Adolescent Idiopathic Scoliosis (AIS): Conservative Care

Adolescent Idiopathic Scoliosis (AIS) management is determined by multiple factors including those discussed in the previous post. Degree and nature of the curve and age of the patient are important considerations. The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) has developed guidelines for conservative care, which may include any of the following treatments (not a complete list):

  1. Physiotherapy scoliosis-specific exercises 
  2. Manual therapy including gentle mobilization and soft-tissue release techniques
  3. Correction of leg length discrepancies with heel lifts
  4. Respiratory function exercises
  5. Scoliosis Bracing

Several schools of thought/care exist for scoliosis management, including:

  1. Lyon Method
  2. Schroth Method 
  3. Scientific Exercise Approach to Scoliosis (SEAS)
  4. Barcelona Scoliosis Physical Therapy School (BSPTS) 
  5. Dobosiewicz Method (Dobomed)
  6. Side Shift
  7. Functional Individual Therapy of Scoliosis (FITS)

A common theme can be found among all of these methods. Most seek to enhance the following:

  1. Patient awareness of curvature
  2. Spinal mechanics
    1. mobilizing contracted tissues and restricted joints
    2. strengthening weak or elongated muscles
    3. stabilizing the spine in a neutral posture position (achieving postural balance)
  3. Vestibular, visual, and proprioceptive integration and function
  4. Breathing mechanics
  5. Posture during activities of daily living
  6. Self-image and self-esteem

Patient education, 3-dimensional postural corrections, individualized exercises, and braces are common components of a conservative management plan. Exercises are designed to elongate, de-rotate, and stabilize the spine, and provide neuromuscular re-education.

Visit a healthcare practitioner you trust to discuss your personalized management options. Improve your care and inform your choices by engaging in multidisciplinary discussion.

Reference

Berdishevsky, H., Lebel, V., Bettany-Saltikov, J., Rigo, M., Lebel, A., Hennes, A., …, & Durmala, J. (2016). Physiotherapy scoliosis-specific exercises – a comprehensive review of seven major schools. Scoliosis Spinal Disord., 11, 20

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