Completion of a formal physiotherapeutic scoliosis-specific exercise training program for adolescent idiopathic scoliosis increases patient compliance to home exercise programs

Simhon, Matthew E.; Fields, Mark; Grimes, Kelly; Bakarania, Prachi; Matsumoto, Hiroko; Boby, Afrain Z; Berdishevsky, Hagit; Roye, Benjamin; Roye, David P.; Vitale, Michael G.

doi:10.1007/s43390-020-00253-8

Cited by 6 publications

(3 citation statements)

References 19 publications

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“…It is possible that if the adolescent exists within a complex medical system that is not supportive of Schroth, then this creates a variation in accessibility to Schroth treatment and the frequency of supervised sessions reduces. The supervised sessions appear to be important because the completion of a formal Schroth training program with a Schroth instructor has been shown to correlate with an increase in compliance in a home exercise program [ 23 ]. It would be useful to determine the level of supervision, system support and accessibility, and motivation strategies required to achieve positive outcomes considering the supervision of Schroth exercises has been noted to be more beneficial than unsupervised Schroth [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

How Schroth Therapists Vary the Implementation of Schroth Worldwide for Adolescents with Idiopathic Scoliosis: A Mixed Methods Study

Marchese,

Ilhan,

Pacey

2023

JCM

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(1) Background: Schroth is a type of physiotherapeutic scoliosis specific exercise (PSSE) prescribed to adolescents with idiopathic scoliosis (AIS). Studies have investigated the effectiveness of Schroth but are yet to elucidate how Schroth is applied clinically and the factors that influence their prescription. (2) Methods: A mixed methods design was used comprising an anonymous survey and semi-structured interviews of Schroth therapists who treated AIS and who were publicly listed on the Barcelona Scoliosis Physical Therapy School or the International Schroth 3-dimensional Scoliosis Therapy School websites. The survey included 64 questions covering demographics, session and treatment characteristics, and whether therapists included other treatment modalities in their clinical practice. A convenience sample of survey participants were invited to participate in a semi-structured interview to further explore the factors that influenced their prescription of Schroth for AIS. Results from the survey were analyzed descriptively (n, %), whereas inductive thematic analysis was used for the interviews. (3) Results: of the 173 survey respondents (18% response rate), most were from Europe and North America (64.0%), female (78.6%), physiotherapists (96.0%), and worked in private settings (72.3%). Fifty-two per cent of participants used other types of PSSE as an adjunct to Schroth, the Scientific Exercise Approach to Scoliosis (SEAS) being the most frequently used (37.9%). Non-PSSE methods were used ‘at some point’ as an adjunct by 98.8% of participants, including massage and other soft tissue techniques (80.9%), Pilates (46.6%), and Yoga (31.5%). The Schroth techniques used by all survey respondents included breathing and pelvic corrections. Seven participants were interviewed, but data saturation was achieved after only four interviews. Thematic analysis revealed four, inter-related broad themes describing the factors that influenced Schroth prescription for AIS: (1) the adolescent as a whole, including physical, emotional and mental characteristics, and patient goals, (2) family, including parent relationship with the adolescent and the motivation of parents in regard to Schroth, (3) the systems within which the treatment was being offered, such as vicinity to the clinic and the presence of financial insurance support, and (4) therapist characteristics, such as their training and experience. (4) Conclusions: Schroth therapists worldwide use a variety of adjunctive methods to treat AIS. Therapists prescribing Schroth exercises to AIS consider the complex interplay of intra-, inter- and extra-personal factors in clinical practice. These considerations move beyond the three components of evidence-based practice of research, patient preferences, and clinical expertise, towards a systems-based reflection on exercise prescription.

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Section: Discussionmentioning

confidence: 99%

How Schroth Therapists Vary the Implementation of Schroth Worldwide for Adolescents with Idiopathic Scoliosis: A Mixed Methods Study

Marchese,

Ilhan,

Pacey

2023

JCM

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“…46 Unfortunately, completion of a structured PSSE program (>10 visits) still only results in 50% rate of compliance with home exercises at one week and 23.5% at one year. 47 Despite questionable compliance, Fan et al have demonstrated that in a prospective trial, 40 patients treated with 6 months of PSSE +/-bracing had statistically significant, durable improvement in curve magnitude at 2 years with no cases of deterioration. 48 While PSSE have been shown to contribute to halting curve progression, the clinical significance of such improvements remain unproven, and further research is needed to better define the impact of this treatment discipline.…”

Section: Physiotherapeutic Scoliosis Specific Exercisesmentioning

confidence: 99%

Update in Nonoperative Management of Adolescent Idiopathic Scoliosis to Prevent Progression

Shannon¹,

Mackenzie²,

Hariharan³

et al. 2021

Journal of the Pediatric Orthopaedic Society of North America

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The primary goal of nonoperative treatment of adolescent idiopathic scoliosis (AIS) is to prevent curve progression. The risk of progression and estimation of growth remaining should be performed through a combination of serial X-rays, menarche history, serial height measurement, triradiate cartilage status, Risser grade, and Sanders Skeletal Maturation Stage with a left-hand bone age X-ray. For AIS patients with growth remaining and a curve magnitude between 25 and 45 degrees, conservative treatment with a rigid thoracolumbosacral orthosis (TLSO) is indicated. Rigid TLSOs (e.g., Wilmington, Boston, Rigo-Cheneau) are superior to other brace types, but there is insufficient evidence to recommend a specific type of rigid TLSO. Brace wear for at least 13 hours per day is indicated until skeletal maturity to limit curve progression. Physiotherapeutic scoliosis-specific exercises (PSSE) should be considered in addition to bracing for patients with moderate curves because there is growing evidence that PSSE improve overall patient-perceived back status when used as an adjunct to brace treatment. However, PSSE have not been shown to decrease the likelihood of curve progression for patients with mild curves; therefore, insufficient evidence exists to recommend PSSE for asymptomatic patients with mild curves. The nonoperative treatment of AIS remains an active area of investigation, and further research is needed to better compare brace types, optimize brace weaning, and understand the effectiveness of PSSE.

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“…Adolescent idiopathic scoliosis (AIS) is an unexplained three-dimensional malformation of the spine, with an incidence of about 2–3% in the population between 10 years of age and bone maturation [ 1 ]. AIS can lead to many problems such as limited function, pain, poor appearance and decreased quality of life [ 2 , 3 ]. The most commonly used method for measuring the severity of scoliosis is the Cobb’s angle, which is mainly used to measure the lateral angle of the spine on the frontal surface using standard anterior and posterior X radiographs [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Network meta-analysis of short-term effects of different strategies in the conservative treatment of AIS

Zhang

2021

Eur J Med Res

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Purpose To evaluate the short-term effects of different conservative treatments on in adolescent idiopathic scoliosis. Methods By searching the relevant literature of adolescent idiopathic scoliosis, the curative effects of the three regimens of bracing therapy combined with scoliosis-specific exercises, simple treatment with brace and simple scoliosis-specific exercises were compared. Review manager 5.3, Stata MP16 and Network software packages were used for Reticular Meta-analysis of Cobb’s angles before and after treatment. Results A total of 364 patients were included in four clinical studies. Reticular meta-analysis showed that the short-term effect of bracing treatment combined with scoliosis-specific exercises was better than that of treatment with brace and scoliosis-specific exercises, with effects of 2.71(95% CI 0.83–4.58) and 3.67(95% CI 1.21–6.14), respectively. There was no statistical difference between simple bracing therapy and scoliosis-specific exercises. Conclusion Among the three common conservative treatments of adolescent idiopathic scoliosis, the short-term effect of bracing treatment combined with scoliosis-specific exercises is better than that of bracing treatment or scoliosis-specific exercises.

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Completion of a formal physiotherapeutic scoliosis-specific exercise training program for adolescent idiopathic scoliosis increases patient compliance to home exercise programs

Cited by 6 publications

References 19 publications

How Schroth Therapists Vary the Implementation of Schroth Worldwide for Adolescents with Idiopathic Scoliosis: A Mixed Methods Study

How Schroth Therapists Vary the Implementation of Schroth Worldwide for Adolescents with Idiopathic Scoliosis: A Mixed Methods Study

Update in Nonoperative Management of Adolescent Idiopathic Scoliosis to Prevent Progression

Network meta-analysis of short-term effects of different strategies in the conservative treatment of AIS

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