Schroth therapy is one of the oldest and most well-established approaches to Scoliosis – while it was once a somewhat niche approach (or at least viewed as such) in the years before significant research on non-surgical treatment options began to take place, today Schroth is a well-developed program backed by a great deal of scientific research – much of it supported by some of the most important names in the Scoliosis treatment field.
Schroth therapy has recently been “updated” and improved upon, taking into account more modern developments and research, this has been branded as the “Schroth best practice” program.
Schroth best practice offers not only an update to the traditional methods but also a simplification for the patient’s perspective. While the traditional Schroth therapy is still viewed in some circles as the best option for larger curves, Schroth best practice offers an easier to learn program effective for smaller curves. It has been shown by Borysov and Borysov[1] as well as in a paper by Lee 2014[2] that this new program can be highly effective.
These are just two more studies that show that Schroth therapy has real value for the right kind of patient – however, recent research has also called into the question the value of Schroth best practice, over the more traditional approach to Schroth.
Recent studies
A recent meta-analysis (that is to say, a study of studies[3]) looking at the overall effectiveness of Schroth based approaches have provided us with a timely reminder that the right treatment at the right time is critical – since contrary to the evidence from Borysov and Lee, this study found that the more traditional Schroth and Schroth 3d treatment programs actually have provided a more favourable effect than the newer best practice approach.
The finding is somewhat complex – among 15 studies that were included in this meta-analysis, eight studies investigated general Schroth exercise, four studies investigated Schroth 3d treatment, and three studies investigated Schroth best practice. all 4 Schroth 3d treatment studies covered a 6 month (or longer) treatment period – however, only 1 Schroth best practice study was conducted over a 6 month period. The two other studies investigated Schroth best practice treatment for 1 month and under 1 week. This is problematic since only “Bootcamp” style scoliosis treatment options actually provide treatment for under a month – and it’s widely recognised (including by the Schroth best practice school of thought) that longer duration treatment will be more effective – nonetheless, over the short term, the more traditional approaches appeared to be more effective.
From this, the study authors concluded that the improvements added to the Schroth best practice approach notwithstanding, exercise duration is more important than the specific type of Schroth therapy being for overall results. [4]
Is Schroth best practice the way forward?
Schroth best practice is just one strand of treatment within the Schroth group of approaches – Like all approaches, some studies show better results and others, and, being a fairly new approach, it will also take some time for those truly long-duration studies to become available. At the UK Scoliosis clinic, we view Schroth best practice, like more traditional Schroth, as an excellent tool under the right circumstances. We believe in a wholly customised approach, taking the best from whichever therapy is most likely to assist the specific patient in question. What is clear, however, is that just as with bracing, choosing a treatment approach and sticking with it over time is critical for success in non-surgical scoliosis treatment.
[1] Maksym Borysov* and Artem Borysov Scoliosis short-term rehabilitation (SSTR) according to ‚Best Practice’standards-are the results repeatable? Scoliosis 2012, 7:1
[2] Lee SG. Improvement of curvature and deformity in a sample of patients with Idiopathic Scoliosis with specific exercises. OA Musculoskeletal Medicine 2014 Mar 12;2(1):6
[3] Joo-hee parK et al. Effects of the schroth exercise on idiopathic scoliosis: a meta-analysis European Journal of Physical and Rehabilitation Medicine 2018 June;54(3):440-9
[4] Joo-hee parK et al. Effects of the schroth exercise on idiopathic scoliosis: a meta-analysis European Journal of Physical and Rehabilitation Medicine 2018 June;54(3):440-9
