X-ray of teenage spine with Scoliosis
What is Schroth specific physiotherapy for Scoliosis?
Rosemary Marchese is a Physiotherapist in Sydney, Australia who has travelled to New York to train in the Schroth Method for the conservative (non- surgical management) of scoliosis, kyphosis, and postural related issues.
Schroth therapy can play an integral role in minimising the risk of progression and the need for surgery secondary to the scoliosis, as well as improving lung and digestive function, independence with activities of daily living, musculoskeletal symmetry and balance and more.
The BSPTS Schroth based method for Scoliosis
The use of this method usually begins during adolescence for people with idiopathic scoliosis or kyphoscoliosis and a Cobb angle greater than 15 degrees (this is one of the measurements taken from the X-ray). The scoliosis specific exercises are based on the original works of Katharina Schroth. The research and knowledge have been further developed and taught by the Barcelona Scoliosis Physical Therapy School (BSPTS) under the guidance of Dr. Manuel Rigo.
The BSPTS is a recognised method for the treatment of scoliosis by the International group Society of Scoliosis Orthopaedic Rehabilitation Treatment (SOSORT). A good time to begin the exercises is when the person is in the adolescent growth spurt because of the increased risk of curve progression during that window of time. Maturity level is also very important, as the client needs to be able to concentrate and follow directions as exercises are taught. If the child is younger they are more appropriate for a modified version of the program. All sessions are directed by a Schroth-Certified BSPTS Physiotherapist. The physiotherapist will review X-ray films, perform a musculoskeletal evaluation and create a program that is specific to the circumstance and curve pattern of the individual. A home exercise program will be developed, including photographs and often a video to assist with the carryover of all the corrections and exercises for the home program.
Exercises have been shown to have a positive effect on decreasing the progression of curves, improving posture, lung and organ function, and for pain management.
The exercises use the following principles of correction including:
- Self-elongation from a neutral stable pelvis.
- The ability to recognise the different shapes of each side of the back and how to produce forces to decrease this difference–initially in a support position progressing to being upright and while moving. The correction is in 3D – it’s not just a simple ‘sideways curve of the spine’.
- Corrective breathing is then used to expand area of the spine that are compressed due to the scoliosis.
- Stabilisation/strengthening in the corrected posture, which carries over to activities of daily living.
What changes, if any, are expected?
The changes the exercises make in the spine depend on various factors including Cobb angle, skeletal health and maturity, trunk imbalance, amount of rotation, amount of soft tissue tightness, and degenerative changes in the discs or the joints of the back, and general health and activity level. Improvements in pain levels and function are also major goals of treatment.
Of course, other physiotherapy treatment modalities may be used as needed, but it is essential that those with scoliosis are more aware of the benefits of the Schroth Method and that this type of care can only be delivered by physiotherapists that have passed certification examinations and extensive specialised training – this is not your ordinary back care.
Education about scoliosis
Education of the child and family is a vital part of the process. Knowing what to do and what to avoid is all part of the approach. Some exercises can actually make the scoliosis worse so it’s important for the child and family to be aware of this. However we encourage physical activity and all efforts are made to support a physically active lifestyle. Scoliosis can be stressful enough, so it is important to create a motivating and comforting environment for the child and family.
Does this mean my child won’t need a brace?
Not necessarily. The treatment plan for all cases is individualised and it is important that the physiotherapist liaises with the other health professionals involved as required.
If you are interested in finding out more here are some research articles on the effectiveness of physiotherapy scoliosis specific exercise programs. Some of these can be found on the free database PUBMED or ask at your local library.
- Schreiber S, Parent EC, Moez EK, et al. The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis-an assessor and statistician blinded randomized controlled trial: “SOSORT 2015 Award Winner”. Scoliosis. 2015;10:24.
- Kuru T, Yeldan İ, Dereli EE, Özdinçler AR, Dikici F, Çolak İ. The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis: A randomised controlled clinical trial. Clin Rehabil. 2015
- Monticone, M, Ambrosini, E, Cazzaniga, D, Rocca, B, Ferrante, S. Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial. European Spine Journal Eur Spine J. 2014:1204–1214.
- Schreiber, Sanja; Parent EC,; Mez EK, et al. Schroth Physiotherapeutic Scoliosis-Specific Exercises Added to the Standard of Care Lead to Better Cobb Angle Outcomes in Adolescents with Idiopathic Scoliosis – an Assessor and Statistician Blinded Randomized Control Trial. PLoS ONE 11 (12): e0168746. doi: 10.1371/journal. Pone.0168746
- Scoliosis Research Society (SRS) Statement on Physiotherapy Scoliosis Specific Exercises go to https://www.srs.org/about-srs/quality-and-safety/position-statements/srs-statement-on- physiotherapy-scoliosis-specific-exercises
Please reach out at any time with any questions or concerns.