Corrective exercises specific for adolescent idiopathic scoliosis presented with bilateral leg pain: a case report describing an adaptive program and the recorded improvement as expressed by Cobb angle

Abstract

Adolescent idiopathic scoliosis is considered as the most common type of scoliosis. A 13-year-old female complained of bilateral leg pain, left > right, and severe headache. She was referred to an orthopaedic physical therapy clinic. Spinal X-ray revealed right thoracolumbar scoliosis with Cobb angle of about 48°. The primary curve was in the lumbar vertebrae, directed to the left, and the secondary curve was in the thoracic vertebrae, directed to the right. Two surgeons recommended corrective surgery, while one recommended physiotherapy for 6 months. The third surgical opinion was based on magnetic resonance imaging that presented normal cervical spine, mild scoliotic deformity of lower dorsal vertebrae with right-sided convexity and of lumbar vertebrae with left-sided convexity, L4–5 broad based posterior and left posterolateral disc protrusion, and L5–S1 mild central posterior disc protrusion. At the final evaluation after 18 months of a corrective exercise program, the patient reported no symptoms at rest or with exercises. The improvement was evidenced by Cobb angle change from 48° to 21°, pelvic shift, and general spinal flexibility and strength. The current case report describes a specific corrective exercise protocol adapted to a case of adolescent idiopathic scoliosis that presented with bilateral leg pain.

Evaluations of the spinal curvatures in the sagittal plane: reference measurements, categorization, discriminatory and diagnostic accuracy

“…When an individual maintains their spinal curvatures in the sagittal plane with adequate patterns, there is a better distribution of the loads on the vertebral structures and improved impact absorption capacity. in turn, changes in these curvatures cause an imbalance in the forces on the spine and can lead to injury [30]. SEN -sensitivity, SPE -specificity, LR+ -positive likelihood ratio, LR--negative likelihood ratio, PV+ -positive predictive value, PV--negative predictive value, x -the calculation could not be carried out since some of the entered values included one or more zero instances Some studies have provided reference values for postural patterns, but some left a void with respect to a definition of this parameter, since the lack of symptoms does not guarantee the absence of postural alterations [8,17].…”