Physical Therapy Intervention for the Treatment of AIS
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Transcript Physical Therapy Intervention for the Treatment of AIS
A 3-D Treatment Approach to Treating Scoliosis
According to the Principles of C.L. Schroth
Michelle Dwyer, DPT
Schroth and SEAS Certified for the Treatment of Scoliosis and Spinal Deformities
• Parents- Too much “wait and see”
• Patients- Lack of knowledge regarding how to help
themselves beyond bracing and waiting
• Therapists- Inadequately educated and equipped in
scoliosis treatment
• Orthotists-Traditional bracing lacks 3-D corrections,
resulting in flat back and other poor cosmetic changes
• Doctors- Is there a way to help patients sooner?
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Postural Awareness
Stretching/ Strengthening
Hip ROM
Spinal Stability
Body Mechanics
• Schroth Based PT
- Barcelona Physical Therapy School
• SEAS
- ISICO, Stephano Negrini MD, Milan, Italy
• Team Approach
PCP/ Pediatrician, Orthotist, Orthopedic/Neurosurgeon,
Other?
• Community Involvement
Curvy Girls, Hope’s Closet, local meeting and support groups.
• Primarily Adolescent Idiopathic Scoliosis Treatment
• Deformities in the Sagittal Plane ( Scheurmann’s,
Hyper-Kyphosis and Hyper- Lordosis
• Curve Specific
• Cognitive, sensory- motor, kinesthetic, neuromuscular
exercises to reduce scoliosis posture
History and Goals
Correct scoliosis posture
Germany 1921
Inpatient
Spain 1968
Outpatient
USA 2005
First certified therapists
2011 First US course held
Steven’s Point, WI
Reduce risk of progression
Strengthen asymmetrically
Improve respiration
Diminish functional
limitations
Reduce pain
Improve body mechanics
Improve self image and quality
of life
Precautions:
• Osteoporosis
• Post- Surgery
• Juvenile Hypermobility Syndrome (JHS)
• Osteogenesis Imperfecta
• Spondylolisthesis
Contraindications:
• Reactive Scoliosis (tumor, disease, etc)
• Inflammatory diseases- during active phase
• Psychiatric Issues
May be treated but with limitations:
• Syndromic and
Neuromuscular Scoliosis
• Post – Surgery
• Adult Degenerative Scoliosis
• Infantile (Age 0-3), Juvenile (age 4-9) *
* SRS Classification
Risk of Progression Factor
Patient Age
Risser Score
Cobb Angle
Age patient is first seen
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Screening- Adam’s Test
Angle of Trunk Rotation- (ATR) Using Scoliometer
• >5 ° in sitting = + Screen
Postural- Frontal, Sagittal and Aerial
X- Ray- Cobb, Apex, Rotations, CSL, Risser
Height Measurement – Sitting and Standing
Vital Capacity
Thoracic Function
Pain
Quality of Life – SRS 22, SRS 36, TAPS, QLSPD
Schroth Exercises
Semi-Hanging Sagittal Plane
Prone on Knees-Transverse Plane
Anterior Gravity Assisted
Schroth Exercise
Supine Gravity Assisted- Transverse
Plane
Standing 3D Correction
Assessment Photos
Assessment Photos
In Brace Correction
Pre/ Post Brace Comparison
Pre Brace X-Ray
In Brace X- Ray
Sagittal Plane Correction
Visit 1
Visit 3
Exercises Using Schroth Principles
Exercises Using Schroth Principles
Visit 1 - Uncorrected
Visit 3 - Corrected Posture
Exercises – Sport Specific and In-Brace
Sport Specific Training In Corrected Posture
Case Study
Visit 1
Visit 1
Sagittal Visit 1
Visit 2 Sagittal Plane Correction
Sagittal Correction
Psoas Stretch
Stretching- Stabilization
Supine Hamstring Stretch
Scapular / Core Stability
Sagittal Correction
Visit 1
Visit 6 - 2 month follow up
Patient Follow Up
Visit 1
2 Month follow up
PT Treatment Options
Local Program
Basic Program 2x wk-
8wks
Progression
Monthly, Quarterly, Bi-
Annually
Until Risser 5
Immersion Program
Basic Program for 5
consecutive days
Progression
First yr every 3 months
Bi-Annually to Risser 5
Assistants