A Pilot Study on the Effect of Outpatient Schroth Exercises on Thoracolumbar and Lumbar Curves in Adult Scoliosis Patients

Abstract

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.

Conservative Treatment of Degenerative Lumbar Scoliosis

“…The study, however, did not evaluate the impact of the exercises on pain and disabilities [70]. A prospective pilot study by Ng et al [72] showed that 9 months of scoliosisspecific exercises at home reduced the thoracolumbar or lumbar curves in over 30% of the ADIS and DLS subjects [72]. Also, our unpublished study showed that 6 weeks of SSE reduced pain and disability ratings of subjects with ADIS and DLS.…”

“…The poor outcomes of the above interventions are not unexpected, as the treatments were directed towards pain relief, but not the deformities and the global imbalance that are causing the symptoms [69]. Treatment approaches that target spinal deformities yielded better results in terms of reduction in pain and disability ratings in ADIS patients [70][71][72][73][74][75][76]. Yet, it has to be noted that many of the studies targeted younger cohorts who suffered from ADIS rather than DLS.…”

“…Many case reports and case series studies have reported that scoliosis-specific exercises (SSE) and multi-modal rehabilitation reduce pain, disability, and curves in patients ADIS [70][71][72][73][74][75][76]. Yet, only a few studies have targeted patients with DLS.…”

“…While many studies have addressed the coronal curves in ADIS and DLS patients, very few studies have addressed the impact of SSE on the sagittal profile of patients [72]. The effects of SSE on the sagittal profile of this group of patients are thus uncertain.…”

Physical Rehabilitation in the Management of Symptomatic Adult Scoliosis

“…The above treatments aim at pain reduction and stabilization of the curve, but not at the sagittal imbalance which is so often seen in patients with DLS. Recent studies have shown that physiotherapeutic scoliosis-specific exercises (PSSE), mirror image exercises, and chiropractic manipulation together with multimodal rehabilitation reduced pain and disability ratings in ADIS patients with thoracolumbar and lumbar curves [55][56][57][58][59][60][61][62][63][64][65][66][67]. Also, bracing is able to stabilize progressive curves in 80% of the adults with scoliosis [68].…”