We suggest that symmetric mobilisation exercises should take place in the rehabilitation programme of AIS.

full protocol

Data

Full-text available

Dec 2014

full protocol

Data

Full-text available

Dec 2014

Electromyographic Assessment of Functional Symmetry of Paraspinal Muscles during Static Exercises in Adolescents with Idiopathic Scoliosis

Article

Full-text available

Sep 2014
BMRI

Background: The question of how to correct and rehabilitate scoliosis remains one of the most difficult problems of orthopaedics. Controversies continue to arise regarding various types of both symmetric and asymmetric scoliosis-specific therapeutic exercises. Objective: The aim of the present paper was to conduct an electromyographic assessment of functional symmetry of paraspinal muscles during symmetric and asymmetric exercises in adolescents with idiopathic scoliosis. Materials and methods: The study was conducted in a group of 82 girls, mean age 12.4 ± 2.3 years with single- or double-major-idiopathic scoliosis, Cobb angle 24 ± 9.4°. The functional biopotentials during isometric work of paraspinal muscles in "at rest" position and during two symmetric and four asymmetric exercises were measured with the use of the Muscle Tester ME 6000 electromyograph. Results: In general, asymmetric exercises were characterised by larger differences in bioelectrical activity of paraspinal muscles, in comparison with symmetric exercises, both in the groups of patients with single-curve and double-curve scoliosis. Conclusion: During symmetric and asymmetric exercises, muscle tension patterns differed significantly in both groups, in comparison with the examination at rest, in most cases generating positive corrective patterns. Asymmetric exercises generated divergent muscle tension patterns on the convex and concave sides of the deformity.

Effect of specific exercises on the sagittal profile of scoliotic spines

Article

Full-text available

Oct 2007
Scoliosis

The use of exercises in the treatment of scoliosis: An evidence-based critical review of the literature

Article

Jul 2009
Pediatr Rehabil

Martha C. Hawes

The loss of flexibility in a spinal curvature defines it as a structural spinal deformity; a curvature sufficiently mobile to resolve with a change in posture is a non-structural or 'functional' scoliosis which is within the normal limits of movement for a human spine. It, therefore, seems logical that exercise-based therapies designed to improve and/or maintain flexibility and range of motion of the spine and thorax would be useful in the treatment of scoliosis. Recognition of the importance of maintaining flexibility of the thoracic spinal column to avoid scoliosis-associated pulmonary dysfunction made the use of exercise-based therapies a topic of clinical interest in ancient Greece. In recent years, successful prevention of polio epidemics has resulted in a stable change in patient populations such that most individuals diagnosed with scoliosis do not suffer from irreversible central nervous system compromise. As a result, realistic opportunities to examine the role of exercise in treatment of scoliosis are available for the first time in history. A growing body of evidence from independent sources is consistent with the hypothesis that exercise-based approaches can be used effectively to reverse the signs and symptoms of spinal deformity and to prevent progression in children and adults.

Physical exercises in the treatment of idiopathic scoliosis at risk of brace treatment – SOSORT consensus paper 2005

Article

Full-text available

Feb 2006
Scoliosis

Based on a recognized need for research to examine the premise that nonsurgical approaches can be used effectively to treat signs and symptoms of scoliosis, a scientific society on scoliosis orthopaedic and rehabilitation treatment (SOSORT) was established in Barcelona in 2004. SOSORT has a primary goal of implementing multidisciplinary research to develop quantitative, objective data to address the role of conservative therapies in the treatment of scoliosis. This international working group of clinicians and scientists specializing in treatment of scoliosis met in Milan, Italy in January 2005. As a baseline for developing a consensus for language and goals for proposed multicenter clinical studies, we developed questionnaires to examine current beliefs, before and after the meeting, regarding (1) the aims of physical exercises; (2) standards of treatment; and (3) the impact of such treatment performed by specialists in the field. The responses to the questionnaires show that, in principle, specialists in scoliosis physiotherapy do not disagree and that several features can be regarded, currently, as standard features in the rehabilitation of scoliosis patients. These features include autocorrection in 3D, training in ADL, stabilizing the corrected posture, and patient education.

Therapeutic exercises for idiopathic scoliosis in adolescents

Article

Feb 2024

Background: Adolescent idiopathic scoliosis (AIS) is a pathology that changes the three-dimensional shape of the spine and trunk. While AIS can progress during growth and cause cosmetic issues, it is usually asymptomatic. However, a final spinal curvature above the critical threshold of 30° increases the risk of health problems and curve progression in adulthood. The use of therapeutic exercises (TEs) to reduce the progression of AIS and delay or avoid other, more invasive treatments is still controversial. Objectives: To evaluate the effectiveness of TE, including generic therapeutic exercises (GTE) and physiotherapeutic scoliosis-specific exercises (PSSE) in treating AIS, compared to no treatment, other non-surgical treatments, or between treatments. Search methods: We searched CENTRAL, MEDLINE, Embase, four other databases, and two clinical trials registers to 17 November 2022. We also screened reference lists of articles. Selection criteria: Randomised controlled trials (RCTs) comparing TE with no treatment, other non-surgical treatments (braces, electrical stimulation, manual therapy), and different types of exercises. In the previous version of the review, we also included observational studies. We did not include observational studies in this update since we found sufficient RCTs to address our study aims. Data collection and analysis: We used standard Cochrane methodology. Our major outcomes were progression of scoliosis (measured by Cobb angle, trunk rotation, progression, bracing, surgery), cosmetic issues (measured by surface measurements and perception), and quality of life (QoL). Our minor outcomes were back pain, mental health, and adverse effects. Main results: We included 13 RCTs (583 participants). The percentage of females ranged from 50% to 100%; mean age ranged from 12 to 15 years. Studies included participants with Cobb angles from low to severe. We judged 61% of the studies at low risk for random sequence generation and 46% at low risk for allocation concealment. None of the studies could blind participants and personnel. We judged the subjective outcomes at high risk of performance and detection bias, and the objective outcomes at high risk of detection bias in six studies and at low risk of bias in the other six studies. One study did not assess any objective outcomes. Comparing TE versus no treatment, we are very uncertain whether TE reduces the Cobb angle (mean difference (MD) -3.6°, 95% confidence interval (CI) -5.6 to -1.7; 2 studies, 52 participants). Low-certainty evidence indicates PSSE makes little or no difference in the angle of trunk rotation (ATR) (MD -0.8°, 95% CI -3.8 to 2.1; 1 study, 45 participants), may reduce the waist asymmetry slightly (MD -0.5 cm, 95% CI -0.8 to -0.3; 1 study, 45 participants), and may result in little to no difference in the score of cosmetic issues measured by the Spinal Appearance Questionnaire (SAQ) General (MD 0.7 points, 95% CI -0.1 to 1.4; 1 study, 16 participants). PSSE may result in little to no difference in self-image measured by the Scoliosis Research Society - 22 Patient Questionnaire (SRS-22) (MD 0.3 points, 95% CI -0.3 to 0.9; 1 study, 16 participants) and improve QoL slightly measured by SRS-22 Total score (MD 0.3 points, 95% CI 0.1 to 0.4; 2 studies, 61 participants). Only Cobb angle results were clinically meaningful. Comparing PSSE plus bracing versus bracing, low-certainty evidence indicates PSSE plus bracing may reduce Cobb angle (-2.2°, 95% CI -3.8 to -0.7; 2 studies, 84 participants). Comparing GTE plus other non-surgical interventions versus other non-surgical interventions, low-certainty evidence indicates GTE plus other non-surgical interventions may reduce Cobb angle (MD -8.0°, 95% CI -11.5 to -4.5; 1 study, 80 participants). We are uncertain whether PSSE plus other non-surgical interventions versus other non-surgical interventions reduces Cobb angle (MD -7.8°, 95% CI -12.5 to -3.1; 1 study, 18 participants) and ATR (MD -8.0°, 95% CI -12.7 to -3.3; 1 study, 18 participants). PSSE plus bracing versus bracing alone may make little to no difference in subjective measurement of cosmetic issues as measured by SAQ General (-0.2 points, 95% CI -0.9 to 0.5; 1 study, 34 participants), self-image score as measured by SRS-22 Self-Image (MD 0.1 points, 95% CI -0.3 to 0.5; 1 study, 34 participants), and QoL measured by SRS-22 Total score (MD 0.2 points, 95% CI -0.1 to 0.5; 1 study, 34 participants). None of these results were clinically meaningful. Comparing TE versus bracing, we are very uncertain whether PSSE allows progression of Cobb angle (MD 2.7°, 95% CI 0.3 to 5.0; 1 study, 60 participants), changes self-image measured by SRS-22 Self-Image (MD 0.1 points, 95% CI -1.0 to 1.1; 1 study, 60 participants), and QoL measured by SRS-22 Total score (MD 3.2 points, 95% CI 2.1 to 4.2; 1 study, 60 participants). None of these results were clinically meaningful. Comparing PSSE with GTE, we are uncertain whether PSSE makes little or no difference in Cobb angle (MD -3.0°, 95% CI -8.2 to 2.1; 4 studies, 192 participants; very low-certainty evidence). PSSE probably reduces ATR (clinically meaningful) (-MD 3.0°, 95% CI -3.4 to -2.5; 2 studies, 138 participants). We are uncertain about the effect of PSSE on QoL measured by SRS-22 Total score (MD 0.26 points, 95% CI 0.11 to 0.62; 3 studies, 168 participants) and on self-image measured by SRS-22 Self-Image and Walter Reed Visual Assessment Scale (standardised mean difference (SMD) 0.77, 95% CI -0.61 to 2.14; 3 studies, 168 participants). Further, low-certainty evidence indicates that 38/100 people receiving GTE may progress more than 5° Cobb versus 7/100 receiving PSSE (risk ratio (RR) 0.19, 95% CI 0.67 to 0.52; 1 study, 110 participants). None of the included studies assessed adverse effects. Authors' conclusions: The evidence on the efficacy of TE is currently sparse due to heterogeneity, small sample size, and many different comparisons. We found only one study following participants to the end of growth showing the efficacy of PSSE over TE. This result was weakened by adding studies with short-term results and unclear preparation of treating physiotherapists. More RCTs are needed to strengthen the current evidence and study other highly clinically relevant outcomes such as QoL, psychological and cosmetic issues, and back pain.

Proceedings of the 17th International Research and Philosophy Symposium (IRAPS): Sherman College of Chiropractic

Conference Paper

Full-text available

Nov 2022

Book of Abstracts for IRAPS 2022

I Have Scoliosis: A Guidebook for Patients, Family Members, and Therapists

Book

Full-text available

Aug 2021

Hans-Rudolf Weiss

Increasingly evidence can be found for physiotherapy in the treatment of patients with a scoliosis. Bracing, once controversial, is now regarded as having a scientific basis. In contrast, evidence is lacking for the surgical treatment of scoliosis and recent studies on long-term results raise serious question. The future, therefore, belongs to the conservative, non-surgical treatment of scoliosis. The good news is that the latest developments in specific physiotherapy and bracing, aimed at helping the patients according to their individual curve pattern, now offer improved chances of stopping curvature progression and even the potential to reduce a significant proportion of curvatures. Therapy specific to scoliosis aims for results acceptable for everyday living and to minimize its effects on the afflicted. After a short time and without major theoretical training, patients can learn a sense of postural awareness and help themselves by learning to avoid curvature-stimulating behavior.

The effects of exercise therapy on adolescent idiopathic scoliosis: An overview of systematic reviews and meta-analyses

Article

Full-text available

Feb 2021
COMPLEMENT THER MED

Background Exercise therapy was suggested as an appealing treatment option for Adolescent Idiopathic Scoliosis (AIS) patients with less side effects, lower economic costs, and more psychological benefits. Nevertheless, no unanimous findings about the efficacy of exercise therapy have been obtained from previous systematic reviews and/or meta-analyses. Objective To provide an overview of previous systematic reviews and/or meta-analyses on the effectiveness of exercise therapy on AIS treatment. Methods Systematic searches in Medline, Eric, CINAHL, Embase, SPORTDiscus, PsycINFO, and the Cochrane Library for systematic reviews and/or meta-analyses of randomized controlled trials (RCTs), non-randomized comparison studies (NRS) or observational studies using exercise as an intervention, and with outcome measures including Cobb angle, angle of trunk rotation (ATR), and quality of life. The methodological quality of the review articles was evaluated by A Measurement Tool to Assess Systematic Reviews (AMSTAR) checklist. Results Ten systematic reviews and meta-analyses were included. The quality of most of the review articles is moderate with a mean score of 6/11 on the AMSTAR scale. Overall, there is increasing evidence showing the efficacy of exercise therapy on reducing the Cobb angle and angle of trunk rotation, and improving perceived quality of life. Conclusion Exercise therapy was found to have potential benefits to treat physiological and psychological aspects of AIS patients. However, the findings were not conclusive given that some reviews relied on data from the trials with potential risk of bias and significant heterogeneity. More high-quality research is still needed to verify these findings.

Krankengymnastische Methoden und Konzepte

Chapter

Jan 2004

Lernen als operatives Geschehen. Frau Dr. Félice Affolter arbeitete zunächst als Lehrerin für gehörlose und sprachgestörte Kinder, bevor sie ein Psychologiestudium mit dem Schwerpunkt Entwicklungspsychologie und später ein Studium zur Kinderaudiologin abschloss. Die Zusammenarbeit mit Piaget in Genf beeinflusste maßgeblich ihr Konzept. Seiner Theorie zufolge ist Lernen kein rein additiver Prozess (durch Gewohnheit), sondern ein operatives Geschehen, d. h. eine kognitive Entwicklung. Aufbauend auf den Entwicklungsstufen bei Kindern nach Piaget beobachtete Affolter systematisch Entwicklungsleistungen gehörloser und blinder Kinder und verglich diese mit Gesunden (Affolter 1992). Die Befunde zeigten, dass sich die Entwicklungsleistungen gehörloser und blinder Kinder bei erhaltenem taktil-kinästhetischem Sinn von sinnesgesunden Kindern nicht unterschieden. Verhaltensauffällige und sprachgestörte Kinder zeigten keine Beeinträchtigung der visuellen bzw. auditiven Leistung, wohl aber bei der taktil-kinästhetischen Informationsaufnahme und -Verarbeitung. Daraus wurden folgende Schlussfolgerungen gezogen: Kinder lernen durch die Auseinandersetzung mit dem Alltag (Interaktion) und sind dabei auf eine funktionierende taktil-kinästhetische Informationsaufnahme angewiesen. Schwer sprachgestörte Kinder versagen durch eine mangelhafte Aufnahmefähigkeit von »Spürinformationen« in ihrer alltäglichen Interaktion und werden in ihrer Entwicklung auffällig.

Outcome Measurement of Scoliosis Rehabilitation by Use of Surface Topography

Article

Jan 1999
Stud Health Tech Informat

The aim of this study was to investigate whether it is possible to show the result of a rehabilitation program by means of surface reconstruction of the trunk. In our rehabilitation center we used the Formetric system to measure 1454 patients with scoliosis without brace before and after a 4-6 week rehabilitation period. The ratio male:female was about 1:5 with a curvature angle of 37° according to Cobb and an average age of 21 years. We compared the Formetric data for average lateral deviation, maximal deviation, average rotation, maximal rotation, and of the trunk index (measure for all curves) before and after the rehabilitation with the t-test. The values for average and maximal lateral deviation showed a highly significant decrease after the in-patient rehabilitation phase from 12.4 / 22.6 to 11.5 / 21.4 mm. The same applies for the trunk index as a measure for the correction of all existing curves. The average surface rotation was not significantly reduced (from 6.4° to 6.3°), whereas maximal rotation did decrease significantly from 12.1° to 12.0°. Automated surface measurement of the trunk seems to be appropriate for quality management in the rehabilitation of patients with spinal deformities, although one cannot exclude errors, and thus small changes in the posture cannot be quantified in individual cases.

Adölesan İdiopatik Skolyozlu ve Sağlıklı Çocuklarda Denge ve Postür Parametrelerinin Karşılaştırılmalı Olarak İncelenmesi

Thesis

Full-text available

Jan 2007

Gizem Irem Kinikli

Bilimleri Enstitüsü, Fizik Tedavi ve Rehabilitasyon Programı Uzmanlık Tezi, Ankara, 2007. Adölesan idiopatik skolyoz (AİS), gövde ve göğüs kafesindeki geometrik ve morfolojik değişikliklerle ilişkili üç boyutlu bir deformitedir. Bu çalışmada amacımız; AİS'li çocuklarda denge karakteristiklerini sağlıklı olgularla karşılaştırmak ve AİS'li olguların postüral bozukluklarının stabilometre üzerinde ölçülen postüral sapmalarla ilişkisini incelemektir. Çalışmaya, Hacettepe Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji polikliniğine ayaktan gelerek muayene ve ortoröntgenogramla aynı cerrah tarafından adölesan idiopatik skolyoz tanısı konmuş, 10-18 yaşları arasında, cerrahi geçirmemiş 20 hasta ile aynı yaş grubu ve cinsiyetteki normal kemik gelişiminin değerlendirilmesi için ayaktan takibe gelen 20 sağlıklı kişi alınmıştır. AİS'li olguların postür bozukluklarını saptamak amacıyla posteriyor ve lateral yönde olmak üzere iki şekilde postür analizi yapılmıştır. Postür analizi için fotoğraf çekilerek dijital ortamda postüral sapmalar hesaplanmıştır. AİS'li ve sağlıklı olguların dengeleri stabilometre üzerinde değerlendirilmiştir. Çalışmanın sonucunda, AİS'li olguların hareketsiz ayakta durma sırasında ön, arka, sağ ve sol postüral salınım puanlarının aynı yaş ve cinsiyetteki sağlıklı kişilerle benzer olduğu (p>0,05); ayrıca AİS'li olguların postür bozukluklarına ait uzunluk ve açı ölçümlerinin denge parametreleriyle ilişkili olduğu görülmüştür (p<0,05). AİS popülasyonundaki kişisel farklılıklar ile ölçüm metodunun güvenirliğinin her olgunun statik test formatındaki sonuçlarını etkileyebileceğini düşünmekteyiz. AİS'li olguların eğriliğinin saptandığı anda ve sonraki takiplerinde postür analizi değerlendirmeleri ile birlikte dengelerinin sağlıklı olgularla karşılaştırmalı olarak analiz edildiği çalışmalara ihtiyaç vardır. Anahtar Kelimeler: Adölesan idiopatik skolyoz, postür analizi, stabilometre, denge, postüral salınım.

Katharina Schroth's method in idiopathic scoliosis with two cases

Article

Jun 2009

Exercise programs are important issue in scoliosis rehabilitation. Special scoliosis exercises which were developed by Katharina Schroth are one of them. Katharina Schroth's method is an intensified exercise program which is based on breath exercises and biofeedback in scoliosis rehabilitation. According to Katharina Schroth, active elongation, active lateral deflection and active derotation of the spine contribute to correcting sagittal profile. In this method, first of all type of scoliosis is determined, classification is made, after that everyday posture and proper breathing techniques are shown. During application of Katharina Schroth method, using appropriate corset and correct calculation of progression factor are important as well as choosing right exercises. The outcomes of the two patients who have scoliosis and treated by Katharina Schroth's method and with corset, and the features of this method were discussed in this article. In one of the two cases, progression of the curve was prevented and in other case, regression of scoliosis has been provided.

Evaluation of tile result quality in spinal deformities rehabilitation by objective back shape analysis

Article

Apr 1999
PHYS MED REHAB KUROR

In rehabilitation we are looking for possibilities to measure the result quality of treatment methods for further comparison. For the evaluation of the treatment results in the rehabilitation of patients with spinal deformities, automated surface reconstruction systems may be used. The aim of the following study was to investigate whether it is possible to show the result quality of a rehabilitation program by means of surface reconstruction of the trunk. In our rehabilitation center we made measurements with the Formetric System in 1454 patients with scoliosis without brace before and after a 4 6 week rehabilitation. The ratio male/female was about 1/5 with a curvature angle according to Cobb 37 and an average age of 21 years. We made the statistical comparison of the formetric data for average lateral deviation, maximal deviation, average rotation, maximal rotation and of the trunk index (measure for all curves) before and after the re habilitation with the help of the t-test. The values for average and maximal lateral deviation showed a highly significant decrease after the inpatient rehabilitation phase. The same applies for the trunk index as measure for the correction of all existant curves. The average surface rotation was reduced at a p-value of 0.067, whereas maximal rotation did not show relevant changes. The use of the automated surface measurement of the trunk seems to be appropriate for quality management in the rehabilitation of patients with spinal deformities; even one has to respect error margins and thus small changes in the posture cannot be objectivated in the individual case. The measurements were made without respecting the apical vertebrae indices already implemented in the system, which, however, have to be noted additionally. When respecting these indices, the treatment result may become more exact and the measurement errors may be reduced.

Treatment of Scoliosis

Article

Dec 1999

Physiotherapeutic Scoliosis-Specific Exercises for Adolescents with Idiopathic Scoliosis.

Article

Full-text available

Feb 2014
Eur J Phys Rehabil Med

The use of exercises for the treatment of Adolescents with Idiopathic Scoliosis is controversial. Whilst exercises are routinely used in a number of central and southern European countries, most centres in the rest of the world (mainly in AngloSaxon countries), do not advocate its use. One of the reasons for this is that many health care professionals are usually not conversant with the differences between generalised physiotherapy exercises and physiotherapeutic scoliosisspecific exercises (PSSE): while the former are generic exercises usually consisting of lowimpact stretching and strengthening activities like yoga, Pilates and the Alexander technique, PSSE consist of a program of curvespecific exercise protocols which are individually adapted to a patients` curve site and magnitude. PSSE`s are performed with the therapeutic aim of reducing the deformity and preventing its progression. It also aims to stabilise the improvements achieved with the ultimate goal of limiting the need for corrective braces or the necessity of surgery. This paper introduces the different `Schools' and approaches of PSSE currently practiced (Scientific Exercise Approach to Scoliosis SEAS, Schroth, Barcelona Scoliosis Physical Therapy School BSPTS, Dobomed, Side Shift, Functional Individual Therapy of Scoliosis FITS and Lyon) and discusses their commonalities and differences. http://www.minervamedica.it/en/journals/europa-medicophysica/article.php?cod=R33Y9999N00A140288

Papel de la fisioterapia y el deporte en la escoliosis idiopática

Article

Dec 2001
Rehabilitacion

A bibliographic review of the material obtained from the Spanish Medical Index databases and Med-line during 1992-1998 was carried out. Its objective was to review the present day scientific knowledge on the treatment of Idiopathic Scoliosis by physiotherapic techniques. The results obtained with electrostimulation techniques as a single therapy, cinesitherapy as an isolated therapy and co-adjuvant of the orthesis treatment and the indications regarding athletic activity performed with this disease are analyzed. The indication for electrotherapy in the treatment of Idiopathic Scoliosis is practically obsolete since it has no demonstrated effectivity in detaining its progression. Cinesitherapy as an isolated technique is not considered capable of modifying the natural history of the idiopathic scoliosis, however its importance as a coadjuvant to the orthopedic treatment to improve the functional results is concluded from the studies performed. Regarding sports, the indications are not made with a therapeutic objective. Athletic activities should be recommended with the aim of not separating these adolescents from an important developmental area.

Exercises for adolescent idiopathic scoliosis

Article

Aug 2012

Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine . While AIS can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. The use of scoliosis-specific exercises (SSE) to reduce progression of AIS and postpone or avoid other more invasive treatments is controversial. To evaluate the efficacy of SSE in adolescent patients with AIS. The following databases (up to 30 March 2011) were searched with no language limitations: CENTRAL (The Cochrane Library 2011, issue 2), MEDLINE (from January 1966), EMBASE (from January 1980), CINHAL (from January 1982), SportDiscus (from January 1975), PsycInfo (from January 1887), PEDro (from January 1929). We screened reference lists of articles and also conducted an extensive handsearch of grey literature. Randomised controlled trials and prospective cohort studies with a control group comparing exercises with no treatment, other treatment, surgery, and different types of exercises. Two review authors independently selected studies, assessed risk of bias and extracted data. Two studies (154 participants) were included. There is low quality evidence from one randomised controlled study that exercises as an adjunctive to other conservative treatments increase the efficacy of these treatments (thoracic curve reduced: mean difference (MD) 9.00, (95% confidence interval (CI) 5.47 to 12.53); lumbar curve reduced:MD 8.00, (95% CI 5.08 to 10.92)). There is very low quality evidence from a prospective controlled cohort study that scoliosis-specific exercises structured within an exercise programme can reduce brace prescription (risk ratio (RR) 0.24, (95% CI 0.06 to1.04) as compared to usual physiotherapy (many different kinds of general exercises according to the preferences of the single therapists within different facilities). There is a lack of high quality evidence to recommend the use of SSE for AIS. One very low quality study suggested that these exercises may be more effective than electrostimulation, traction and postural training to avoid scoliosis progression, but better quality research needs to be conducted before the use of SSE can be recommended in clinical practice.

Exercises for adolescent idiopathic scoliosis

Chapter

Apr 2009

The method of Katharina Schroth - history, principles and current development

Article

Full-text available

Aug 2011
Scoliosis

Hans-Rudolf Weiss

ABSTRACT: Katharina Schroth, born February 22nd 1894 in Dresden Germany, was suffering from a moderate scoliosis herself and underwent treatment with a steel brace at the age of 16 years before she decided to develop a more functional approach of treatment for herself. Inspired by a balloon, she tried to correct by breathing away the deformities of her own trunk by inflating the concavities of her body selectively in front of a mirror. She also tried to 'mirror' the deformity, by overcorrecting with the help of certain pattern specific corrective movements. She recognized that postural control can only be achieved by changing postural perception. From 1921 this new form of treatment with specific postural correction, correction of breathing patterns and correction of postural perception was performed with rehabilitation times of 3 months in her own little institute in Meissen and in the late 30's and early 40's she was supported by her daughter, Christa Schroth. After World War II, Katharina Schroth and her daughter moved to West Germany to open a new little institute in Sobernheim, which constantly grew to a clinic with more than 150 in-patients at a time, treated as a rule for 6 weeks. In the 80's this institute was renamed to 'Katharina Schroth Klinik'. At this time the first studies were carried out and the patient series for the first prospective controlled trial was derived from the patient samples of 1989-1991. Content, rehabilitation times and patients meanwhile have changed, and braces have been developed to offer highest treatment security. Therefore today, bracing in the patient at risk has to be regarded as the primary treatment. We have been able to reduce the training times by adapting the old techniques and introducing new forms of postural education (sagittal correction, ADL correction and experiential learning) whilst the programme is still based on the original approaches of the 3-dimensional treatment according to Katharina Schroth, namely specific postural correction, correction of breathing patterns and correction of postural perception.

Physical exercises in the treatment of adolescent idiopathic scoliosis: An updated systematic review

Article

Full-text available

Jan 2011
Physiother Theor Pract

Two years ago we published an update of another of our previous systematic reviews about the effectiveness of physical exercises (PEs), and we found that the evidence on exercises for AIS was of level 1b. Now we have updated these results in the field of exercises for AIS with the final aim to find the strongest evidence as possible about PEs. Our goal was to verify if treatment with specific exercises for AIS has changed in these years. The study design was a systematic review. A bibliographic search with strict inclusion criteria (patients treated exclusively with exercises, outcome Cobb degrees, all study designs) has been performed on the main electronic databases. We found a new paper about active autocorrection (Negrini et al, 2008 b), a prospective controlled cohort observational study on patients never treated before so the number of manuscripts considered in the systematic review was 20. The highest quality study (RCT) compared 2 groups of 40 patients, showing an improvement of the curve in all treated patients after 6 months. All studies confirmed the efficacy of exercises in reducing the progression rate (mainly in early puberty) and/or improving the Cobb angles (around the end of growth). Exercises were also shown to be effective in reducing brace prescription. Appendices of the popular exercise protocols that have been used in the research studies that are examined are included with detailed description and illustrations. This study (like the previously published systematic reviews) showed that PEs can improve the Cobb angles of individuals with AIS and can improve strength, mobility, and balance. The level of evidence remains 1b according to the Oxford Centre for Evidence-based Medicine, as previously documented.

Structural rehabilitation of the spine and posture: Rationale for treatment beyond the resolution of symptoms

Article

Full-text available

Feb 1998
J MANIP PHYSIOL THER

To provide a rationale for active chiropractic rehabilitative treatment that extends beyond the single goal of resolution of symptomatic complaints. A manual search of available reference texts and a search of MEDLINE were collected with an emphasis on tissue healing sequelae and the role of mechanical loading on this process. The reviewed material indicates that all tissue growth and repair is influenced by mechanical loading and body posture and is positively affected by body postures that normalize/minimize adverse mechanical stresses and strains. Altered alignment of the human frame may lead to poor healing of the body tissues and eventual pathological architectural changes may occur in muscle, ligament, bone and central nervous system. Minimization of altered postural/structural loading of the human frame may take longer than resolution, or maximal reduction, of offensive symptoms. By itself, a patient's perception of pain is not a valid indicator of health. Because mechanical loading of the neuromusculoskeletal tissues plays a vital role in influencing proper growth and repair, chiropractic rehabilitative care should focus on the normalization/minimization of aberrant stresses and strains acting on spinal tissues. Manipulation alone cannot restore body postures or improve an altered sagittal spinal curve. Therefore, postural chiropractic adjustments, active exercises and stretches, resting spinal blocking procedures, extension traction and ergonomic education are deemed necessary for maximal spinal rehabilitation. Chiropractic studies that demonstrate structural improvements are sorely lacking and needed. The use of passive treatment modalities as the sole means of chiropractic intervention for the management of patients suffering with neuromusculoskeletal dysfunction no longer has a place in modern chiropractic practice after the acute phase of healing has passed.

Rehabilitation of adolescent patients with scoliosis - What do we know? A review of the literature

Article

Jul 2009
Pediatr Rehabil

Hans-Rudolf Weiss

Different opinions exist about the efficacy of conservative scoliosis treatment. Because this divergence of opinion corresponds to a great variety of standards applied, it is also not surprising that the results of conservative treatment differ a lot. Scoliosis normally does not have such dramatic effects that immediate surgery would be indicated. Moreover, it is clear that functional and physiological impairments of scoliosis patients--including pain, torso deformity, psychological disturbance and pulmonary dysfunction--require therapeutic intervention. The triad of out-patient physiotherapy, intensive in-patient rehabilitation and bracing has proven effective in conservative scoliosis treatment in central Europe. Indication, content and results of the individual treatment procedures are described and discussed. The positive outcomes of this practice validate a policy of offering conservative treatment as an alternative to scoliosis patients, including those for whom surgery is discussed.

The effectiveness of a three-dimensional exercise regime in the treatment of idiopathic scoliosis

Article

Jan 1992

Courses of the curvature of idiopathic scoliosis under the influence of a physiotherapeutical rehabilitation programme

Article

Jan 1990

Hans-Rudolf Weiss

Scoliosis: incidence and natural history. A prospective epidemiological study

Article

Apr 1978

A prospective study was carried out of the incidence and natural history of adolescent idiopathic scoliosis in 26,947 students. Data were obtained on 1,122 students with idiopathic scoliosis. The incidence of idiopathic scoliosis was 4.5 per cent. The female-to-male ratio was 1.25:1.0 over-all, but the ratio varied directly with the severity of the curve--that is, 1:1 for curves of 6 to 10 degrees, and 5.4:1 for curves of more than 20 degrees. Progression of the curve was determined by a two-year follow-up of 603 patients. Progression was observed in 6.8 per cent of the students and in 15.4 per cent of the skeletally immature girls with scoliosis of more than 10 degrees at the initial examination. In 20 per cent of the skeletally immature children with curves of 20 degrees at the initial examination, there was no progression. Spontaneous improvement of the curve occurred in 3 per cent and was seen more frequently in curves milder than 11 degrees. Treatment was required in 2.75 students per 1,000 screened.

Scoliosis: A prospective epidemiological study

Article

Nov 1975

A two and a half-year prospective study was carried out to determine incidence rates and distributions of various parameters associated with idiopathic scoliosis. Data were also collected on the progression curves detected at the initial screening. The results showed: (1) that the incidence rate was 13.6 per cent with a female-to-male ratio of 1.2:1, (2) that the most common type of curve was thoracolumbar, and (3) that spontaneous improvement occurred in approximately 22 per cent of those patients followed for an average of one year.

The prediction of curve progression in untreated idiopathic scoliosis during growth

Article

Oct 1984

We reviewed the cases of 727 patients with idiopathic scoliosis in whom the initial curve measured from 5 to 29 degrees. The patients were followed either to the end of skeletal growth or until the curve progressed. One hundred and sixty-nine patients (23.2 per cent) showed progression of the curve. The incidence of curve progression was found to be related to the pattern and magnitude of the curve, the patient's age at presentation, the Risser sign, and the patient's menarchal status. We found no correlation between progression of the curve and the patient's sex, Harrington factor, rotational prominence, family history, or radiographic measurements. A progression factor was calculated using the three strongest correlations available at initial examination: the magnitude of the curve, the Risser sign, and the patient's chronological age. A graph and nomogram are presented that can serve as a guide for advising patients' families and for planning continuing care.

Equilibrium Factors as Predictors of the Prognosis in Adolescent Idiopathic Scoliosis

Article

Nov 1980

Postural equilibrium factors were evaluated as indicators of the prognosis in 52 patients with adolescent idiopathic scoliosis. The hypothesis was that dysfunction in these equilibrium factors might imply a higher risk for the curve to progress. The postural equilibrium was studied by stabilometry, and the function of the central nervous system was assessed by electoencephalography (EEG) and the vestibular function by electronystomography (ENG). During a follow-up period averaging 2.9 years, ten patients showed progression of the scoliosis. No differences were found in the distribution and frequency of abnormalities between the patients with progressive and nonprogressive scoliosis. Stabilometry, electroencephalography, and electronystomography as used in this study did not seem to be of predictive value for the outcome in the individual case.

Kriimmungsverlaufe idiopathischer Skoliosen unter dem EinfluD eines krankengymnastischen Rehabilitation-programs Effect of the exclusive employment of physiotherapy in patients with idiopathic scoliosis. Retrospective study

648-654

Rigo M G Ouera-Salva
Puigdevall N Kinesitheradie
H R Weiss
M Rigo
G Quera-Salva
M Puigdevall

RIGO. M. OUERA-SALVA. G. and PUIGDEVALL. N.: KinesitheraDie de WEISS, H. R.: Kriimmungsverlaufe idiopathischer Skoliosen unter dem EinfluD eines krankengymnastischen Rehabilitation-programs. Orthop Prax 2 6 648-654, 1990. RIGO, M., QUERA-SALVA, G. and PUIGDEVALL, M.: Effect of the exclusive employment of physiotherapy in patients with idiopathic scoliosis. Retrospective study. In Proceedings of the l l t h International Congress of the World Confederation for Physical Therapy, London, 28 July-2 August, 1319-1321. 1991.

Benefits of Schroth rehabilitation program for idio-pathic scoliosis patients Sauramps Medical, Montpellier, p. 233, 1992. la scoliose.>ifficultk d'evaluation des resultats

Jan 1982
16-17

H R Weiss

June, 332-339, 1992. WEISS, H. R.: Benefits of Schroth rehabilitation program for idio-pathic scoliosis patients. In Proceedings of the European Spinal Deformities society, Lyon, 17-1 9 June, Sauramps Medical, Montpellier, p. 233, 1992. la scoliose.>ifficultk d'evaluation des resultats. In P. Duconge and R. Guilloux La scoliose aujourd'hui -la scoliose demain. XXtme Congrts du GEKTS, Lyon, 16-17 October, pp. 153-154, 1992. I. NACHEMSON, A,, LONSTEIN, J. and WEINSTEIN, S.: Report of the prevalence and natural history committee. Denver 1982.

Krankengymnastik auf neu-rophysiologischer Basis bei der idiopathischen Skoliose -Ergebnisse eincr 10 jahrigen prospektiven Studie. Paper at the The effectiveness of a three-dimen-sional exercise regime in the treatment of idiopathic scoliosis

Jul 1992
27-30

R Paijschert
F U Niethart
H R Weiss
J Bettany

PAIJSCHERT, R., and NIETHART, F. U.: Krankengymnastik auf neu-rophysiologischer Basis bei der idiopathischen Skoliose -Ergebnisse eincr 10 jahrigen prospektiven Studie. Paper at the 41 st Jahrestagung der Norddeutschen Orthopadenvereinigung E. V., Cologne, 28-30 June, 1992. WEISS, H. R. and BETTANY, J.: The effectiveness of a three-dimen-sional exercise regime in the treatment of idiopathic scoliosis. In Proceedings of the VIIth International Symposium on Spinal Deformity and Surface Topography, Montreal, Canada, 27-30

Report of the prevalence and natural history committee. Denver

A Nachemson
J Lonstein
S Weinstein

Krankengymnastik auf neu-rophysiologischer Basis bei der idiopathischen Skoliose -Ergebnisse einer 10 jährigen prospektiven Studie. Paper at the 41st Jahrestagung der

R Pauschert
F U Niethart

Spontanverlauf der idiopathischen Skoliose. Paper at the 2nd Sobernheimer Skoliose-Workshop, Sobernheim

May 1992

J Heine

HEINE, J.: Spontanverlauf der idiopathischen Skoliose. Paper at the 2nd Sobernheimer Skoliose-Workshop, Sobernheim, 25 April 1992. 40 Dev Neurorehabil Downloaded from informahealthcare.com by McMaster University on 11/06/14 For personal use only.

Benefits of Schroth rehabilitation program for idiopathic scoliosis patients

H R Weiss

Krümmungsverläufe idiopathischer Skoliosen unter dem Einfluβ eines krankengymnastischen Rehabilitation-programs

H R Weiss

Effect of the exclusive employment of physiotherapy in patients with idiopathic scoliosis. Retrospective study

M Rigo
G Quera-Salva
M Puigdevall

Kinésithérapie de la scoliose. Difficulté d'evaluation des resultats. La scoliose aujourd'hui,—la scoliose demain

M Rigo
G Quera-Salva
N Puigdevall

Difficulté d'evaluation des resultats. La scoliose aujourd'hui,-la scoliose demain

M Rigo
G Quera-Salva
N Puigdevall

Preliminary results and worst-case analysis of inpatient scoliosis rehabilitation

Abstract

No full-text available

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