Purpose: Research suggests that physical exercise improves scoliosis patients’ respiratory function, strength and postural balance; however, further research is needed to prove its effect for treating the skeletal deformity. The Schroth method is a form of effective treatment used at FYZICAL Therapy & Balance Center of Naperville. Patients are making successful gains in decreasing curvatures, as seen on future X-rays via Cobb angle measurements, including skeletally mature patients.
Patient: The subject of this case study is a 15 year-old female with idiopathic scoliosis. She traveled from Indiana to come to the clinic for therapy sessions. The patient is active in water skiing, running, and dancing. She was diagnosed in July 2013, and treatment with FYZICAL started October 2013. Her Cobb angle measurements were 24 degrees right thoracic and 31 degrees left lumbar. Goals of therapy were to prevent progression of her curve, with the possibility of reducing severity of curvature.
Overview of Treatment Plan:
The patient was seen for therapy with Dr. William Block, DPT, for the Schroth method of treating scoliosis. Her sessions served to educate her about her curve tendencies and postural corrections to carryout in therapy and ideally day-to-day life. A home exercise program (HEP) was demonstrated prior to her departure. Initially, she was offered postural corrections and pelvic corrections; hanging and supine, side-lying, seated, and prone exercises focused on breathing through postures were prescribed. Pictures are provided of the exercise with notes on how to properly perform HEP poses. The patient returned to review preceding exercises, progress the exercises, continue execution of the new HEP, reach a point where continue HEP for longer term without visits to therapy.
Progression of Treatment:
Evaluation: The patient was evaluated and treated for one hour, followed by three days of intensive 2-hour sessions on exercises. The patient received pictures with commentary about the goals of the postures in each exercise. She then followed a home exercise program for one month, 15 minutes per day until the next visit.
Follow-up 1: The patient came in the first week of November after one month of HEP for a two-hour session. Corrections were provided in order to better the postural accuracy of the exercises. HEP was updated by adding exercises and increased duration of postures. Daily regimen progressed to 20 minutes per day.
Follow-up 2: The patient came after another month of HEP for a two-hour session. Patient continues independent HEP due to increased technique efficiency. The HEP was updated by adding more core work and total body exercises. Patient expected to perform 20 minutes per day.
Follow-up 3: The patient came in the last week of January after another month of HEP for a two-hour session. As shown in follow up X-Ray, the patient’s curve had improved. Cobb Angle measurements improved for thoracic curvature 18 degrees and lumbar curvature 11 degrees. Dr. William Block noted patient had improved postural symmetry, rib expansion measurements, body awareness, and strength. It was in the best interest of the patient to continue HEP. HEP was updated and finalized for patient to continue 10-15 minutes exercises per day to maintain postural corrections, and reduce progression of curve.
Final update: After 6 months, patient updated Dr. Block on periodic X rays with her physician. Follow up X-Ray done in September 2014 suggested her thoracic curve was 16 degrees and lumbar 11 degrees.
- Patient participated in 6 PT sessions, either one or two hours in duration
- Right thoracic curve improved 24 to 18 degrees
- Left lumbar curve improved 31 to 11 degrees
Conclusions: Utilizing Schroth method based exercises in sessions and at home resulted in reduction of curvatures. The Schroth based physical therapy suggests efficacy in reducing Cobb angle measurements in skeletally mature idiopathic scoliosis patients.