Physiotherapeutic Scoliosis Specific Exercises (PSSE) can reduce the risk of progression in Adolescent Idiopathic Scoliosis during the peak of growth: A prospective study with a control group

Η έρευνα παρουσιάστηκε από τον Νίκο Καραβίδα στο 14th Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) Meeting, στο San Francisco των Η.Π.Α τον Απρίλιο του 2019. Πρόκειται για μια σημαντική προσωπική έρευνα, που αποδεικνύει ότι η εφαρμογή των Ειδικών Φυσικοθεραπευτικών Ασκήσεων για την Σκολίωση (PSSE), μπορεί να μειώσει σημαντικά την πιθανότητα επιδείνωσης της σκολίωσης κατά την φάση της μέγιστης ανάπτυξης, καθώς και την ανάγκη εφαρμογής κηδεμόνα. 

Στην Schroth Scoliosis & Spine Clinic έχουν αντιμετωπιστεί με μεγάλη επιτυχία πολλές περιπτώσεις Εφηβικής Ιδιοπαθούς Σκολίωσης και πολλά παιδιά έχουν καταφέρει να αποφύγουν την εφαρμογή κηδεμόνα.

Περίληψη έρευνας:

Introduction: During the last 5 years, many high-quality Randomized Control Trials (RCT) have been published, providing scientific evidence for the effectiveness of Physiotherapeutic Scoliosis Specific Exercises (PSSE) in scoliosis treatment. The main goal of treatment in mild scoliosis is to prevent progression and avoid bracing.

Objective: The objective of this study is to evaluate the efficacy of PSSE, as an exclusive treatment, during the peak of growth.

Methods: 19 patients (16 girls – 3 boys, mean age 12.1 years, Risser sign 0.8, Thoracic (Th) Cobb angle 25.7^ο and Lumbar/Thoracolumbar (L/TL) Cobb angle 22.7^ο) performed Schroth exercises for scoliosis treatment. They attended regular supervised sessions with a Physiotherapist and followed a home-program 5 times per week. Inclusion criteria were defined as Cobb > 15^ο, Risser 0-2 and Angle Trunk Rotation (ATR) > 5^ο, measured by a scoliometer. The outcome parameters were the Cobb angle before and after the intervention (improvement or progression were defined as angle difference more than 5^ο) and the number of patients that finally needed a brace. Average follow up time was 20.1 months. Control group was consisted by 22 patients (21 girls – 1 boy, mean age 11.1 years, Risser sign 0-3, Cobb Th 19.3^ο, Cobb L/TL 18.9^ο). They were retrospectively analyzed and performed generic or no exercises.

Results and Discussion: For PSSE group, 13 patients (68.4%) remained stable, 3 (15.8%) improved and 3 (15.8%) worsened, while for Control group, 5 (22.7%) were stable and 17 (77.3%) worsened. 4 patients (21.1%) finally needed a brace for the PSSE group and 10 (45.5%) in Control group. The results seem to be significantly in favor of PSSE group, despite the fact that initial Cobb angle was higher than the Control group.

Conclusions and Significance: Schroth exercises (PSSE) reduced the risk of progression in Adolescent Idiopathic Scoliosis (AIS) patients, during the riskiest period of growth spurt. PSSE proved to be superior than general or no exercises. Our results are in accordance with the recently published literature, showing the effectiveness of PSSE, which should be the first step of scoliosis treatment, in order to avoid progression and bracing.

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