Study design: This is a pilot prospective cohort study.Objectives: To investigate if outpatient Schroth exercises (SBP) affect thoracolumbar or lumbar curves in adult scoliosis patients.Background: Adult scoliosis tends to progress and is associated with an increased prevalence of low back pain. The outcome of conservative treatment is not satisfactory, as treatment is not directed towards spinal deformity. This study investigates if SBP influences the thoracolumbar and lumbar curves in patients with adult scoliosis. Materials and methods:Adult patients with thoracolumbar and lumbar curves ≥ 20 o were taught SBP exercises once weekly for 4 weeks. They then performed the exercises at home three times a week, for 9 months. Baseline measurements included Cobb angles, coronal offset, sagittal vertical axis (SVA), T4-12 kyphosis, L1-S1 lordosis, sacral slope, pelvic incidence and pelvic tilt. They were compared to post-intervention measurements, using paired t tests.Results: SBP exercises statistically significantly decreased the Cobb angle (p = 0.0032), improved the ATR (p = 0.012), increased the sacral slope (p = 0.03), decreased the pelvic tilt (p = 0.0032) and the SVA (p = 0.032). Conclusion:The SBP exercises improved the Cobb angles and SVA in adult scoliosis patients with thoracolumbar and lumbar curves.
The effectiveness of spinal bracing in the treatment of adolescent idiopathic scoliosis has been controversial. Some studies have shown that bracing is only as effective as observation, whilst others have shown that bracing is superior to observation, halting progression and effectively reducing progression to surgical threshold. Recently, some studies have even shown improvement of curves with bracing. Yet, many of these studies have been judged to be of low methodological quality. In 2005, the Scoliosis Research Society (SRS) attempted to standardize the inclusion criteria and outcome measurements for bracing studies, to enable comparison among studies. In the guidelines, progression of ≤ 5 o is regarded as success. It is apparent that SRS did not regard improvement of curves probable. Improvement which is defined as a decrease of ≥ 6 o was not proposed until 2009. This may reflect an improvement in outcome with bracing in the last one to two decades.
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