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scoliosis resources brisbane

Valuable information and research articles for our clients

Research articles

exercise

Specialised exercise in Scheuermann's 

In a randomised control trial, back exercises in general, and Schroth therapy in particular, is an effective treatment for preventing and significantly improving the thoracic Cobb angle and symptomatic representation in Scheuermann’s patients (Bezalel et al 2019).One study looking at Schroth exercises in young female and male adults with thoracic and thoracolumbar Scheuermann's kyphosis showed improvement in pain with intensive rehabilitation (Weis et al). 

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Effect of Intensive Rehabilitation on Pain in Patients with Scheuermann’s Disease

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The Effect of Schroth Therapy on Thoracic Kyphotic Curve and Quality of Life in Scheuermann’s Patients: A Randomized Controlled Trial

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Brace treatment for patients with Scheuermann's disease - a review of the literature and first experiences with a new brace design

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 Specialised Exercise for scoliosis in children & teens 

​Scoliosis exercises are helpful at any stage of your journey - whether you are watching and waiting or wearing a brace, there are multiple research studies supporting their use, especially during the period of monitoring where they were shown to be superior than monitoring alone in lessening risk of progression and in some case improving Cobb.​ There are multiple studies confirming benefit of adding exercises to the care of scoliosis, when it comes to improving posture, lessening/preventing and in some cases improving Cobb, as well as all of them showing improvement in muscle endurance and quality of life (Schrieber et al 2015).In syndromic and neuromuscular cases, exercise to improve respiratory function and 24 hour postural support subsequently benefits surgical outcomes (Vaille & Mary, 2013) and  prevents/minimisse the onset of associated complications(Ferrai et al., 2010).

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  • ​Physical exercises in treatment of adolescent idiopathic Scoliosis:

updated systematic review. Physiotherapy theory and practice 2011, 27 (1): 80-114 https://pubmed.ncbi.nlm.nih.gov/21198407/

 

  • ​The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis: a randomised controlled clinical trial. Clin Rehabil. 2016 Feb;30(2):181-90.

https://pubmed.ncbi.nlm.nih.gov/25780260/

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  • The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis-an assessor and statistician blinded randomized controlled trial:

"SOSORT 2015 Award Winner” https://scoliosisjournal.biomedcentral.com/articles/10.1186/s13013-015-0048-5

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  • SEAS exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis.

Results of a randomised controlled trial, Eur Spine J. 2014 Jun;23(6):1204-14. https://pubmed.ncbi.nlm.nih.gov/24682356/

 

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  • Scoliosis intensive out-patient rehabilitation based on Rigo-Concept, Studies Health Tech&Info, 135,  208-227

​      https://pubmed.ncbi.nlm.nih.gov/18401092/

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  • Effects of Specific Exercise Therapy on Adolescent Patients With Idiopathic Scoliosis- A Prospective Controlled Cohort Study, SPINE:

August 1, 2020 - Volume 45 - Issue 15 - p 1039-1046 https://journals.lww.com/spinejournal/Fulltext/2020/08010/Effects_of_Specific_Exercise_Therapy_on_Adolescent.10.aspx

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  • Effect of conservative management on the prevalence of surgery in patients with adolescent idiopathic scoliosis. Pediatr Rehabil 2003, 6(3-4):209-214.

https://pubmed.ncbi.nlm.nih.gov/14713587/​​​

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Specialised exercise for scoliosis in adults

​Specialised physiotherapy and specific, individualised exercise programs help scoliosis patients to overcome their symptoms and adopt a more balanced posture while also reducing pain/stiffness and stabilising/ lessening the curve’s progression without the need for surgery. Bracing is sometimes used for support and pain relief. One study looking at scoliosis exercises in adults with scoliosis showed improvement in posture and Cobb in 68% of patients (Negrini et al 2015).

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  • Rehabilitation in adult spinal deformity. Turk J Phys Med Rehabil. 2020 Sep; 66(3): 231–243.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7557622/

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bracing

Bracing for Scoliosis

What evidence exists for Physiotherapeutic exercises during bracing in children/teens?

​Combing bracing with specialised exercise programs are shown to be more effective than bracing alone, in one study the exercise group had better improvement in Cobb with exercises added 17% compared to 4% with bracing alone, more scoliosis remained stable with exercises added with 62% of curves remaining stable compared to 45%, and less curves progressed with only 21% compared to 50% (Hong et al 2017). (14.1%).

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What evidence is there for exercises during brace weaning?

​There are multiple studies confirming benefit of adding exercises to bracing in preventing rebound effect on removing the brace, and for weaning from the brace, as well as improving Cobb.

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  • ​​Specific exercises performed in the period of brace weaning can avoid loss of correction in Adolescent Idiopathic Scoliosis (AIS) patients: Winner of SOSORT's 2008 Award for Best Clinical Paper Scoliosis 2009 Apr 7;4:8. doi: 10.1186/1748-7161-4-8 https://pubmed.ncbi.nlm.nih.gov/19351395/

Is bracing effective in teens?

Scoliosis bracing is the most common non-surgical treatment often needed for progressive scoliosis especially in younger patients and is often prescribed by your specialist to try and stop the curve progressing and avoid surgery, according to one high quality study bracing was 70% effective at preventing curve progression and can be up to 92% effective if wearing a 3D style scoliosis brace (Weiss et al 2017).  Another study showed bracing and exercise reduced risk of progression to surgery significantly from 28.1% reported surgeries from the centre with the policy of non-intervention to 14% with bracing and exercise intervention (Rigo et al).

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  • A comparison between Boston brace and European braces in the treatment of Adolescent Idiopathic Scoliosis patients: A Systematic Review based on SRS criteria  ​https://pubmed.ncbi.nlm.nih.gov/37924388/

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Is bracing effective in adults?

​The decision to brace for adults is dependant on a number of factors including whether there is a progressive curvature, whether or not they are a surgical candidate, if they have pain and postural decline that is not likely to respond to exercise therapy alone. Adults often need a combination of exercise and bracing is usually part time for postural support and pain relief.

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  • Non - specific chronic low back pain in patients with scoliosis—an overview of the literature on patients undergoing brace treatment. J Phys Ther Sci. 2019 Nov; 31(11): 960–964.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6879412/

Surgery

How do I know when to consider surgery for scoliosis?

Surgery for scoliosis is often considered when the curvature is at risk of progression as an adult and/or significantly impacts the patient's quality of life or poses health risks. The choice between a back brace for scoliosis and surgery depends on multiple factors, including the severity of the curvature, patient age, and potential for growth. 

Is there evidence for pre-hab in children/teens?

​Research demonstrates that pre-habilitation programs reduce medical expenditures, and improve patients' postoperative pain, disability, self-efficacy, psychological behaviours, and satisfaction with surgical outcomes. The available literature suggests there is an opportunity to improve patient experience, clinical outcomes and reduce medical costs with the use of pre-habilitation in spine surgery. Specific to scoliosis, intensive rehab in 5 days prior to surgery resulted in improved correction outcomes in rigid curvatures.

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  • Five days of inpatient scoliosis-specific exercises improve preoperative spinal flexibility and facilitate curve correction of patients with rigid idiopathic scoliosis: https://pubmed.ncbi.nlm.nih.gov/39325330/

Is there evidence for post-operative rehabilitation?

​​Postoperative scoliosis rehabilitation consisting of stabilizing postural and respiratory exercises, manual therapy and psychological intervention and pain treatment by medication, showed reduction in pain intensity and frequency. Chronic pain as a late result following scoliosis surgery can be reduced by an intensive in-patient rehabilitation, at least in the short term. 

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What outcomes can I expect after surgery?

​40 year follow up studies have shown similar pain, function and quality of life scores for those who underwent surgery compared to those who did not. That is considering those who underwent surgery required the intervention at the time, while others did not.

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  • The effect of spinal fusion on the long-term outcome of idiopathic scoliosis.

​https://scoliosisjournal.biomedcentral.com/track/pdf/10.1186/s13013-018-0157-z.pdf

 

​The guidelines for returns o surgery differ for each patient depending on age, curve severity prior to surgery, the type of surgery, number of levels fused, and the pre-surgical health of the patient including and whether or not pre-habilitation was completed. 

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  • What are the timeframes for return to school and sport after surgery?

https://publications.aap.org/aapgrandrounds/article-abstract/32/5/55/90889/Regaining-Functional-Activity-After-Spinal-Fusion?redirectedFrom=fulltext

POST-OP

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