The principles of correction follow the global postural alignment and are applied with high intensity forces created inside the body (‘from inside’) involving isometric tensions, expansions and specific breathing. BSPTS is based on the principles developed by Katharina Schroth. For adults over the age of 18, the main goals are to improve the clinical view, eliminate pain, and prevent scoliosis progression. Scoliosis. Treatment indications for the Dobomed method follow the 2011 SOSORT guidelines . The Scoliosis exercises are designed to be most effective for curves that are <20 degrees. VL assisted in drafting the manuscript. – An Update, Scoliosis Prevention – Blood Test to Predict Scoliosis. Myofascial release is important to promote mobilization and flexibility of the spine before correction. Furthermore, exercises can help reduce the correction loss in brace weaning for AIS . Google Scholar. Each scoliosis patient has his/her own unique curve pattern and is evaluated separately. The hitch exercise is used for lumbar or thoracolumbar curves, whereas the hitch-shift exercise is an option for double major curves. The Schroth “50 x Pezziball” exercise where the patient sits on a Swiss-ball in front of a mirror (a) and performs active 3D auto self-correction using the wall bar (b). AL assisted in drafting and editing the manuscript. 27). Using a scoliometer in supine position, the degree of correction with breathing exercises can be assessed. Stabilization of the trunk is one of the primary objectives of SEAS. Schroth body blocks: H – Hip-pelvic block including the lower limbs reaching the lower end vertebra (LEV) of the lumbar curve. This bending position is thought to facilitate active self-correction between two symmetrical and stable zones, and helps to consolidate the correct postural habit beyond the therapeutic session. Sit-to-Stands 13. Betts T. The development of a classification system for the treatment of scoliosis by the side shift. (Measure: sagittal plane alignment), What is the easiest movement to perform/remember? T – Thoracic block between UEV and LEV of the thoracic curve. 25 and 26 the use of RAB and specific mobilization and flexibility are demonstrated. SOSORT promotes and encourages conservative, evidence-based medicine regarding scoliosis and provides education, guidelines and consensus about treatment options to people with scoliosis . For AIS patients, observation only is recommended in curves up to 15°. Bend your upper body forward and lower your chest close to your knees. 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°. nine hours in group) the patients can reproduce the correction in several starting positions and can start practicing at home. Red arrows represent areas of muscle activation around the convexities towards the midline. Post was not sent - check your email addresses! The Lyon approach uses visualization with mirrors and video to help with curve correction (Fig. This type of unpredictability also defines the development and progression of scoliosis in an individual. Sensory-motor balance training (Fig. She is instructed to transition into the “hitch” position (c) by lifting her left heel on the same side as the convexity of the curve while keeping her hip and knee straight. (Measure: Rib overhanging – trunk frontal plumb-line), Is elongation necessary? Reduce the contrary leg to the carpet once you fold onto 1 knee. The Side Shift approach to correct scoliosis curves was developed by Dr. Min Mehta in 1984 and has been used by therapists at the Royal National Orthopaedic Hospital since that time. Ideal stretches for those with scoliosis include: While lying on your back, cross one leg over the other, then pull your legs in toward you. In the middle of the 20th century, Dr. Pierre Stagnara established an organized nonsurgical approach to manage scoliosis with casts and braces, and in 1947 he created the Lyon brace. Fizjoterapia: diagnosis and therapy in the management of people with different needs. BSPTS principles of correction are based on the original principles described by Katharina Schroth . Initially the physiotherapist assists the patient with manual correction using tools that provide biofeedback for the patient, such as video cameras, TV screens, and mirrors. People who have scoliosis will likely differ in the degree of curvature and the location of the curvature along the spine. Numerous studies have been written by Dr. Hans Weiss, the medical director of the Asklepios Katharina Schroth Rehabilitation Center from 1995 to 2008, and by Dr. Manuel Rigo, director of the Barcelona Scoliosis Physical Therapy School (BSPTS). In Figs. 39 and 40). PubMed 92a–e ), then move on to performing corrective patterns (Fig. a The initial radiograph shows a thoracic scoliosis curve of 38° Cobb. 21) offers a scoliosis-specific intensive inpatient rehabilitation program. CAS Scoliosis 11, 20 (2016). The physiotherapist requires extensive training and many clinical years of experience in order to perfect the BSPTS method. Patient using postural correction and the corrective expansion/contention technique to achieve the best possible correction. The method of Katharina Schroth - history, principles and current development. Additionally, patients can participate in FITS’s Special Inpatient Rehabilitation program regardless of Cobb angle, Risser sign, and age. In 2011, Bialek  conducted a study analyzing the effect of the FITS method and bracing on (1) single or (2) double structural scoliosis with Cobb angle 10–25° (Group A) and on patients with Cobb between 20–45° (Group B). Facilitation of three-plane corrective breathing in functional positions and brace wearing (Figs. In the early 1960’s, Antonio Negrini (Fig. 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. This stretch does a great job of stretching out the upper back along with the muscles that attach into the spine. After World War II, Katharina Schroth and her daughter moved to West Germany and opened an institute in Bad Sobernheim, which soon grew into a full-scale scoliosis treatment clinic that served more than 150 inpatients at a time . Williams MA, Heine JP, Williamson EM, Toye F, Dritsaki M, Petrou S, Crossman R, Lall R, Barker KL, Fairbank J, Harding I, Gardner A, Slowther AM, Coulson N, Lamb SE. Incidence of surgery in conservatively treated patients with scoliosis. Expansion/contraction technique is about expanding any part of the trunk in any direction ‘from inside,’ by using only the muscle force (independent of breathing movements). In Fig. If you susp… As can be seen by the therapeutic approach of each school, and the scientific evidence supporting each school’s method of treatment, each of the seven schools promotes a unique technique and unique exercises. Blue arrows on the shoulders represent bilateral shoulder traction. For cases where the Cobb angle is 20° or greater, the method depends primarily on casting and bracing for its effectiveness. Unique rotational angular breathing (RAB) exercises (Fig. The sagittal plane is fixed in a physiological posture to improve flat back if necessary. 2008;30(10):772–85. Type II is any curve pattern that can be corrected to the midline of the coronal plane, aligning the spine with the pelvis, with partial derotation of the vertebrae (moderately flexible curves). Scoliosis exercises do not replace medical therapies for scoliosis but they can complement medical treatment. (a, b): Patient with a right thoracolumbar scoliosis curve performs a side shift to the left in a sitting-to-standing position (a) and in the standing position (b) as part of side shift exercises which can be done as part of activities of daily living (ADLs). 32a) and Nevia Verzini founded a scoliosis center that later became known as the “Centro Scoliosi Negrini” (CSN) in Vigevano, Italy. 22), who is the head physical therapist at the Medical Spine Center in Bad Sobernheim, Germany. Their studies [15–29] demonstrate positive outcomes from use of the Schroth method on back muscle strength, breathing function, pain, quality of life and self-image, slowing curve progression, improving Cobb angles and decreasing the prevalence of surgery. Light brown arrows represent bilateral shoulder traction, which is required for stabilization during active self-correction. As the patient develops muscle memory through motor learning and sensorimotor feedback, the patient is able to make auto-corrections by themselves without the need for treatment tools. (a, b): Patient performing typical DoboMed method exercises before the application of thoracic kyphosis (a) and with thoracic kyphosis (b). Pediatr Rehabil. By doing these scoliosis back exercises, you acknowledge that it is at your own risk. Both individual and group treatments share these same goals: Proactive spinal corrections to avoid surgery. Forward Bends. Scoliosis. 54), Side-lying exercises (Fig. Treatment of AIS using strict Schroth principles is aimed at preventing curve progression before the end of growth. This question is very important to verify that the exercise was carried out properly. Stretch your arms and hands out in front of you. During the hitch-shift exercise, in the standing position, the patient is instructed to lift their heel on the convex side of the lower curve, as done in the hitch exercise, while immobilizing the lower curve with their hand and shifting their trunk to the concavity of the upper curve. FITS also focuses on sensory motor balance exercises and lower trunk stabilization. Directed movements of the thorax and spine to improve respiratory function. Unlike other methods of scoliosis treatment, the FITS method has no traditional classification system; rather, it relies on an individual approach. Physical therapy intervention studies on idiopathic scoliosis: review with the focus on inclusion criteria. Weiss H, Moramarco M, Moramarco K. Risks and long-term complications of adolescent idiopathic scoliosis surgery vs. non-operative and natural history outcomes. For lumbar scoliosis curves, perform while sitting. Under this approach, the physical therapy exercises are properly viewed as supplemental to the casting and bracing, and in each case are adapted to the individual’s particular needs. e An advanced FITS stabilization exercise where the patient balances on her hands and knees on balance discs atop balance boards, Patients demonstrating typical FITS exercises with elastic bands, which help facilitate the scoliosis specific correctional patterns. Google Scholar. Biomechanical spinal growth modulation and progressive adolescent scoliosis – a test of the ‘vicious cycle’ pathogenetic hypothesis: Summary of an electronic focus group debate of the IBSE. Scoliosis is a three-dimensional deformative abnormality of the spine. 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