Physical Therapy and Exercise
Specific scoliosis rehabilitation and exercise programs can play an important role in scoliosis treatment.
Traditionally there has been the opinion that “exercise and physiotherapy does not work for scoliosis”.
While this maybe true for general physiotherapy or general exercise programs such as core stability programs being used to try and stop progression of idiopathic scoliosis.
The development of scoliosis specific programs offer new approaches to scoliosis treatment that are growing in evidence.
For example in a small adolescent idiopathic curve i.e. less than 20 degrees where there is a family history of scoliosis, a specific scoliosis physiotherapy program such as SEAS may be the most suitable treatment. Another example can be when a curve is non progressive i.e. in late adolecents or middle age. With CBP or CLEAR alone it maybe be possible to help improve posture, manage pain and stabilise the spine.
In cases of a progressive idiopathic scoliosis where the curve is greater than 20 degrees, rehabilitation, exercise programs and physiotherapy are not considered strong enough treatments and their main benefit is when used in conjunction with bracing.
Research has shown that when specialised scoliosis rehabilitation and exercise programs have been used in conjunction with bracing it has improved the results of hard bracing. In this case the exercise programs seem to help to strengthen the muscles supporting the spine and keep the spine flexible during brace treatment and to help maintain the correction achieved with bracing.
It is important to understand that only specialised scoliosis rehabilitation and exercise programs that are specifically designed to treat scoliosis, such as the SpineCor exercise program, SEAS, Schroth, Chiropractic BioPhysics and CLEAR, have been shown to be helpful.
SEAS stands for the Scientific Exercise Approach to Scoliosis. It is a technique developed in Italy. It is the most evidence based Physical therapy or Rehabilitation approach to treating scoliosis and has been in use for over 20 years. It involves assessing the patient for weakness in muscle balance and strength, flexibility and neurological control. The patient is then taught how to do an Active Self Correction that is specific to that curve. Once the patent has mastered the Active Self Correction they are then taught a series of exercises that target the identified weaknesses while also performing the active self correction.
Chiropractic Biophysics often referred to as CBP, is a biomechanically based technique system that uses a combined chiropractic and rehabilitation approach. CBP uses a concept of mirror image correction i.e if the torso is shifted over to the right then it is over corrected to left with the goal of eventual re-alignment. CBP uses a protocol called EAT, which involves mirror image Exercise, Adjustment and Traction. Traction as used in CBP is not the traditional pulling from each end of the spine which is actually called “distraction”. In the CBP approach, traction refers to an overcorrection of the posture and spine with the aid of specialised stretching equipment.
There are several published case studies and case series showing improvement in postural/psudo scoliosis, mature idiopathic and adult scoliosis. As a treatment by itself CBP is not proven for progressive childhood scoliosis, but my be useful as an adjunct treatment to bracing.
CLEAR Institute The CLEAR Institute is a chiropractic technique system that focuses on scoliosis treatment. CLEAR shares similar origins to CBP but there are some differences in treatment approach. CLEAR practitioners use seated x-ray analysis and a mix of seated traction and flexion distraction tables in combination with vibration and balance exercises.There is a focus in CLEAR treatment on attempting to restore the normal sideways curve of the neck as CLEAR practitioners are taught that this is an underlying cause of scoliosis. There are several published case studies and case series showing improvement in mature idiopathic and adult scoliosis. As a treatment by itself CLEAR is not proven for progressive childhood scoliosis, but my be a useful treatment in combination with bracing in Juvenile and adolescent cases.