Neuropathological Aspects of Conservative Treatment of Scoliosis – A Theoretical View Point

Abstract

An upright body posture cannot be maintained passively for reasons including a high location of the centre of gravity (COG) and a small support area. Proper alignment of body parts is maintained automatically, tending towards a pattern encoded in the CNS. A particularly important role in posture regulation is played by the short muscles of the back, which respond to being stretched with a contraction. During the early phase of scoliosis, the CNS automatically corrects abnormalities, but over time habituation occurs and the CNS treats them as something normal. Any attempt to restore proper body alignment is treated as an error and CNS automatically restores this abnormal pattern. With a prolonged deviation in body part alignment, CNS treats it as a defect and runs compensatory mechanisms to restore the balance of the body as a whole. Balance is ensured by postural compensation, but this does not restore proper body part alignment. In the treatment of scoliosis, it is important both to slow down progression and to prevent the development of abnormal postural habits, which are part of a vicious circle even without progression. Secondary prevention is therefore needed in all patients. Passive observation limits the possibilities for prevention and contradicts the principle of early implementation of rehabilitation. Depending on the size of the angle of curvature, recommended treatments of scoliosis comprise observation, corset bracing, and surgery. Physiotherapy is often treated as an unconventional and ineffective treatment. Often, the biggest problem is transferring the resulting correction to automatic maintenance of a correct posture in the vertical position. The aim of this paper was to discuss the conservative treatment of scoliosis with regard to difficulties maintaining the correct alignment of the body parts in the vertical position that accompany scoliosis.

Serial Case Reporting Yoga for Idiopathic and Degenerative Scoliosis

“…14 The studies evaluating the efficacy of bracing and other conservative therapies are inconsistent, and thus their findings must be regarded as inconclusive. [15][16][17][18][19][20][21][22][23][24][25][26][27][28] Several small studies are optimistic about yoga-like media alcanzó un 40,9 %. No hubo diferencias significativas de las mejorías entre los subtipos adolescentes idiopáticos y degenerativos (un 49,6 % y un 38,4 %, respectivamente).…”

Postural Rehabilitation for Adolescent Idiopathic Scoliosis during Growth

“…School children spend many hours writing, reading, watching TV and doing homework on a daily basis. Their sitting postures are important, because improper sitting postures may result in progression of spinal curvatures [ 23 ]. Studies have shown that children habitually slumped or when were asked to relax.…”

Scoliosis: Review of types of curves, etiological theories and conservative treatment

“…Seven studies [2,5,[21][22][23][24][25] discuss its biomechanics, pathogenesis and kinematics. For treatment of scoliosis, two studies [3,8] talk about surgery and fifteen studies [4,[9][10][11][12][26][27][28][29][30][31][32][33][34][35] about different forms of conservative treatment.…”

“…One being Postural scoliosis (Grade I), which is without any bony changes or muscular weakness [26]. The causative factor may be the impairment of the postural reflex mechanism or wrong postural habits.…”

“…Early detection in school screening programs has also led to successful non-operative management of idiopathic scoliosis [12]. Depending on the size of the angle of curvature and its progression, recommended treatments of scoliosis comprise thorough observation (to prevent the progression), corset bracing and in the last surgery [26].…”