Single curve scoliosis & Schroth technique

[philanopsis]

A 14 year old girl with single curve of 39 degree between T10 to L3, convexity to left, with dorsal rib hump on left from about left 8th rib downwards. No thoracic curves, ribs on right appropriately separated from each other. Cheneau brace measured but not available yet. How does one use the Schroth technique on her? Thanks

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[gcoe]

Hi philanopsis

Below is an old article in Physiotherapy on the Schroth Method:

http://www.easyvigour.net.nz/pilates...2Treatment.pdf

The technique has some good evidence for preventing further deterioration and improving Cobb angles. However it sounds like you have to intervene before the end of puberty to be really effective.

Below is a systematic review that examines the Schroth Method and other techniques for Adolescent idiopathic scoliosis. As the results of the review are positive it would be well worth you getting it and examining what they did in the clinical trials:

PEDro - Detailed Search Results

I am not trained in the method but it does sound a lot like other somatic education methods like the Feldenkrais and Alexander methods which I am trained in. These methods require considerable investment in time and you first learn to work on your own body awareness using the technique before applying it to patients/students. Someone more knowledgable on the method may give you better advice, however it sounds like it would require quite a bit of training to practice the method effectively. Such methods usually do.

[philanopsis]

I have Lehnert-Schroth's book and have gone through it. The book describes techniques for 3 and 4 curve scoliosis, and most of it is for thoracic scoliosis. However, my daughter has only a single curve and it's T10 to L2-3. So it's really hard to decide if we should go ahead with Schroth technique. The nearest Schroth centre is 4 hours by flight away in a different country and we are still trying to make arrangements to fly there.

I'm also aware most of the techniques are mainly for early puberty scoliosis. She measured 31 degrees six months ago when her bones were skeletally almost mature (Risser 4 plus already). We were reassured and told to let nature take its course. Well, six months later it's 39 degrees and the surgeons are talking about surgery in the near future. So rather than wait, I'll try anything else first that is relatively evidence-based.

So, if there are any Schroth practitioners out there, please do advise if Schroth technique can be applied to a single curve scoliosis that is low thoracic and lumbar.

Many thanks.

[gcoe]

Hi philanopsis

Sorry - I didn't realise you were the patients mum, I thought you were a physiotherapist. In this case and given the fact that things have progressed a bit, yes I would pursue hands on professional guidance and support rather than advice at a distance.

I take it you are in Singapore. Have you tried contacting the Singapore Physiotherapy Association? Their database of their members may list those who have an interest in scoliosis. or the administrator may be able to email their members to ask who has expertise on your behalf. The sorts of physios involved in this area may be paediatric physios, physios who consult and screen for scoliosis in schools or possibly rehab physios that deal with a younger age group.


http://www.physiotherapy.org.sg/

Best of luck finding somebody

[estherderu]

Dear Philanopis,

The number of health professionals trying to achieve evidence based therapy specifically in children with AIS is growing worldwide. Medical specialists and therapists have joined to form the SOSORT www.sosort.org. One of the results of this combined effort is the online scoliosis journal. Scoliosis

As a SOSORT member I can reassure you that Schroth, together with the SEAS method from Italy are the most evidence based ways of treating a scoliosis patient at this moment. The curve type is not the most important issue. Exercise should always be included in the total "treatment" It is never too late to start exercising...... It is not only of emminent importance to strengthen muscles, mobilize and maintain a good posture before bracing, but also during brace wearing and during brace weaning.

If you cannot find anyone with enough expertise in your country it is a possibility to try going to another. The Schroth Institutes I know off in Germany and Spain (and the therapists working with them), will offer extensive and intensive training for a number of weeks. This intensive training is always monitored by a medical specialist. This intensive therapy is often sufficient for a longer time and does need to be repeated in certain cases.

good luck with your daughter

Esther

[eramses]

Since she is young she might benefit from a brace, although I've had most success with the schroth method. You can find a few schroth exercises on youtube but visiting a schroth clinic is also a good idea. If a clinic is too far away, I recommend getting the book or going with a program like this one that shows you how to do all the exercises in video format.