Tag: scoliosis specific exercise

What Is Scoliosis Specific exercise?

Posted on May 20, 2024 by - Blog

Every Scoliosis case is unique, and at the UK Scoliosis clinic, we believe this means each case needs a unique treatment program. Scoliosis-specific exercise is just one of the many tools which we can use to treat scoliosis cases.

Historically, general exercises like Pilates and yoga (sometimes performed in a specific way) were used as an attempted treatment, but modern research has shown that they lack a direct impact on its prevention or control. Fortunately, two specialised approaches, Schroth and SEAS, have emerged as effective tools for reducing scoliosis progression and promoting correction.

 

Understanding Scoliosis-Specific Exercise

Scoliosis-specific exercises are meticulously designed routines, customised for each patient, aiming to counteract the curvature of scoliosis. Unlike bracing, scoliosis-specific exercise does require consistent effort on the part of the patient since the focus is on self-correction and maintaining improved posture in daily life.

 

SEAS – Scientific Exercise Approach To Scoliosis

SEAS is an individualised exercise program tailored for scoliosis treatment. It can be used independently for small curves or as a complement to bracing for larger curves and those with high progression risks.

 

Schroth Method

The first scientific approach to treating Scoliosis with exercise, Schroth was developed in 1921 by Katharina Schroth. The Schroth method consists of over 100 individualised exercises chosen based on the patient’s specific curve. The program addresses functional issues associated with scoliosis, actively working to improve the condition during everyday life, not just during targeted exercise sessions.

 

Chiropractic Biophysics (CBP)

While not directly designed for Scoliosis treatment, Chiropractic Biophysics deserves an honourable mention. CBP involves a biomechanical analysis of the spine and posture, followed by a targeted program aimed at shifting them back to normal alignment. There’s currently no research which recommends CBP as a mainline Scoliosis treatment, however at the UK Scoliosis clinic we sometimes also use it as part of a comprehensive rehabilitation plan for individuals who are suffering back pain.

 

Effectiveness of Scoliosis-Specific Exercise

Research indicates that physiotherapy-based scoliosis-specific exercise programs are effective in managing small curves (10-20 degrees) in adolescence. For curves exceeding 20 degrees, exercise alone is not considered sufficient, but it enhances long-term results when combined with bracing. These programs improve muscular balance, strength, spinal flexibility, neuromuscular coordination, postural symmetry, and reduce pain in adults with scoliosis.

 

Scoliosis-Specific Exercise at the UK Scoliosis Clinic

The UK Scoliosis Clinic offers individually tailored programs as standalone treatments or as part of comprehensive plans involving bracing and complementary approaches. Recognising that one size does not fit all, our clinic emphasises regular review, updating, and modification of exercise programs to ensure continuous improvement tailored to each patient’s needs and abilities.

 

Disadvantages of Scoliosis-Specific Exercise

Posted on March 19, 2023 by - Blog

While there are several non-surgical treatment options available for scoliosis, scoliosis-specific exercise is a popular method that, like bracing, is gaining popularity. However, like any treatment approach scoliosis specific exercise also has its disadvantages that need to be considered.

 

Scoliosis Specific Exercise

Scoliosis-specific exercise is a highly specialised area of physiotherapy-based approaches to treating musculoskeletal conditions – unlike normal forms of physiotherapy, it does not focus on symmetrical, therapeutic movements, but rather attempts to use a person’s own body and strength to oppose a Scoliotic curve. Scoliosis-specific exercise – specifically the Schroth method, is the oldest approach to scoliosis treatment and has now been practised for over a hundred years. There’s no question that exercise-based approaches can indeed stop the development of Scoliosis and reduce it in some cases[1] – so it’s well worth considering. However, there are some disadvantages:

 

Limited impact on larger curves

One of the biggest disadvantages of scoliosis-specific exercise is the lack of scientific evidence supporting its effectiveness in larger curves. Most studies conclude that bracing is a better approach for larger curves and is a faster way to correct scoliosis overall. Some studies do show that exercise approaches may be effective in slowing the growth of a curve[2], but what’s needed (especially in a more significant case) is correction – not just slowing.  That being said, it does seem that combining an exercise-based approach with bracing is more effective than bracing alone.[3]

 

Requires commitment and consistency

Like any exercise program, Scoliosis specific exercise requires commitment and consistency. The exercises must be performed regularly to see any benefits, and this can be challenging for some patients – especially young children. Some patients may find it difficult to maintain the same level of motivation over a prolonged period. This can be especially challenging for people who are already struggling with chronic pain, making it harder for them to keep up with the exercises. Sadly without consistency, exercise-based approaches will not work.

 

Requires supervision

Scoliosis-specific exercise programs require supervision to be truly effective – like bracing, a treatment plan needs constant monitoring and adjustment to have the best possible impact. This can be a disadvantage for people who live in remote areas or do not have easy access to a scoliosis specialist. Patients who attempt to perform exercises without proper guidance may inadvertently worsen their condition. This is why it is crucial to seek professional advice and maintain it while using exercise-based approaches to treatment.

 

Can lead to muscle imbalances

Scoliosis-specific exercise focuses on strengthening specific muscles to correct the curvature of the spine. However, this can lead to muscle imbalances, where some muscles become overdeveloped while others remain underdeveloped. Muscle imbalances can cause pain and discomfort, and in severe cases, can lead to other medical conditions such as joint problems. When a program is properly monitored by a professional this shouldn’t be a problem – but it’s a risk for anyone who does not have the proper guidance.

 

Does not address underlying issues

While exercise-based approaches may be effective in reducing the curvature of the spine and alleviating pain in some cases, it does not address the underlying issues that led to scoliosis. In some cases, scoliosis may be caused by underlying medical conditions such as neuromuscular disorders or genetic factors, but the typical idiopathic scoliosis seen in teenagers and young people cannot be “cured” with exercise. To be fair, it cannot be “cured” with bracing either – the only way to truly manage the condition is to maintain the spine in as straight an alignment as possible until skeletal maturity is reached. Many professionals view that this is easier to do with bracing than exercise, because of the cost and effort involved in 10-15 years of exercise monitoring.

 

Is Scoliosis specific exercise right for me?

Scoliosis-specific exercise can be a valuable part of an overall treatment plan and may be the right option for some smaller curves, or stable curves in adults. This being said, it has its disadvantages, and patients should carefully consider these before deciding on this treatment option alone.

 

 

[1] ‘SEAS (Scientific Exercises Approach to Scoliosis): a modern and effective evidence based approach to physiotherapic specific scoliosis exercises‘
Romano M, Negrini Am Parzini S, Tavernaro M, Zaina F, Donzelli S and Negrini S 2015, Scoliosis 2015 10:3, DOI: 10.1186/s13013-014-0027-2

 

[2] ‘Scoliosis-Specific exercises can reduce the progression of severe curves in adult idiopathic scoliosis: a long-term cohort study’
Negrini A, Donzelli S, Negrini M, Negrini S, Romano M, and Zaina F 2015,, Scoliosis Jul 11 10:20

 

[3] ‘The effectiveness of combined bracing and exercise in adolescent idiopathic scoliosis based on SRS and SOSORT criteira: a prospective study‘
Negrini S, Donzelli S, Lusini M, Minnella S and Zaina F 2014, BMC Musculoskelet Disord. 2014; 15: 263, Published online 2014 Aug 6. doi:  10.1186/1471-2474-15-263

 

Is exercise recommended for people with scoliosis?

Posted on March 30, 2019 by - Blog

The role of sport and exercise as it relates to scoliosis and its treatment is a complex one. It has been known for some time that participants in some activities, such as gymnastics, seem to have a higher risk of developing scoliosis – at the same time, it has also long been suggested that exercises such swimming could help to reduce scoliosis. These are just two examples of the seemingly contradictory information available on scoliosis and exercise – this week, we summarise the latest findings and guidelines.

 

Do some forms of exercise cause scoliosis?

At present, there is certainly evidence to suggest that participants in some activities, such as gymnastics or dance have a higher chance of developing scoliosis. Indeed, research suggests that gymnasts are up to 12 times more likely to develop scoliosis than non-gymnasts on the whole.[1] There is a 10-fold higher incidence of scoliosis among rhythmic gymnasts[2] and an increased incidence of scoliosis has been reported in ballet dancers (24%)[3] What this observation does strongly suggest is the value of regular scoliosis screening for those involved in gymnastics, ballet and other forms of exercise which involve much contortion of the body and spine. What this evidence does not necessarily mean is that gymnastics causes scoliosis, since correlation does not necessarily mean causation.

While it does seem as though patients with scoliosis are more likely to participate in sports like gymnastics[4] it is now thought that this is because patients with scoliosis tend to have a higher prevalence of joint laxity than the general population this makes them more flexible[5], which would be a natural advantage in these activities. Therefore, avoiding such activities probably won’t do anything to prevent or avoid scoliosis.

 

Isn’t exercise good for everyone?

At the risk of providing a very simplistic answer, yes. Almost all scoliosis clinicians agree that those with scoliosis should actively take part in sport and physical activities[6]. This is not least because the psychological and social aspects of exercise are shown to be related to the patient’s self-image in a positive way[7] – indeed, it has also been reported that persons with scoliosis who exercise regularly, show higher self-esteem and have better psychological outcomes from treatment[8]. Therefore, SOSORT also recommends that patients with scoliosis should remain active in sports activities[9], especially since, as outlined above, participation does not seem to directly affect the occurrence or degree of scoliosis[10].

 

Can exercise cure scoliosis?

Tired out girl

Specialised forms of exercise can treat scoliosis, but most forms of exercise still make a positive contribution to health !

It was once thought that a range of everyday exercises may be beneficial for scoliosis suffers – today the picture s more refined. For example, it was once widely reported that popular forms of general exercise, such as swimming (which has traditionally been recommended as a good sports activity for scoliosis and even prescribed by some physicians as a treatment),could be a possible corrective approach. Now we know that swimming does not seem to have any positive effect on scoliosis, although its certainly a great low-impact form of exercise, and a lot of fun!

To return to the point about causation and correlation, there is also at least one older study from 1983, which screened 336 competitive adolescent swimmers for scoliosis and found the prevalence of scoliosis to be 6.9%[11], which is more than double the average. Despite this, there is no evidence to suggest that swimming is a causative factor of scoliosis.

If general exercise does not seem to improve scoliosis, is there an approach that can? In fact, there are several forms of specialised exercise which have now been developed with the sole aim of reducing and controlling scoliosis – these are the Schroth and SEAS approaches, both of which have proven to be successful alone, and far more successful when combined with bracing. You can learn much more about both approaches on our site – but for more information please don’t hesitate to get in touch!

 

 

[1] Prevalence and predictors of adolescent idiopathic scoliosis in adolescent ballet dancers’

Longworth B., Fary R., Hopper D, Arch Phys Med Rehabil. 2014 Sep;95(9):1725-30. doi: 10.1016/j.apmr.2014.02.027. Epub 2014 Mar 21

[2] Tanchev PI, Dzherov AD, Parushev AD, Dikov DM, Todorov MB. Scoliosis in rhythmic gymnasts. Spine. 2000;25(11):1367–72.

[3] Warren MP, Brooks-Gunn J, Hamilton LH, Warren LF, Hamilton WG. Scoliosis and fractures in young ballet dancers. Relation to delayed menarche and secondary amenorrhea. N Engl J Med. 1986;314(21):1348–53.

[4] Meyer C, Cammarata E, Haumont T, Deviterne D, Gauchard GC, Leheup B, et al. Why do idiopathic scoliosis patients participate more in gymnastics? Scand J Med Sci Sports. 2006;16(4):231–6.
Meyer C, Haumont T, Gauchard GC, Leheup B, Lascombes P, Perrin PP. The practice of physical and sporting activity in teenagers with idiopathic scoliosis is related to the curve type. Scand J Med Sci Sports. 2008;18(6):751–5.

[5] Kesten S, Garfinkel SK, Wright T, Rebuck AS. Impaired exercise capacity in adults with moderate scoliosis. Chest. 1991;99(3):663–6.

[6] Liljenqvist U, Witt K-A, Bullmann V, Steinbeck J, Völker K. Empfehlungen zur Sportausübung bei Patienten mit idiopathischer Skoliose. Sportverletz Sportschaden. 2006;20(01):36–42.

[7] Fällström K, Cochran T, Nachemson A. Long-term effects on personality development in patients with adolescent idiopathic scoliosis. Influence of type of treatment. Spine. 1986;11(7):756–8.

[8] Liljenqvist U, Witt K-A, Bullmann V, Steinbeck J, Völker K. Empfehlungen zur Sportausübung bei Patienten mit idiopathischer Skoliose. Sportverletz Sportschaden. 2006;20(01):36–42.

[9] Negrini S, Aulisa L, Ferraro C, Fraschini P, Masiero S, Simonazzi P, et al. Italian guidelines on rehabilitation treatment of adolescents with scoliosis or other spinal deformities. Eura Medicophys. 2005;41(2):183–201.

[10] Kenanidis E, Potoupnis ME, Papavasiliou KA, Sayegh FE, Kapetanos GA. Adolescent idiopathic scoliosis and exercising: is there truly a liaison? Spine. 2008;33(20):2160–5.

[11] Becker TJ. Scoliosis in swimmers. Clin Sports Med. 1986;5(1):149–58.

Scoliosis specific exercise can reduce curve progression in adult scoliosis patients

Posted on July 13, 2018 by - Blog

While many of the patients we see at our clinic are children with juvenile or adolescent scoliosis, adult scoliosis cases also represent a significant percentage of those we help. There are many approaches which can be used in tackling adult scoliosis, but one of the most commonly chosen is scoliosis specific exercise. It was once thought that surgery was the only effective treatment for adult scoliosis, but today research is confirming that high quality, individualised treatment programs can be effective in stopping the progression of scoliosis in adults.

 

Adult scoliosis – an important field of research

While scoliosis clinicians often tend to focus on scoliosis in adolescents, it has long been known that idiopathic scoliosis can (and often does) continue to progress during adulthood after skeletal maturity[1], when growth has stopped.

While the development of scoliosis in adults is slower, over time the curve does worsen which can lead to a reduction in functional capacity and the development or the worsening of spinal pain and associated radicular symptoms[2](pain which radiates from the root of a nerve at the spinal column into the arms or legs), as well as spinal degenerative changes. This means that research into the best ways to tackle adult scoliosis is equally important as in adolescent scoliosis.

In fact, more than 60 % of cases of adult scoliosis progress, particularly in the case of curves exceeding 30 ° Cobb at skeletal maturity, regardless of the curve pattern[3]. Unlike adolescent scoliosis however, Marty-Poumarat[4] has shown that the rate of progression in adult scoliosis is linear (regular and constant) and can therefore be used to establish an individual prognosis. This rate of progression, if left untreated is deemed to be around 0.5-1 °per year[5].

While the prevailing view for some time has been that adult idiopathic scoliosis was only suitable for treatment with surgery when the curve becomes significant enough – more recent research clearly suggests that non-surgical approaches can be effective in reducing curve magnitude and halting progression, potentially eliminating the need for surgery in many cases.

In a short-term case series Weiss et al. showed 43.93 % of 107 patients improved 5 or more Cobb degrees immediately after 4 – 6 weeks of in-patient scoliosis specific exercise program[6], while Morningstar et al. showed that 19 patients treated with spinal manipulation and various physiotherapeutic procedures reported immediately after the therapy an average correction of 17 ° Cobb [7][8]. In an earlier case report, Negrini et al. showed a 18.5 Cobb degrees reduction after one year of Scoliosis Specific SEAS exercises[9].

 

Treating adult scoliosis with scoliosis specific exercise – new research

Now, a larger study by Negrini et al. has now gone further in establishing the effectiveness of SEAS exercises in reducing the progression of scoliotic curves. SEAS exercises (one of the types we utilise in our own clinic) are scoliosis-specific exercises. In adult patients they are aimed to recover postural collapse, postural control and vertebral stability through the process known as active self-correction. Typically, therapy includes at least two weekly exercise sessions each lasting 45 min – but exercise prescription varies significantly in both length and frequency, since to be effective an exercise program must be individually tailored.

The study considered adults (18 years or more) who exhibited curves larger than 30° and documented curve progression during adulthood (at least 6° Cobb) or adults with curves larger than 40° who had refused surgical treatment. Patients were prescribed Scoliosis Specific SEAS Exercises exclusively and were required to practice their exercises regularly for at least ten months per year. Patients were assessed a minimum of 1 year after their first assessment, via x-rays which were independently verified.

 

Results

The results from the study were highly encouraging – it confirmed that that Scoliosis Specific Exercises can be effective to obtain stability and, in some cases, to reduce the Cobb angles by degrees. In highly progressive curves, exercises appear to slow down the progression of the curvature (worsening).  Of the 34 patients included in the study, an average reduction of 4.1 degrees cobb was achieved after one year. [10]

More broadly, the study also went to confirm the fact that scoliosis specific exercise programs need to be maintained and monitored, and that the patient must continue to adhere to the exercise program in the long term in order to see sustained improvement.[11]

While the authors of the study were pleased with the outcome, it’s fair to say that more research on scoliosis specific exercise is required and will continue to be published over the coming months and years. Future larger, long term, observational studies will provide us with more insight on defining the best Scoliosis Specific Exercises management approach and explore other very important issues associated with adult progressive spinal deformities, such as, sagittal global balance, back pain, disability and quality of life.

 

Treatment for adult scoliosis at the UK Scoliosis Clinic

At the UK Scoliosis clinic, we utilise a variety of approaches as part of our scoliosis specific exercise program. This allows us to tailor our approach to our patient’s specific needs – this might include exercise programs based on the SEAS or Schroth methodologies as well as bracing if required. It’s because our scoliosis specialists have such a wide variety of tools at their disposal that we’re able to achieve targeted, measured and provable results for our patients.

 

 

[1] Collis DK, Ponseti IV. Long-term follow-up of patients with idiopathic scoliosis not treated surgically. J Bone Joint Surg Am. 1969;51(3):425 – 45

[2] Guigui P, Rillardon L. Adult spinal deformities. Rev Prat. 2006;56(7):701– 8

[3] Weinstein SL, Dolan LA, Spratt KF, Peterson KK, Spoonamore MJ, Ponseti IV. Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA, J Am Med Assoc. 2003;289(5):559 – 67, Weinstein SL. Natural history. Spine. 1999;24(24):2592–600

[4] Marty-Poumarat C, Scattin L, Marpeau M, Garreau De Loubresse C, Aegerter P. Natural history of progressive adult scoliosis. Spine. 2007;32(11):1227 – 34, discussion 1235.

[5] Ibid.

[6]Weiss HR. Influence of an in-patient exercise program on scoliotic curve. Ital J Orthop Traumatol. 1992;18(3):395 – 406

[7] Morningstar MW, Woggon D, Lawrence G. Scoliosis treatment using a combination of manipulative and rehabilitative therapy: a retrospective case series. BMC Musculoskelet Disord. 2004;5:32.

[8] We wish to note that in this instance, the term ‘immediately’ should be taken literally – more research is needed to establish the long term prognosis offered by CLEAR  and associated approaches.

[9] Negrini A, Parzini S, Negrini MG, Romano M, Atanasio S, Zaina F, et al. Adult scoliosis can be reduced through specific SEAS exercises: a case report. Scoliosis. 2008;3:20

[10] Negarini et al. Scoliosis-Specific exercises can reduce the progression of severe curves in adult idiopathic scoliosis: a long-term cohort study. Scoliosis (2015) 10:20

[11] Ibid.