Category: Applied Functional Science
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Kwan KYH, Cheng ACS, Koh HY, Chiu AYY, Cheung KMC. Effectiveness of Schroth exercises during bracing in adolescent idiopathic scoliosis: results from a preliminary study. Scoliosis and Spinal Disorders 2017; 12: 1-7

The use of exercises as an adjunct to bracing, or instead of bracing, in the treatment of scoliosis is being investigated by a number of researchers. Early results have been very promising compared to therapeutic interventions during the 20th century. This is probably due to the use of curve-specific movements compared to the traditional approaches. The promise is that many teenagers with idiopathic scoliosis will not need to undergo surgical stabilization.

This article compared the results of bracing to a program of bracing and physical therapy based on the Schroth method. The Schroth method was initially created by Katharina Schroth in Germany and further developed by her daughter Christa Lehnert-Schroth as a “stand-alone” program to avoid the scoliosis bracing that did not produce the desired effect in many cases. The program, based on spinal biomechanics, focuses on breathing and corrective movements that are performed (for the most part) in an upright body position.

The article above reported on 24 patients treated with the additional exercises compared to a control group that was treated with bracing only. The radiographic measurements of the spinal curves were compared after an average of 18 months of treatment. Spinal curve changes of 6 degrees were used to designate each subject’s curve as improved, unchanged, or worsened. The results of this study demonstrated that the addition of Schroth exercises improved the curve measurements. In the exercise group, 17% improved (compared to 4%), 62% were unchanged (compared to 46%), and 21% worsened (compared to 50%). They also analyzed a sub-group of 13 patients in the exercise group that were more compliant with the exercises and found that 31% improved, and 69% remained unchanged, and none had worsened.

At Gray Institute®, the Truths or Principles of human movement that transcend all functional activities and medical diagnoses, have been applied to the treatment of scoliosis. The Strategies that produce the Techniques (movements) are very consistent with the Schroth method that began over a century ago; and are detailed in the book Three-Dimensional Treatment For Scoliosis, first published in English in 2007. 

Movements to correct the deformity and then strengthen the muscles to maintain the improved postural alignment are designed based on the biomechanics of the curve. Location of the curve will also influence the selection of a client-specific program. Applied Functional Science® (AFS) Strategies using both top-down and bottom-up drivers can correct the curves at both the superior and inferior ends. Maybe more important is the ability to treat “S” curves by attacking the bottom curve from below and the top curve from above. This is how the AFS principle of Driven is leveraged to treat scoliosis.

Taking advantage of the Principle of 3D, active or static correction will include the sagittal plane for any kyphosis combined with frontal plane for the lateral curvature and transverse plane for the rib and vertebral rotation. The correction can be held statically in all three planes at the same time. Active correction can occur in one plane while static correction is maintained in the other two. Slow active correction can occur in all three planes simultaneously.

The word “slow” was used for correction because the Load to Explode Principle guides the strengthening movements. Loading movements lengthen and activate the muscles that decelerate the movement and then reverse the movement. If corrective movements are performed quickly, the wrong muscles will be activated. For this reason, strengthening movements use motions that make the curves worse, but activate the muscles to correct the curves. Static strengthening can also be utilized from the corrected positions, but the loading force must be in the direction to “undo” the correction.

The initial encouraging results of functional movements to reduce scoliosis curves also reminds us at Gray Institute® how much more we need to learn about maximizing the efficacy of our interventions. Ed Paget, an Osteopath and GIFT Fellow, has built on the AFS foundation and Principle-Strategy-Technique Process he learned in GIFT (40-week mentorship program in AFS) to take these Strategies and organize the movements into client-based scoliosis programs. What new path might you career take after experiencing the GIFT Journey?

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