The effectiveness of two different exercise approaches in adolescent idiopathic scoliosis: A single-blind, randomized-controlled trial

Objectives The purpose of this study was to compare the efficacy of two different types of exercise methods in patients with adolescent idiopathic scoliosis. Methods In total, 28 subjects with adolescent idiopathic scoliosis with a mild curve magnitude (10°–26°) were randomly divided into two groups: the Schroth group (n = 14) and the core group (n = 14). The patients in the Schroth group were treated with supervised Schroth exercises, and the patients in the core group were treated with supervised core stabilization exercises; both groups performed the exercises for three days per week for a total of 10 weeks, and both were given additional traditional exercises to perform. Assessment included Cobb angle (Radiography), trunk rotation (Adam’s test), cosmetic trunk deformity (Walter Reed Visual Assessment Scale), spinal mobility (Spinal Mouse), peripheral muscle strength (Biodex System 4-Pro), and quality of life (Scoliosis Research Society-22 questionnaire). Results It was found that patients in the Schroth group showed greater improvement in Cobb angles, thoracic trunk rotation angle, cosmetic trunk deformity, spinal mobility, and quality of life than those in the core group (p<0.05), except for in lumbar trunk rotation angle. Peripheral muscle strength improvement was greater in the core group than in the Schroth group (p<0.05). Conclusion Schroth exercises are more effective than core stabilization exercises in the correction of scoliosis and related problems in mild adolescent idiopathic scoliosis, and core stabilization exercises are more effective than Schroth exercises in the improvement of peripheral muscle strength. Trial registration NCT04421157

Treatment of Patients with Scoliosis Using a Unique Anterior Scoliosis Correction Technique

Treatment for adolescent idiopathic scoliosis (AIS) is dependent upon multiple factors, including curve type and magnitude, curve progression, skeletal maturity, and clinical trunk deformity. While fusion is effective at achieving curve correction, it is associated with disadvantages including prominent implants beneath the skin, back muscle scarring and atrophy, decreased spine range of motion, and decreased functional spinal mobility. Additional concerns include the potential for longer term development of premature adjacent level disc and facet joint degeneration above and below the fusion. Due to these issues with spinal fusion, surgeons have explored alternative surgical approaches to correct spinal deformity and halt curve progression using either growth modulation or remodeling of the spine while preserving motion. This paper provides an overview of a non-fusion scoliosis correction technique called Anterior Scoliosis Correction (ASC).

The Angle of Trunk Rotation in School Children: A Study from an Idiopathic Scoliosis Screening. Prevalence and Optimal Age Screening Value

(1) Background: Idiopathic scoliosis is a deformity of the growing spine. It affects 2–3% of adolescents; yet its cause is still unknown. At the early stage of idiopathic scoliosis (IS), the signs are not very noticeable. That is why the primarily school-based screening for scoliosis is so important. (2) Methods: This was a cross-sectional analysis of 6850 respondents. Participants were elementary school students in the metropolitan area of Poland. The suspicion of IS was based on detection of three-dimensional deformity of the spine using scoliometer. (3) Results: Respondents were divided into two groups: Angle of trunk rotation (ATR) = 0–3º and ATR > 3º. Presented research using a referral criterion of 5º ATR showed that in the group of participants who had ATR > 3º the largest percentage of 5 degree values was recorded at the second and third measurement level of the spine (30.5%, 31.1%, respectively). Analyzing the differences between the two groups of girls (ATR = 0–3º, ATR > 3º), statistically significant differences were recorded between 9 and 11 years of age (p = 0.0388). Girls with ATR > 3º at all measuring levels are significantly slimmer than girls with ATR 0–3º; (4) Conclusions: Age; sex, and risk of developing angle of trunk rotation are very closely associated. The main thoracic (level 2) and thoraco-lumbar (level 3) level of measuring of the spine appears to be the most differentiating in the diagnosis of scoliosis. Girls with a lower degree of trunk deformity (4–6º trunk rotation), which can present mild scoliosis and those with a higher degree (7º trunk rotation) have lower body mass than girls within the norm.

Severe scoliosis in an adolescent, benefits of early detection: a case report

Presentations of scoliosis to primary health care physicians are not rare. Challenges may arise when it comes to screening and who require treatment once diagnosed. Idiopathic scoliosis is a three-dimensional spine and trunk deformity that is considered the most common form of scoliosis in children. It commonly does not cause symptoms and may be overlooked. However, if there was progressive deformity and it remained untreated, it may cause serious complications. Apart from medical concerns, emotional and cosmetic worries due to visible deformity may lead to psychological and social effects. Despite advances in understanding scoliosis, there are still controversies when it comes to optimal screening and treatment of this condition. This case is about a thirteen years old female who presented with intermittent back symptoms and was found to have a severe form of idiopathic thoracolumbar scoliosis. Through this case, author will be discussing different aspects of scoliosis (prevalence, screening, diagnosis, and treatment options) with emphasis on psychological support and guidance to the physician on how to overcome this challenge.

Core stabilization exercises versus scoliosis-specific exercises in moderate idiopathic scoliosis treatment

Background: There are several kinds of scoliosis-specific and general physiotherapeutic exercise methods used in scoliosis rehabilitation. But there is need for comparable studies on the effectiveness of different exercise approaches for the treatment of adolescent idiopathic scoliosis. Objectives: Comparison of the effects of combined core stabilization exercise and bracing treatment with Scientific Exercises Approach to Scoliosis and bracing treatment in patients with moderate adolescent idiopathic scoliosis. Methods: Thirty females with adolescent idiopathic scoliosis, who have moderate curves (20°–45°), were randomly divided into two groups. In addition to brace wearing for 4 months, one group received core stabilization exercise therapy, while the other received scientific exercises approach to scoliosis exercise therapy. The outcome measures were based on Cobb angle, angle of trunk rotation, body symmetry, cosmetic trunk deformity, and quality of life. Results: Thoracic and lumbar Cobb angles and trunk rotation angles, body symmetry, and cosmetic trunk deformity improved for both groups. Quality of life did not change in either group. The pain domain of the Scoliosis Research Society-22 questionnaire improved in the core stabilization group only. Conclusion: Both treatment conditions including core stabilization with bracing and scientific exercises approach to scoliosis with bracing had similar effects in the short-term treatment of moderate adolescent idiopathic scoliosis. Clinical relevance This study showed that when scientific exercises approach to scoliosis (SEAS) and core stabilization (CS) exercises were administered with equal intensity, the effects of the two treatment protocols including CS and bracing and SEAS and bracing were similar in the treatment of patients with moderate adolescent idiopathic scoliosis (AIS).

Self-evaluation of Trunk Aesthetics in Conservatively Treated Children and Adolescents with Idiopathic Scoliosis

Background. Trunk deformity is an important manifestation of idiopathic scoliosis (IS). Patients’ perception of spinal deformity and its impact on their quality of life (QoL) are important aspects of scoliosis treatment. The aim of this study was to determine the correlation between radiographic parameters (Cobb angle), clinical parameters (angle of trunk rotation, ATR), and the type of conservative treatment used vs the perception of trunk aesthetics as well as QoL in IS patients. Material and methods. The study enrolled 90 subjects (68 females, 22 males) diagnosed with IS (age: 9-18 years, 14.3± 2.1; Cobb angle 10-66°, 22.2°±12.2; ATR 2-20°, 7.6°±3.9). The study group was divided into (1) patients treated with bracing and physiotherapy (n=35) and (2) subjects undergoing physiotherapy alone (n=55). The perception of trunk deformity was analysed with the TAPS visual scale. QoL was measured with the Polish version of the SRS-22 questionnaire. Results. The study showed that the patients’ perception of their trunk aesthetics significantly worsened with increasing Cobb angle (TAPS, rS= -0.327, p<0.01) and ATR (TAPS, rS= -0.228, p<0.05) values. Moreover, higher ATR values sig­ni­ficantly decreased the patients’ QoL (SRS-22, rS= -0.232, p<0.05). Bracing significantly worsened the patients’ perception of aesthetics and QoL (TAPS, 3.2±0.8 vs 3.8±0.6, p<0.05; SRS-22, 3.9±0.4 vs 4.0±0.4, p<0.05 for patients treated with bracing and physiotherapy alone, respectively). Conclusions. 1. The magnitude of scoliosis, angle of trunk rotation, and bracing leads to worsen perception of trunk aesthetics and quality of life. 2. The curvature angle, angle of trunk rotation, brac­ing, female sex, and age are all associated with a worse perception of trunk aesthetics and quality of life. Self-evaluation of trunk aesthetics and qua­lity of life do not depend on the type of scoliosis. 3. In planning the management of idiopathic sco­lio­sis, one should take into account the impact of spi­nal deformity on worse patient-rated body aes­thetics.