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Idiopathic Scoliosis: Conservative Treatment

Idiopathic scoliosis is a three-dimensional spinal deviation of unknown cause, occurring in otherwise healthy children.

The most common form is adolescent idiopathic scoliosis, affecting 0.47-5.2% of adolescents. Diagnosis is based on a Cobb angle greater than 10 degrees, measured on x-ray. Other parameters like trunk rotation and quality of life questionnaires also monitor scoliosis progression and treatment effects. Curve progression depends on sex, growth potential, and curve severity at diagnosis. Girls are more frequently affected, but boys show greater curve progression. Physiotherapy approaches like the Schroth method can treat mild scoliosis. Schroth uses sensorimotor principles and patient education to improve posture and breathing function. The goals of conservative treatment are to address respiratory issues, back pain, and appearance while avoiding surgery. Ongoing research is needed to optimize nonsurgical scoliosis management and prevent deformity progression in vulnerable paediatric populations.  

 Within our program of work, we have completed a meta-analysis which indicates a positive moderate to large effect size of the Schroth method on patients with idiopathic scoliosis (IS) across analysed outcomes. However, this comprehensive analysis was limited by the small number of available studies, limited sample sizes, and few common outcome measures. To build on these promising findings, future high-quality research is needed with larger participant pools, standardised outcomes, and appropriate control groups to minimize bias. There is great incentive to further investigate the Schroth method’s effects on IS patients in order to optimize evidence-based practice. Our study provides initial support for Schroth therapy benefits that can inform clinicians, physiotherapists, and exercise specialists working with IS. This may encourage future research needed to solidify the role of Schroth and conservative scoliosis management in preventing progression in vulnerable paediatric populations. Standardised, rigorous studies will help translate these preliminary findings into improved patient care and outcomes. 

Application of the Schroth Method in the Treatment of Idiopathic Scoliosis: A Systematic Review and Meta-Analysis.

Dimitrijević V, Šćepanović T, Jevtić N, Rašković B, Milankov V, Milosević Z, Ninković SS, Chockalingam N, Obradović B, Drid P. Int J Environ Res Public Health. 2022 Dec 13;19(24):16730. doi: 10.3390/ijerph192416730.

Cosmetic changes in patients following a Schroth exercise regime: a two year follow-up.

Shannon T, Jetvić N, Chockalingam N.Stud Health Technol Inform. 2021 Jun 28;280:302. doi: 10.3233/SHTI210513.

Prof. Nachiappan Chockalingam

Professor of Clinical Biomechanics

CBRT Staffordshire University