1
|
Swaby L, Perry DC, Walker K, Hind D, Mills A, Jayasuriya R, Totton N, Desoysa L, Chatters R, Young B, Sherratt F, Latimer N, Keetharuth A, Kenison L, Walters S, Gardner A, Ahuja S, Campbell L, Greenwood S, Cole A. Bracing Adolescent Idiopathic Scoliosis (BASIS) study - night-time versus full-time bracing in adolescent idiopathic scoliosis: study protocol for a multicentre, randomized controlled trial. Bone Jt Open 2023; 4:873-880. [PMID: 37972634 PMCID: PMC10655615 DOI: 10.1302/2633-1462.411.bjo-2023-0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Aims Scoliosis is a lateral curvature of the spine with associated rotation, often causing distress due to appearance. For some curves, there is good evidence to support the use of a spinal brace, worn for 20 to 24 hours a day to minimize the curve, making it as straight as possible during growth, preventing progression. Compliance can be poor due to appearance and comfort. A night-time brace, worn for eight to 12 hours, can achieve higher levels of curve correction while patients are supine, and could be preferable for patients, but evidence of efficacy is limited. This is the protocol for a randomized controlled trial of 'full-time bracing' versus 'night-time bracing' in adolescent idiopathic scoliosis (AIS). Methods UK paediatric spine clinics will recruit 780 participants aged ten to 15 years-old with AIS, Risser stage 0, 1, or 2, and curve size (Cobb angle) 20° to 40° with apex at or below T7. Patients are randomly allocated 1:1, to either full-time or night-time bracing. A qualitative sub-study will explore communication and experiences of families in terms of bracing and research. Patient and Public Involvement & Engagement informed study design and will assist with aspects of trial delivery and dissemination. Discussion The primary outcome is 'treatment failure' (Cobb angle progression to 50° or more before skeletal maturity); skeletal maturity is at Risser stage 4 in females and 5 in males, or 'treatment success' (Cobb angle less than 50° at skeletal maturity). The comparison is on a non-inferiority basis (non-inferiority margin 11%). Participants are followed up every six months while in brace, and at one and two years after skeletal maturity. Secondary outcomes include the Scoliosis Research Society 22 questionnaire and measures of quality of life, psychological effects of bracing, adherence, anxiety and depression, sleep, satisfaction, and educational attainment. All data will be collected through the British Spine Registry.
Collapse
Affiliation(s)
- Lizzie Swaby
- SCHARR, Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Daniel C. Perry
- Alder Hey Children’s Hospital, Liverpool, UK
- University of Liverpool, Liverpool, UK
| | - Kerry Walker
- SCHARR, Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Daniel Hind
- SCHARR, Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | | | | | - Nikki Totton
- SCHARR, Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Lauren Desoysa
- SCHARR, Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Robin Chatters
- SCHARR, Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Bridget Young
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Frances Sherratt
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Nick Latimer
- SCHARR, Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Anju Keetharuth
- SCHARR, Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | | | - Stephen Walters
- SCHARR, Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Adrian Gardner
- Royal Orthopaedic Hospital, Birmingham, UK
- Aston University, Birmingham, UK
| | - Sashin Ahuja
- Noah’s Ark Children’s Hospital for Wales, Cardiff, UK
- Cardiff University, Cardiff, UK
| | - Laura Campbell
- School of Medicine, Keele University, Keele, UK
- Keele University, Keele, UK
| | | | - Ashley Cole
- Sheffield Children’s Hospital, Sheffield, UK
| | - on behalf of the BASIS study group
- SCHARR, Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
- Alder Hey Children’s Hospital, Liverpool, UK
- University of Liverpool, Liverpool, UK
- Sheffield Children’s Hospital, Sheffield, UK
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
- Evelina London Children’s Hospital, London, UK
- Royal Orthopaedic Hospital, Birmingham, UK
- Aston University, Birmingham, UK
- Noah’s Ark Children’s Hospital for Wales, Cardiff, UK
- Cardiff University, Cardiff, UK
- School of Medicine, Keele University, Keele, UK
- Keele University, Keele, UK
- Manchester University NHS Foundation Trust, Manchester, UK
| |
Collapse
|
2
|
Hannink E, Toye F, Newman M, Barker KL. The experience of living with adolescent idiopathic scoliosis: a qualitative evidence synthesis using meta-ethnography. BMC Pediatr 2023; 23:373. [PMID: 37481537 PMCID: PMC10362777 DOI: 10.1186/s12887-023-04183-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 07/06/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is a common spinal deformity with physical and psychosocial implications for adolescents. The aim of this qualitative evidence synthesis (QES) was to systematically search for, identify, and synthesise qualitative research in order to improve our understanding of what it is like to live with AIS and to facilitate empathetic and effective healthcare. METHODS We systematically searched 4 databases (Medline, EMBASE, PsycINFO and CINAHL) and used the 7 phases of meta-ethnography to synthesise qualitative evidence including studies with children and adolescents, and additional viewpoints from parents about the experience of AIS. RESULTS We distilled 7 themes. (1) Diagnosis turned time on its head revolves around the AIS diagnosis and the uncertainty of the future that accompanied it. (2) Usual activities no longer the same explores how activities and participation in everyday life are impacted by AIS. (3) Hiding my body describes the pervasive struggle with self-image and appearance. (4) I want to feel normal again explores adolescents' desire to return to 'normality' and challenges of feeling different. (5) Balancing isolation and support considers the relationships in the adolescents' lives alongside their feelings of isolation. (6) Trying to keep control of treatment decisions explores how adolescents and their parents strive to feel in control. (7) Fearing surgery yet feeling hopeful focused on the apprehension and fear around spinal surgery and the beacon of hope it represented. CONCLUSIONS Our QES contributes to the understanding of the adolescent experience of living with AIS. From our findings, clinicians can better understand the physical and psychosocial obstacles and the challenges faced throughout the journey of AIS to inform their clinical interactions with these patients.
Collapse
Affiliation(s)
- Erin Hannink
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Rd., Headington, Oxford, OX3 7HE, UK.
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Rd., Headington, Oxford, OX3 7LD, UK.
| | - Francine Toye
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Rd., Headington, Oxford, OX3 7HE, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Rd., Headington, Oxford, OX3 7LD, UK
| | - Meredith Newman
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Rd., Headington, Oxford, OX3 7HE, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Rd., Headington, Oxford, OX3 7LD, UK
| | - Karen L Barker
- Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Rd., Headington, Oxford, OX3 7HE, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Rd., Headington, Oxford, OX3 7LD, UK
| |
Collapse
|
3
|
Jamison M, Glover M, Peterson K, DeGregorio M, King K, Danelson K, O'Gara T. Lumbopelvic postural differences in adolescent idiopathic scoliosis: A pilot study. Gait Posture 2022; 93:73-77. [PMID: 35093665 DOI: 10.1016/j.gaitpost.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/14/2021] [Accepted: 01/04/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND A primary etiology of adolescent idiopathic scoliosis (AIS) is currently unknown, but poor postural control of the spinal extensor musculature has been identified as an AIS risk factor. Identifiable postural differences would aid in advancing the precise postural behaviors that should be modified during Physiotherapy Scoliosis Specific Exercise (PSSE) to help limit the progression of AIS. RESEARCH QUESTION Are there any determinable differences in lumbopelvic posture or range of motion between subjects with AIS and controls? METHODS This prospective cohort pilot study consisted of 53 subjects (27 AIS and 26 control) aged 11-17 years. Subjects had their lumbopelvic posture assessed and monitored using the ViMove DorsaVi sensor package. All subjects underwent a live assessment to obtain initial lumbopelvic (LP) range of motion (ROM) measurements. Subjects were then monitored while continuing with normal activities of daily living (ADLs) for 12 h. With an alpha level of 0.05, nonparametric analyses were performed for each variable via a Mann-Whitney U-test. RESULTS During the live assessment, controls exhibited a significantly greater anterior pelvic tilt ROM in the sitting position than the AIS group (p = 0.0433). When compared to female controls, females with AIS had a sitting pelvic tilt ROM that was significantly more retroverted (p = 0.0232) and less anteverted (p = 0.0010). During ADLs, female controls exhibited a higher total number of extension events than their female with AIS (p = 0.0263). These associations did not strengthen with greater spinal deformity. SIGNIFICANCE This work demonstrates postural differences between patients with AIS and controls. Further study is necessary to determine why patients with AIS adopt these postures, and if PSSEs can be utilized to limit the progression of AIS.
Collapse
Affiliation(s)
- Matthew Jamison
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Mark Glover
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Keyan Peterson
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Michael DeGregorio
- Department of Mechanical Engineering, Grand Canyon University, 3300W Camelback Rd, Phoenix, AZ 85017, USA
| | - Kamryn King
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Kerry Danelson
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Tadhg O'Gara
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| |
Collapse
|
4
|
Biofeedback Posture Training for Adolescents with Mild Scoliosis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5918698. [PMID: 35141334 PMCID: PMC8820896 DOI: 10.1155/2022/5918698] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/03/2021] [Accepted: 01/18/2022] [Indexed: 01/30/2023]
Abstract
Adolescent idiopathic scoliosis (AIS) is characterized by uneven shoulders, spinal curvature, and uneven hips, and asymmetry in paraspinal muscle activities is common in AIS. This pilot study was aimed at examining the use of a surface electromyography (sEMG) biofeedback posture training program in adolescents with mild scoliosis (Cobb′s angle < 30°) to attenuate asymmetry in paraspinal muscle activities and control the curve progression. Seven female adolescents (age, 12–14 years) with mild scoliosis (Cobb′s angle < 30°) were recruited. The participants received 30 tailor-made sessions of sEMG biofeedback posture training at a rate of one to two sessions per week for approximately 6 months. The activities of the paraspinal muscles (the trapezius, latissimus dorsi, thoracic erector spinae, and lumbar erector spinae) measured by sEMG during habitual sitting postures and spinal deformity evaluated by 3D ultrasound imaging were compared before and after training. The mean values of the root-mean-square sEMG ratio, an index of symmetry in paraspinal muscle activities of the muscle pairs between the concave and convex sides of the spinal curve, revealed significant asymmetry over the trapezius and lumbar erector spinae before the training (p <0.05). After the training, all seven adolescents achieved relatively more symmetrical paraspinal muscle activities over these two muscle pairs (p < 0.05). In two adolescents, the spinal curvature decreased by 5.7° and 5.6°, respectively, whereas the remaining adolescents showed a minimal curve progression with changes in the spinal curvature controlled under 5°. To conclude, sEMG biofeedback posture training can reduce asymmetry in paraspinal muscle activities and control curve progression in adolescents with mild scoliosis and can potentially be considered an alternative early intervention for muscle reeducation in this cohort.
Collapse
|
5
|
Dufvenberg M, Diarbakerli E, Charalampidis A, Öberg B, Tropp H, Aspberg Ahl A, Möller H, Gerdhem P, Abbott A. Six-Month Results on Treatment Adherence, Physical Activity, Spinal Appearance, Spinal Deformity, and Quality of Life in an Ongoing Randomised Trial on Conservative Treatment for Adolescent Idiopathic Scoliosis (CONTRAIS). J Clin Med 2021; 10:4967. [PMID: 34768487 PMCID: PMC8585057 DOI: 10.3390/jcm10214967] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/18/2021] [Accepted: 10/23/2021] [Indexed: 11/23/2022] Open
Abstract
Adolescents with idiopathic scoliosis (AIS) often receive conservative treatments aiming to prevent progression of the spinal deformity during puberty. This study aimed to explore patient adherence and secondary outcomes during the first 6 months in an ongoing randomised controlled trial of three treatment interventions. Interventions consisted of physical activity combined with either hypercorrective Boston brace night shift (NB), scoliosis-specific exercise (SSE), or physical activity alone (PA). Measures at baseline and 6 months included angle of trunk rotation (ATR), Cobb angle, International Physical Activity Questionnaire short form (IPAQ-SF), pictorial Spinal Appearance Questionnaire (pSAQ), Scoliosis Research Society (SRS-22r), EuroQol 5-Dimensions Youth (EQ-5D-Y) and Visual Analogue Scale (EQ-VAS). Patient adherence, motivation, and capability in performing the intervention were reported at 6 months. The study included 135 patients (111 females) with AIS and >1-year estimated remaining growth, mean age 12.7 (1.4) years, and mean Cobb angle 31 (±5.3). At 6 months, the proportion of patients in the groups reporting high to very high adherence ranged between 72 and 95%, while motivation ranged between 65 and 92%, with the highest proportion seen in the NB group (p = 0.014, p= 0.002). IPAQ-SF displayed significant between group main effects regarding moderate activity (F = 5.7; p = 0.004; ηp2 = 0.10), with a medium-sized increase favouring the SSE group compared to NB. Walking showed significant between group main effects, as did metabolic equivalent (MET-min/week), with medium (F = 6.8, p = 0.002; ηp2 = 0.11, and large (F = 8.3, p = < 0.001, ηp2 = 0.14) increases, respectively, for the SSE and PA groups compared to NB. From baseline to 6 months, ATR showed significant between group medium-sized main effects (F = 1.2, p = 0.019, ηp2 = 0.007) favouring the NB group compared to PA, but not reaching a clinically relevant level. In conclusion, patients reported high adherence and motivation to treatment, especially in the NB group. Patients in the SSE and PA groups increased their physical activity levels without other clinically relevant differences between groups in other clinical measures or patient-reported outcomes. The results suggest that the prescribed treatments are viable first-step options during the first 6 months.
Collapse
Affiliation(s)
- Marlene Dufvenberg
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, SE 581 83 Linköping, Sweden; (B.Ö.); (A.A.)
| | - Elias Diarbakerli
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, SE 141 86 Stockholm, Sweden; (E.D.); (A.C.); (H.M.); (P.G.)
- Department of Reconstructive Orthopaedics, Karolinska University Hospital Huddinge, SE 141 86 Stockholm, Sweden
| | - Anastasios Charalampidis
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, SE 141 86 Stockholm, Sweden; (E.D.); (A.C.); (H.M.); (P.G.)
- Department of Reconstructive Orthopaedics, Karolinska University Hospital Huddinge, SE 141 86 Stockholm, Sweden
| | - Birgitta Öberg
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, SE 581 83 Linköping, Sweden; (B.Ö.); (A.A.)
| | - Hans Tropp
- Department of Biomedical and Clinical Sciences, Linköping University, SE 581 83 Linköping, Sweden;
- Center for Medical Image Science and Visualization, Linköping University, SE 581 83 Linköping, Sweden
- Department of Orthopaedics, Linköping University Hospital, SE 581 83 Linköping, Sweden
| | - Anna Aspberg Ahl
- Department of Orthopaedics, Ryhov County Hospital, SE 551 85 Jönköping, Sweden;
| | - Hans Möller
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, SE 141 86 Stockholm, Sweden; (E.D.); (A.C.); (H.M.); (P.G.)
- Stockholm Center for Spine Surgery, SE 171 64 Stockholm, Sweden
| | - Paul Gerdhem
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Orthopaedics and Biotechnology, Karolinska Institutet, SE 141 86 Stockholm, Sweden; (E.D.); (A.C.); (H.M.); (P.G.)
- Department of Reconstructive Orthopaedics, Karolinska University Hospital Huddinge, SE 141 86 Stockholm, Sweden
| | - Allan Abbott
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, SE 581 83 Linköping, Sweden; (B.Ö.); (A.A.)
- Department of Orthopaedics, Linköping University Hospital, SE 581 83 Linköping, Sweden
| |
Collapse
|
6
|
Liang J, Zhou X, Chen N, Li X, Yu H, Yang Y, Song Y, Du Q. Efficacy of three-dimensionally integrated exercise for scoliosis in patients with adolescent idiopathic scoliosis: study protocol for a randomized controlled trial. Trials 2018; 19:485. [PMID: 30201050 PMCID: PMC6131734 DOI: 10.1186/s13063-018-2834-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 08/02/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal deformities that may progress sharply during growth. The aim of this study will be to evaluate the efficacy of three-dimensionally integrated exercise on the Cobb angle, angle of trunk rotation, sagittal profile, and quality of life in patients with AIS. METHODS/DESIGN The study is designed as a randomized controlled trial. Participants include 42 patients with AIS aged 10-16 years. Randomly assigned patients will follow a 6-month treatment, either in a control group with standard care of observation following the Scoliosis Research Society criteria or in an experimental group with three-dimensionally integrated exercise for scoliosis. Blinded assessments at baseline and immediately after intervention will include the change of Cobb angle, angle of trunk rotation, sagittal index, and quality of life. DISCUSSION If we find that the intervention is effective in improving Cobb angle, angle of trunk rotation, sagittal profile, and quality of life in patients with AIS, this trial will have a positive impact and warrant a change in clinical practice. TRIAL REGISTRATION ClinicalTrials.gov, NCT03427970 . Registered on February 9, 2018, and revised on July 24, 2018.
Collapse
Affiliation(s)
- Juping Liang
- Department of Rehabilitation Medicine, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092 China
| | - Xuan Zhou
- Department of Rehabilitation Medicine, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092 China
| | - Nan Chen
- Department of Rehabilitation Medicine, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092 China
| | - Xin Li
- Department of Rehabilitation Medicine, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092 China
| | - Hong Yu
- Department of Rehabilitation Medicine, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092 China
| | - Yuqi Yang
- School of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, 201318 China
| | - Yuanyuan Song
- Department of Rehabilitation Medicine, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Chongming Branch, Shanghai, 202150 China
| | - Qing Du
- Department of Rehabilitation Medicine, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092 China
| |
Collapse
|
7
|
Théroux J, Stomski N, Losco CD, Khadra C, Labelle H, Le May S. Spinal Manipulative Therapy for Adolescent Idiopathic Scoliosis: A Systematic Review. J Manipulative Physiol Ther 2017; 40:452-458. [PMID: 28822477 DOI: 10.1016/j.jmpt.2017.03.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 02/09/2017] [Accepted: 03/14/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this study was to perform a systematic review of clinical trials of spinal manipulative therapy for adolescent idiopathic scoliosis. METHODS Search strategies were developed for PubMed, CINHAL, and CENTRAL databases. Studies were included through June 2016 if they were prospective trials that evaluated spinal manipulative therapy (eg, chiropractic, osteopathic, physical therapy) for adolescent idiopathic scoliosis. Data were extracted and assessed by 2 independent reviewers. Cochrane risk of bias tools were used to assess the quality of the included studies. Data were reported qualitatively because heterogeneity prevented statistical pooling. RESULTS Four studies satisfied the inclusion criteria and were critically appraised. The findings of the included studies indicated that spinal manipulative therapy might be effective for preventing curve progression or reducing Cobb angle. However, the lack of controls and small sample sizes precluded robust estimation of the interventions' effect sizes. CONCLUSION There is currently insufficient evidence to establish whether spinal manipulative therapy may be beneficial for adolescent idiopathic scoliosis. The results of the included studies suggest that spinal manipulative therapy may be a promising treatment, but these studies were all at substantial risk of bias. Further high-quality studies are warranted to conclusively determine if spinal manipulative therapy may be effective in the management of adolescent idiopathic scoliosis.
Collapse
Affiliation(s)
- Jean Théroux
- Chiropractic Discipline, School of Health Profession, Murdoch University, Murdoch, Western Australia, Australia.
| | - Norman Stomski
- School of Health Profession, Murdoch University, Murdoch, Western Australia, Australia
| | | | - Christelle Khadra
- Faculty of Nursing, University of Montréal, Montréal, Québec, Canada
| | - Hubert Labelle
- Faculty of Medicine, University of Montréal, Montréal, Québec, Canada
| | - Sylvie Le May
- Faculty of Nursing, University of Montréal, Montréal, Québec, Canada
| |
Collapse
|
8
|
Berdishevsky H, Lebel VA, Bettany-Saltikov J, Rigo M, Lebel A, Hennes A, Romano M, Białek M, M’hango A, Betts T, de Mauroy JC, Durmala J. Physiotherapy scoliosis-specific exercises - a comprehensive review of seven major schools. SCOLIOSIS AND SPINAL DISORDERS 2016; 11:20. [PMID: 27525315 PMCID: PMC4973373 DOI: 10.1186/s13013-016-0076-9] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 06/21/2016] [Indexed: 11/10/2022]
Abstract
In recent decades, there has been a call for change among all stakeholders involved in scoliosis management. Parents of children with scoliosis have complained about the so-called "wait and see" approach that far too many doctors use when evaluating children's scoliosis curves between 10° and 25°. Observation, Physiotherapy Scoliosis Specific Exercises (PSSE) and bracing for idiopathic scoliosis during growth are all therapeutic interventions accepted by the 2011 International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT). The standard features of these interventions are: 1) 3-dimension self-correction; 2) Training activities of daily living (ADL); and 3) Stabilization of the corrected posture. PSSE is part of a scoliosis care model that includes scoliosis specific education, scoliosis specific physical therapy exercises, observation or surveillance, psychological support and intervention, bracing and surgery. The model is oriented to the patient. Diagnosis and patient evaluation is essential in this model looking at a patient-oriented decision according to clinical experience, scientific evidence and patient's preference. Thus, specific exercises are not considered as an alternative to bracing or surgery but as a therapeutic intervention, which can be used alone or in combination with bracing or surgery according to individual indication. In the PSSE model it is recommended that the physical therapist work as part of a multidisciplinary team including the orthopeadic doctor, the orthotist, and the mental health care provider - all are according to the SOSORT guidelines and Scoliosis Research Society (SRS) philosophy. From clinical experiences, PSSE can temporarily stabilize progressive scoliosis curves during the secondary period of progression, more than a year after passing the peak of growth. In non-progressive scoliosis, the regular practice of PSSE could produce a temporary and significant reduction of the Cobb angle. PSSE can also produce benefits in subjects with scoliosis other than reducing the Cobb angle, like improving back asymmetry, based on 3D self-correction and stabilization of a stable 3D corrected posture, as well as the secondary muscle imbalance and related pain. In more severe cases of thoracic scoliosis, it can also improve breathing function. This paper will discuss in detail seven major scoliosis schools and their approaches to PSSE, including their bracing techniques and scientific evidence. The aim of this paper is to understand and learn about the different international treatment methods so that physical therapists can incorporate the best from each into their own practices, and in that way attempt to improve the conservative management of patients with idiopathic scoliosis. These schools are presented in the historical order in which they were developed. They include the Lyon approach from France, the Katharina Schroth Asklepios approach from Germany, the Scientific Exercise Approach to Scoliosis (SEAS) from Italy, the Barcelona Scoliosis Physical Therapy School approach (BSPTS) from Spain, the Dobomed approach from Poland, the Side Shift approach from the United Kingdom, and the Functional Individual Therapy of Scoliosis approach (FITS) from Poland.
Collapse
Affiliation(s)
- Hagit Berdishevsky
- Conservative Care for Spine and Scoliosis, ColumbiaDoctors Midtown, Columbia University Medical Center, New York, NY USA
| | | | | | | | - Andrea Lebel
- Scoliosis Physiotherapy Posture and Rehabilitation Centre, Ottawa, ON Canada
| | - Axel Hennes
- Asklepsios Katharina Schroth Spinal Deformities Rehabilitation Centre, Bad Sobernheim, Germany
| | - Michele Romano
- ISICO (Italian Scientific Spine Institute), Milan, Italy
- Italian Scoliosi Study Group (GSS), Vigevano, Italy
| | | | | | - Tony Betts
- Royal National Orthopaedic Hospital, London, UK
| | | | - Jacek Durmala
- Department of Rehabilitation, Medical University of Silesia, Katowice, Poland
| |
Collapse
|
9
|
|