The challenge of developing exercise programs for adolescents with idiopathic scoliosis
There was a recent article discussing physiotherapy exercise programs for children and there were three areas that most Physical Therapists in Private Practice were encountering. One of these was Scoliosis in youth and adults.
I think the area of Scoliosis diagnosis and treatment is fascinating. Scoliosis, the three-dimensional deformity of the spine which develops in young adolescents, has received much interest of late. First, bracing of the spine as a treatment to prevent progression of the curves has reached a strong level of evidence (Level 1) following a Random Controlled Trial (S.L. Weinstein et al. Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med, 369 (2013), pp. 1512-1521)
Over my many years of working in Physical Therapy, the ideas surrounding treatment using bracing and exercise have changed remarkably. In my early work years, it was thought that exercise or electrical stimulation to strengthen the weaker trunk muscles might be able to prevent progression of the curves. However, an article in the Orthopedic literature turned this on its head and referrals to Physical Therapy were greatly reduced as a result.
Thought has now changed on the usefulness of exercise for this area and new interest in developing exercise programs has surged. Recent articles evaluating a very old method of exercise treatment for Scoliosis, developed in Germany early in the century, is now gaining acceptance, the Schroth method.
A recent webinar on Scoliosis through Motivations, Inc. (Course Catalog | Motivations | www.motivationsceu.com/course-catalog) reviews current information around classification, diagnosis and scoliosis specific exercises for young people with scoliosis. The pictured article, free to download on Pub Med Central, details the specifics of seven different types of exercises. A consensus article summarized the similarities between programs and included autocorrection of the spine, training in activities of daily living, stabilizing the corrected posture and patient education. Be aware that new articles are documenting the evidence around these schools of exercise on a regular basis.