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Khalaf ZM, Margulies P, Moussa MK, Bohu Y, Lefevre N, Hardy A. Valid and Invalid Indications for Osteopathic Interventions: A Systematic Review of Evidence-Based Practices and French Healthcare Society Recommendations. Cureus 2023; 15:e49674. [PMID: 38161897 PMCID: PMC10756711 DOI: 10.7759/cureus.49674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
The main aim of this study was to determine the level of evidence in the literature for the main indications of osteopathy as recommended by the French osteopathy societies. This systematic review followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and evaluated articles published between January 2012 and January 2022 with one modification: when level one evidence studies were available, level two to five studies were excluded. Sources included PubMed, the Cochrane library, the French National Health Authority (HAS) and its affiliates. Inclusion criteria were level one published studies on the indications for osteopathic treatment in French and English, and level two to three studies when no level one studies were available. The level of evidence assessment was based on the Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence classification. The primary outcome was the level of evidence in the literature supporting osteopathic practices. The secondary outcome was to assess French professional osteopathy recommendations and French HAS guidelines in relation to the scientific literature. A total of 51 articles and nine recommendations from the HAS and its affiliates met the inclusion criteria for the systematic review. Analysis of the studies revealed 41 osteopathic indications from French osteopathy societies for musculoskeletal, neurosensory, psychological, pediatric, gynecological, digestive, and pulmonary disorders. High-level scientific evidence supported the use of osteopathy for low back pain, sciatica, cervical radiculopathy, and ankle sprain. There was moderate evidence for tension headache, temporomandibular joint disorder, endometriosis, and low back and pelvic pain in pregnant women. HAS recommended five indications, while nine indications were supported in the scientific literature. Osteopathy has been shown to have evidence-based benefits for a range of conditions, in particular for musculoskeletal and neurosensory disorders.
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Affiliation(s)
- Zeinab M Khalaf
- Endocrinology, Diabetes, and Metabolism, clinique du Sport, Paris, FRA
| | | | | | - Yoann Bohu
- Orthopedic Surgery, Clinique du Sport, Paris, FRA
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Milne N, Longeri L, Patel A, Pool J, Olson K, Basson A, Gross AR. Spinal manipulation and mobilisation in the treatment of infants, children, and adolescents: a systematic scoping review. BMC Pediatr 2022; 22:721. [PMID: 36536328 PMCID: PMC9762100 DOI: 10.1186/s12887-022-03781-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To i) identify and map the available evidence regarding effectiveness and harms of spinal manipulation and mobilisation for infants, children and adolescents with a broad range of conditions; ii) identify and synthesise policies, regulations, position statements and practice guidelines informing their clinical use. DESIGN Systematic scoping review, utilising four electronic databases (PubMed, Embase, CINHAL and Cochrane) and grey literature from root to 4th February 2021. PARTICIPANTS Infants, children and adolescents (birth to < 18 years) with any childhood disorder/condition. INTERVENTION Spinal manipulation and mobilisation OUTCOME MEASURES: Outcomes relating to common childhood conditions were explored. METHOD Two reviewers (A.P., L.L.) independently screened and selected studies, extracted key findings and assessed methodological quality of included papers using Joanna Briggs Institute Checklist for Systematic Reviews and Research Synthesis, Joanna Briggs Institute Critical Appraisal Checklist for Text and Opinion Papers, Mixed Methods Appraisal Tool and International Centre for Allied Health Evidence Guideline Quality Checklist. A descriptive synthesis of reported findings was undertaken using a levels of evidence approach. RESULTS Eighty-seven articles were included. Methodological quality of articles varied. Spinal manipulation and mobilisation are being utilised clinically by a variety of health professionals to manage paediatric populations with adolescent idiopathic scoliosis (AIS), asthma, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), back/neck pain, breastfeeding difficulties, cerebral palsy (CP), dysfunctional voiding, excessive crying, headaches, infantile colic, kinetic imbalances due to suboccipital strain (KISS), nocturnal enuresis, otitis media, torticollis and plagiocephaly. The descriptive synthesis revealed: no evidence to explicitly support the effectiveness of spinal manipulation or mobilisation for any condition in paediatric populations. Mild transient symptoms were commonly described in randomised controlled trials and on occasion, moderate-to-severe adverse events were reported in systematic reviews of randomised controlled trials and other lower quality studies. There was strong to very strong evidence for 'no significant effect' of spinal manipulation for managing asthma (pulmonary function), headache and nocturnal enuresis, and inconclusive or insufficient evidence for all other conditions explored. There is insufficient evidence to draw conclusions regarding spinal mobilisation to treat paediatric populations with any condition. CONCLUSION Whilst some individual high-quality studies demonstrate positive results for some conditions, our descriptive synthesis of the collective findings does not provide support for spinal manipulation or mobilisation in paediatric populations for any condition. Increased reporting of adverse events is required to determine true risks. Randomised controlled trials examining effectiveness of spinal manipulation and mobilisation in paediatric populations are warranted.
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Affiliation(s)
- Nikki Milne
- grid.1033.10000 0004 0405 3820Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia ,International Organisation of Physiotherapists in Paediatrics, World Physiotherapy Subgroup, Queensland, Australia
| | - Lauren Longeri
- grid.1033.10000 0004 0405 3820Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia
| | - Anokhi Patel
- grid.1033.10000 0004 0405 3820Department of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia
| | - Jan Pool
- grid.5477.10000000120346234Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, The Netherlands
| | - Kenneth Olson
- International Federation of Orthopaedic Manipulative Physical Therapy and Northern Rehab Physical Therapy Specialists, Anchorage, USA
| | - Annalie Basson
- grid.11951.3d0000 0004 1937 1135University of Witwatersrand, Johannesburg, South Africa
| | - Anita R. Gross
- grid.25073.330000 0004 1936 8227McMaster University, Hamilton, Canada
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Fedorchuk C, Himel B, Lightstone DF. Improved Pain and Quality of Life with Corrected Thoracic and Lumbosacral Spondylolisthesis Subluxations Using CBP ®: A Case Study and 1-Year Follow-Up. J Radiol Case Rep 2022; 16:21-38. [PMID: 35586358 PMCID: PMC9063820 DOI: 10.3941/jrcr.v16i2.4413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
Objective Discuss non-surgical spinal rehabilitation for a 27-year-old male with thoracic and lumbosacral spondylolistheses. A selective literature review and discussion are provided. Clinical Features A 27-year-old male presented with severe, 8/10 mid and low back pain. Initial lateral thoracic and lumbar x-rays revealed grade 1 spondylolistheses at T9-T10 and L5-S1 measuring -5.3 mm and -6.8 mm. Interventions and Outcomes The patient completed 60 sessions of Mirror Image® spinal adjustments, exercises, and traction over 30 weeks. Post-treatment x-rays showed correction in translations at T9-T10 and L5-S1 from -5.3 mm to 0.0 mm and -6.8 mm to -1.0 mm, within normal limits. 1-year follow-up x-rays showed maintained correction. Conclusions This case is the first documented evidence of non-surgical or chiropractic treatment for thoracic and lumbosacral spondylolistheses where spinal alignment was corrected. More research is needed to investigate the clinical implications and applications.
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Affiliation(s)
| | - Blake Himel
- Institute for Spinal Health & Performance, Cumming, GA, USA
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Ren J, Kong L, Wu Z, Zhou X, Huang Q, He T, Fang M. Benefits on pain and mental health of manual therapy for idiopathic scoliosis: A meta-analysis. Front Endocrinol (Lausanne) 2022; 13:1038973. [PMID: 36568101 PMCID: PMC9768362 DOI: 10.3389/fendo.2022.1038973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Idiopathic scoliosis (IS) is a common spinal disorder. Although several studies have reported the benefits of manual therapy for patients with IS in improving pain, anxiety, depression, and spinal disorders, the efficacy of manual therapy in the management of IS remain controversial. Therefore, this review was conducted to assess effects of manual therapy in the management of IS, primarily on pain and mental health of the patients and secondarily on their spinal disorders. METHODS Six electronic databases were searched for randomized controlled trials of manual therapy in the management of IS. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale. The meta-analysis was conducted depending on different outcomes and control therapies using Review Manager version 5.3 software. RESULTS Seventeen studies were included in the present review. The PEDro scores of the included studies ranged from 5-7 points. The aggregated results indicated that Tuina (a traditional Chinese manipulation technique) had valuable improvement effects on pain (standardized mean difference (SMD), 0.92; 95% confidence interval (CI), 0.59 to 1.25; P<0.00001), negative emotions (SMD, 0.82; 95% CI, 0.51 to 1.13; P<0.00001), and disability (SMD, 1.29; 95% CI, 0.39 to 2.19; P=0.005). For the radiographic outcomes including the Cobb angle and vertebral rotation, Tuina, especially when combined with other conservative therapies, showed potential complementary effects for patients with IS. CONCLUSIONS Tuina, as a complementary and alternative therapy, should be considered for the effective management of patients with IS, especially for the improvement of their pain and mental health. More randomized controlled trials are recommended to validate the current evidence. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier CRD42020165220.
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Affiliation(s)
- Jun Ren
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lingjun Kong
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Zhiwei Wu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Xin Zhou
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Qian Huang
- Department of Acupuncture and Tuina, Lianyungang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Lianyungang, China
| | - Tianxiang He
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Fang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Min Fang,
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Huang Q, Zhang L, Li Z, Kong L. Manual therapy for idiopathic scoliosis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21782. [PMID: 32846807 PMCID: PMC7447396 DOI: 10.1097/md.0000000000021782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 07/17/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION More patients with idiopathic scoliosis (IS) preferred to choose manual therapy as a complementary conservative treatment, but the effects of manual therapy for IS remains controversial. The previous reviews could not draw reliable conclusion due to few eligible studies to perform a meta-analysis. In the last decade, however, several new studies were published that assessed the effects of manual therapy in the management of IS, especially in China. Therefore, the present systematic review and meta-analysis will be performed to examine whether manual therapy is effective for IS primarily in improving patient-centerd symptoms and secondarily in radiographic outcomes. METHODS AND ANALYSIS A computerized literature search will be performed in the following electronic databases from their inceptions to June 2020 to identify randomized controlled trials of manual therapy in the management of IS: PubMed, EMBASE, MEDLINE, Cochrane Central Register of Controlled Clinical Trials, China Knowledge Resource Integrated Database, Wanfang Data Information, and Weipu Database for Chinese Technical Periodicals. The quality of included studies will be assessed independently by 2 reviewers using the Physiotherapy Evidence Database scale. The meta-analysis will be performed with the Review Manager Version 5.3 software to assess the effects on patient-centred outcomes and radiographic outcomes of manual therapy for IS. The heterogeneity will be assessed using I statistic and Cochran Q statistic. The subgroup analysis will be conducted based on different control interventions and subpopulations. Quality of evidence will be assessed using the Grades of Recommendation, Assessment, Development and Evaluation. ETHICS AND DISSEMINATION No ethical statement will be required for the performance of this review and meta-analysis. The results of this review will be published in an international peer-reviewed journal.INPLASY registration number: INPLASY202070058.
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Affiliation(s)
- Qian Huang
- Department of Acupunctue and Tuina, Lianyungang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Lianyungang
| | - Lei Zhang
- Department of Acupunctue and Tuina, Lianyungang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Lianyungang
| | - Zhiwei Li
- Department of Acupunctue and Tuina, Lianyungang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Lianyungang
| | - Lingjun Kong
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Morningstar M, Oslin D. Chiropractic rehabilitation plus nighttime bracing for progressive adolescent idiopathic scoliosis: a case-controlled series. Clin Pract 2020; 9:1191. [PMID: 32218916 PMCID: PMC7097832 DOI: 10.4081/cp.2019.1191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 11/11/2019] [Indexed: 01/24/2023] Open
Abstract
Non-operative treatments for scoliosis include various types of scoliosis-specific exercise therapies, as well as dynamic and rigid spinal orthoses. Although there are many studies evaluating various types of bracing-only constructs for scoliosis treatment, few have evaluated bracing when combined with chiropractic care. The present study analyzed the data of 18 patients from the initiation a chiropractic rehabilitation program combined with nighttime bracing. Patients were managed through the end of growth, and results were compared to baseline. Their collective results were compared to a similar group of previously published patients who participated in the same chiropractic rehabilitation program, but did not perform concurrent bracing treatment. Patients initiating the combined chiropractic and bracing treatment achieved a correction of 6° or more 81% of the time, while the remaining 19% remained within 5° of their baseline measurements. The average curve improvement was 9.4°. This was compared to a correction rate of 51.7%, a stabilization rate of 38.3%, and a progression rate of 10% in the group performing chiropractic rehabilitation only.
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Affiliation(s)
| | - Dan Oslin
- Oakland Orthopedic Appliances, Bay City, MI, USA
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7
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A Systematic Review of Chuna Manual Therapy for Adolescent Idiopathic Scoliosis. JOURNAL OF ACUPUNCTURE RESEARCH 2019. [DOI: 10.13045/jar.2019.00157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Alexandre AS, Sperandio EF, Yi LC, Davidson J, Poletto PR, Gotfryd AO, Vidotto MC. PHOTOGRAMMETRY: A PROPOSAL OF OBJECTIVE ASSESSMENT OF CHEST WALL IN ADOLESCENT IDIOPATHIC SCOLIOSIS. REVISTA PAULISTA DE PEDIATRIA 2019; 37:225-233. [PMID: 31340348 PMCID: PMC6651306 DOI: 10.1590/1984-0462/;2019;37;2;00001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 01/28/2018] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective: To evaluate the chest wall shape in patients with adolescent idiopathic scoliosis (AIS) in comparison to healthy subjects and the association between the chest wall shape with the spine deformity and lung function in patients with AIS. Methods: This cross-sectional study enrolled 30 AIS patients and 20 healthy subjects aged 11-18 years old. The Cobb angle evaluation was performed in AIS patients. The chest wall shape was assessed by the photogrammetry method, using the Postural Assessment Software (PAS). We created thoracic markers shaped as angles (A) and distances (D), as follows: A2 (right acromion/xiphoid/left acromion), A4L (angle formed between the outer point of the smallest waist circumference and its upper and lower edges on the left side), A7 (angle formed by the intersection of the tangent segments of the upper and lower scapulae angles), D1R/D1L [distance between the xiphoid process and the last false rib on the right (R) and left (L) sides], and D3 (distance between xiphoid process and anterior superior iliac spine). Results: The thoracic markers A2 and A7 were significantly higher, while the A4L and D1R/D1L were significantly reduced in the AIS group compared to the control. Moderate correlations were found between: A2 and the main and proximal thoracic Cobb angles (r=0.50, r=0.47, respectively); D1R/D1L and the main thoracic Cobb angle (r=- 0.40); and the forced expiratory volume in the first second (FEV1) and D3R (r=0.47). Conclusions: The photogrammetry method was able to detect chest wall changes in AIS patients, besides presenting correlation between Cobb angles and lung function.
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Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, Lebel A, Marti C, Maruyama T, O’Brien J, Price N, Parent E, Rigo M, Romano M, Stikeleather L, Wynne J, Zaina F. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. SCOLIOSIS AND SPINAL DISORDERS 2018; 13:3. [PMID: 29435499 PMCID: PMC5795289 DOI: 10.1186/s13013-017-0145-8] [Citation(s) in RCA: 412] [Impact Index Per Article: 68.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/06/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) produced its first guidelines in 2005 and renewed them in 2011. Recently published high-quality clinical trials on the effect of conservative treatment approaches (braces and exercises) for idiopathic scoliosis prompted us to update the last guidelines' version. The objective was to align the guidelines with the new scientific evidence to assure faster knowledge transfer into clinical practice of conservative treatment for idiopathic scoliosis (CTIS). METHODS Physicians, researchers and allied health practitioners working in the area of CTIS were involved in the development of the 2016 guidelines. Multiple literature reviews reviewing the evidence on CTIS (assessment, bracing, physiotherapy, physiotherapeutic scoliosis-specific exercises (PSSE) and other CTIS) were conducted. Documents, recommendations and practical approach flow charts were developed using a Delphi procedure. The process was completed with the Consensus Session held during the first combined SOSORT/IRSSD Meeting held in Banff, Canada, in May 2016. RESULTS The contents of the new 2016 guidelines include the following: background on idiopathic scoliosis, description of CTIS approaches for various populations with flow-charts for clinical practice, as well as literature reviews and recommendations on assessment, bracing, PSSE and other CTIS. The present guidelines include a total of 68 recommendations divided into following topics: bracing (n = 25), PSSE to prevent scoliosis progression during growth (n = 12), PSSE during brace treatment and surgical therapy (n = 6), other conservative treatments (n = 2), respiratory function and exercises (n = 3), general sport activities (n = 6); and assessment (n = 14). According to the agreed strength and level of evidence rating scale, there were 2 recommendations on bracing and 1 recommendation on PSSE that reached level of recommendation "I" and level of evidence "II". Three recommendations reached strength of recommendation A based on the level of evidence I (2 for bracing and one for assessment); 39 recommendations reached strength of recommendation B (20 for bracing, 13 for PSSE, and 6 for assessment).The number of paper for each level of evidence for each treatment is shown in Table 8. CONCLUSION The 2016 SOSORT guidelines were developed based on the current evidence on CTIS. Over the last 5 years, high-quality evidence has started to emerge, particularly in the areas of efficacy of bracing (one large multicentre trial) and PSSE (three single-centre randomized controlled trials). Several grade A recommendations were presented. Despite the growing high-quality evidence, the heterogeneity of the study protocols limits generalizability of the recommendations. There is a need for standardization of research methods of conservative treatment effectiveness, as recognized by SOSORT and the Scoliosis Research Society (SRS) non-operative management Committee.
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Affiliation(s)
- Stefano Negrini
- Clinical and Experimental Sciences Department, University of Brescia Viale Europa 11, Brescia, Italy
- IRCCS Fondazione Don Gnocchi, Milan, Italy
| | - Sabrina Donzelli
- ISICO (Italian Scientific Spine Institute), Via R. Bellarmino 13/1, 20141 Milan, Italy
| | - Angelo Gabriele Aulisa
- U.O.C. of Orthopedics and Traumatology, Children’s Hospital Bambino Gesù, Institute of Scientific Research, 00165 Rome, Italy
| | - Dariusz Czaprowski
- Center of Body Posture, Olsztyn, Poland
- Department of Physiotherapy, Józef Rusiecki University College, Olsztyn, Poland
| | - Sanja Schreiber
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Alberta Health Services, Department of Surgery, Edmonton, Canada
| | | | - Helmut Diers
- Department of Orthopedics and Trauma Surgery, University Medical Center, Mainz, Germany
| | - Theodoros B. Grivas
- Department of Orthopaedics and Traumatology, “Tzaneio” General Hospital of Piraeus, Piraeus, Greece
| | - Patrick Knott
- Rosalind Franklin University of Medicine and Science, North Chicago, IL USA
| | - Tomasz Kotwicki
- Department of Spine Disorders and Pediatric Orthopedics, University of Medical Sciences, Poznan, Poland
| | - Andrea Lebel
- Scoliosis Physiotherapy & Posture Centre, 231 McLeod Street, Ottawa, Ontario K2P0Z8 Canada
| | - Cindy Marti
- Schroth-Barcelona Institute, LLC, Spinal Dynamics of Wisconsin, SC., Barcelona, Spain
| | - Toru Maruyama
- Saitama Prefectural Rehabilitation Center, Saitama, Japan
| | - Joe O’Brien
- National Scoliosis Foundation, Stoughton, MA USA
| | - Nigel Price
- Section of Spine Surgery, Children’s Mercy Hospitals and Clinics, UMKC Orthopedics, Kansas City, MO USA
| | - Eric Parent
- Department of Physical Therapy, 2-50 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Manuel Rigo
- Salvá SLP (E. Salvá Institute), Vía Augusta 185, 08021 Barcelona, Spain
| | - Michele Romano
- ISICO (Italian Scientific Spine Institute), Via R. Bellarmino 13/1, 20141 Milan, Italy
| | - Luke Stikeleather
- National Scoliosis Center, 3023 Hamaker Court, Suite LL-50, Fairfax, VA 22124 USA
| | - James Wynne
- Boston Orthotics & Prosthetics, Boston, MA USA
| | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), Via R. Bellarmino 13/1, 20141 Milan, Italy
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Stępień A, Fabian K, Graff K, Podgurniak M, Wit A. An immediate effect of PNF specific mobilization on the angle of trunk rotation and the Trunk-Pelvis-Hip Angle range of motion in adolescent girls with double idiopathic scoliosis-a pilot study. SCOLIOSIS AND SPINAL DISORDERS 2017; 12:29. [PMID: 28905003 PMCID: PMC5586026 DOI: 10.1186/s13013-017-0132-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 04/18/2017] [Indexed: 11/20/2022]
Abstract
Background Impairment of spine rotation is a key concept in several theories explaining the pathogenesis and progression of scoliosis. In previous studies, a more limited range of motion in scoliotic girls compared to their non-scoliotic peers was noted. The Trunk-Pelvis-Hip Angle measurement is a test used to assess the range of motion in the trunk-pelvis-hip complex in the transverse plane. The aim of this study was to assess an immediate effect of Proprioceptive Neuromuscular Facilitation specific mobilization (mPNF) on the angle of trunk rotation and Trunk-Pelvis-Hip Angle range of motion in adolescent girls with double scoliosis. Methods The study was conducted on 83 girls aged 10 to 17 years (mean 13.7 ± 1.9) with double idiopathic scoliosis consisting of a right-sided thoracic curve (mean 25.1° ± 13.9°) and a left-sided thoracolumbar or lumbar curve (mean 20.8° ± 11.4°). The angle of trunk rotation and Trunk-Pelvis-Hip Angle were measured at baseline and after PNF mobilization. Bilateral lower limb patterns of Proprioceptive Neuromuscular Facilitation were used in combination with the “contract–relax” technique and stimulation of asymmetrical breathing. In the statistical analysis, the SAS rel. 13.2 software was used. Preliminary statistical analysis was performed using descriptive statistics. According to Shapiro-Wilk criterion of normality, the Wilcoxon test was used to compare paired samples. Next, the data was analyzed using multivariate GLM models. Results In adolescent girls with double scoliosis, significant differences between the left and right side of the body concerning the Trunk-Pelvis-Hip Angle ranges were noted. A single, unilateral PNF mobilization significantly decreased the angle of trunk rotation in the thoracic (p < 0.001) and lumbar spine (p < 0.001). Unilateral PNF mobilization also increased the Trunk-Pelvis-Hip Angle ranges on the left (p < 0.001) and right (p < 0.001) side significantly. Conclusions Unilateral PNF mobilization led to a decrease in the angle of trunk rotation, improvement in the range of motion, and the symmetry of mobility in the transverse plane in the trunk-pelvis-hip complex in adolescent girls with double idiopathic scoliosis. The effects should be treated only as immediate. Further studies are required to determine long-term effects of PNF mobilization on the spinal alignment. Trial registration ISRCTN11750900.
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Affiliation(s)
- A Stępień
- Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland
| | - K Fabian
- Regional Children's Hospital, Jastrzębie Zdrój, Poland
| | - K Graff
- Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland
| | - M Podgurniak
- Department of Physiological Sciences, University of Life Science, Warsaw, Poland
| | - A Wit
- Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland
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Fedorchuk C, Lightstone DF, McRae C, Kaczor D. Correction of Grade 2 Spondylolisthesis Following a Non-Surgical Structural Spinal Rehabilitation Protocol Using Lumbar Traction: A Case Study and Selective Review of Literature. J Radiol Case Rep 2017; 11:13-26. [PMID: 29299090 DOI: 10.3941/jrcr.v11i5.2924] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objective Discuss the use of non-surgical spinal rehabilitation protocol in the case of a 69-year-old female with a grade 2 spondylolisthesis. A selective literature review and discussion are provided. Clinical Features A 69-year-old female presented with moderate low back pain (7/10 pain) and severe leg cramping (7/10 pain). Initial lateral lumbar x-ray revealed a grade 2 spondylolisthesis at L4-L5 measuring 13.3 mm. Interventions and Outcomes The patient completed 60 sessions of Mirror Image® spinal exercises, adjustments, and traction over 45 weeks. Post-treatment lateral lumbar x-ray showed a decrease in translation of L4-L5 from 13.3 mm to 2.4 mm, within normal limits. Conclusions This case provides the first documented evidence of a non-surgical or chiropractic treatment, specifically Chiropractic BioPhysics®, protocols of lumbar spondylolisthesis where spinal alignment was corrected. Additional research is needed to investigate the clinical implications and treatment methods.
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Affiliation(s)
| | | | - Christi McRae
- Private Practice, St. Thomas, US Virgin Islands, USA
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Morningstar MW, Dovorany B, Stitzel CJ, Siddiqui A. Chiropractic Rehabilitation for Adolescent Idiopathic Scoliosis: End-of-Growth and Skeletal Maturity Results. Clin Pract 2017; 7:911. [PMID: 28243430 PMCID: PMC5264549 DOI: 10.4081/cp.2017.911] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/07/2016] [Accepted: 12/28/2016] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to evaluate the radiographic outcomes obtained in a sample of patients treated with a chiropractic scoliosis-specific exercise program for patients with adolescent idiopathic scoliosis. Patients were treated and subsequently followed through skeletal maturity, and their results were reported in accordance with the SOSORT Consensus Guidelines. A total of 60 patient charts were consecutively selected when they met inclusion criteria. Cobb angle measurements and Risser staging were collected on all images. Using SOSORT criteria, 51.7% of patients achieved curve correction and 38.3% achieved stabilization. In the curve correction group, average total correction was 12.75°. A small number of sampled patients’ curves progressed, with a 13% failure rate based upon patients who dropped out before skeletal maturity combined with those who had progressed at skeletal maturity. Future studies are needed to corroborate these observations.
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Negrini S, Minozzi S, Bettany-Saltikov J, Chockalingam N, Grivas TB, Kotwicki T, Maruyama T, Romano M, Zaina F. Braces for Idiopathic Scoliosis in Adolescents. Spine (Phila Pa 1976) 2016; 41:1813-1825. [PMID: 27584672 DOI: 10.1097/brs.0000000000001887] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A Cochrane systematic review. OBJECTIVE To evaluate the efficacy of bracing for adolescents with AIS versus no treatment or other treatments, on quality of life, disability, pulmonary disorders, progression of the curve, psychological, and cosmetic issues. SUMMARY OF BACKGROUND DATA Idiopathic scoliosis is a three-dimensional deformity of the spine. The most common form is diagnosed in adolescence. Although adolescent idiopathic scoliosis (AIS) can progress during growth and cause a surface deformity, it is usually not symptomatic. METHODS We searched CENTRAL, MEDLINE, EMBASE, five other databases, and two trials registers up to February 2015. We also checked reference lists and hand searched grey literature. Randomized controlled trials (RCTs) and prospective controlled cohort studies comparing braces with no treatment, other treatment, surgery, and different types of braces for adolescent with AIS. We used standard methodological procedures expected by the Cochrane Collaboration. RESULTS We included seven studies. Five were planned as RCTs, two as prospective controlled clinical trials. One RCT failed completely, another was continued as an observational study. There was very low quality evidence from one small RCT that quality of life (QoL) during treatment did not differ significantly between rigid bracing and observation. CONCLUSION Two studies showed that bracing did not change QoL during treatment, and QoL, back pain psychological and cosmetic issues in the long term (16 years.) All articles showed that bracing prevented curve progression. The high rate of failure of RCTs demonstrates the huge difficulties in performing RCTs in a field where parents reject randomization of their children. LEVEL OF EVIDENCE 1.
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Affiliation(s)
- Stefano Negrini
- Physical and Rehabilitation Medicine, University of Brescia, IRCCS Fondazione Don Gnocchi Milan, Brescia, Italy
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | | | - Theodoros B Grivas
- Department of Trauma and Orthopedics, Tzanio General Hospital of Piraeus, Piraeus, Greece
| | - Tomasz Kotwicki
- Department of Pediatric Orthopedics and Traumatology, University of Medical Sciences, Poznan, Poland
| | - Toru Maruyama
- Department of Orthopedic Surgery, Saitama Medical University, Kawagoe, Japan
| | | | - Fabio Zaina
- ISICO, Italian Scientific Spine Institute, Milan, Italy
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Byun S, Han D. The effect of chiropractic techniques on the Cobb angle in idiopathic scoliosis arising in adolescence. J Phys Ther Sci 2016; 28:1106-10. [PMID: 27190435 PMCID: PMC4868195 DOI: 10.1589/jpts.28.1106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 12/18/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to examine whether chiropractic techniques would
reduce the curvature of idiopathic scoliosis, which commonly occurs in elementary school
children. [Subjects] The subjects of this study were 5 healthy elementary students who
listened to an explanation of the study methods and purpose of the study and agreed to
participate in the experiment. [Methods] The Cobb angle was measured by taking an X-ray
(FCT-1, Dongmun, Goyangsi, Republic of Korea) taken from the rear, using X-ray film. The
method of intervention this study used was application of chiropractic techniques. Spinal
correction was carried out for 30 minutes per session, which included soft tissue massage,
3 times a week for 8 weeks. [Results] It was established that the Cobb angle was
noticeably decreased after 4 weeks of the intervention. Post Hoc analysis revealed that
the Cobb angle noticeably decreased after 4 weeks compared with the Cobb angle before the
chiropractic techniques were applied. However, no significant difference in Cobb angle was
evident after the fourth week. [Conclusion] This study demonstrated that chiropractic
techniques can effectively reduce the Cobb angle within as little as 4 weeks. So, we can
confirm that the chiropractic techniques were effective for reducing the curvature of
idiopathic scoliosis.
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Affiliation(s)
| | - Dongwook Han
- Department of Physical Therapy, College of Health and Welfare, Silla University, Republic of Korea
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Woggon AJ, Woggon DA. Patient-reported side effects immediately after chiropractic scoliosis treatment: a cross-sectional survey utilizing a practice-based research network. SCOLIOSIS 2015; 10:29. [PMID: 26445594 PMCID: PMC4594736 DOI: 10.1186/s13013-015-0053-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 09/23/2015] [Indexed: 11/29/2022]
Abstract
Background Concern exists regarding the potential for chiropractic treatment to cause adverse effects in individuals with scoliosis. The aim of this paper is to present the self-reported responses of 189 scoliosis patients over 3198 unique visits, collected over one calendar year from nine chiropractic clinics, regarding how they felt and the side effects they experienced immediately after chiropractic treatment. Methods Thirty six private chiropractic clinics specializing in the treatment of scoliosis were asked to participate in a prospective study regarding the side-effects of the chiropractic treatment of scoliosis; 9 agreed to participate. A response form was provided to each scoliosis patient at the end of their clinic visit, and consisted of two questions: “How do you feel after your treatment today?” and “Did you experience any side-effects as a result of your treatment today?” Results One hundred eighty nine informed consent forms were collected and 3198 response forms were collected, suggesting an average of 17 visits per patient. Patients reported feeling worse post-treatment after 5.0 % of the visits. The incidence of side-effects was 29.7 %. Muscle soreness accounted for 35.2 % of all side effects. 99.9 % of all side effects were classified as mild. Six moderate side-effects (sprains/strains) were reported out of 3,198 visits. There were no reported cases of severe side effects. Conclusion Mild side effects were common, although the frequency was slightly lower than the average for chiropractic interventions. The rate of moderate side effects reported was one per 533 visits involving the care of 189 scoliosis patients surveyed from 9 chiropractic offices over a timeframe of one calendar year. No serious adverse events occurred that required medical attention, hospital stays, or surgical intervention. Based upon this preliminary data, side effects reported by scoliosis patients immediately after chiropractic treatment appear to be relatively common but generally benign.
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Affiliation(s)
- A Joshua Woggon
- CLEAR Scoliosis Institute, 437 North 33rd Ave, Saint Cloud, MN 56303 USA
| | - Dennis A Woggon
- CLEAR Scoliosis Institute, 437 North 33rd Ave, Saint Cloud, MN 56303 USA
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Hui W, Jinyuan X, Zhong J, Shuliang Y, Hongquan S, Xitao N, Huanmin H, Wei C, Jianwei P, Nengyi J, Shao C, Honggen D. Effect of a Traditional Chinese Medicine combined therapy on adolescent idiopathic scoliosis: a randomized controlled trial. J TRADIT CHIN MED 2015; 35:514-9. [DOI: 10.1016/s0254-6272(15)30133-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Negrini A, Negrini MG, Donzelli S, Romano M, Zaina F, Negrini S. Scoliosis-Specific exercises can reduce the progression of severe curves in adult idiopathic scoliosis: a long-term cohort study. SCOLIOSIS 2015; 10:20. [PMID: 26279670 PMCID: PMC4537533 DOI: 10.1186/s13013-015-0044-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 06/16/2015] [Indexed: 11/17/2022]
Abstract
Background Scoliosis fusion surgery is generally considered the only means to stop the progression of adult idiopathic scoliosis (ADIS), but for patients refusing surgery there is lack of evidence in favour of conservative treatment. The aim of the present study was to verify the possible effectiveness of scoliosis-specific exercises when facing ADIS progression. Methods We designed a retrospective cohort study. We included 34 ADIS patients in treatment at our Institute (5 males and 29 females, mean age was 38.0 ± 11.0), exclusively treated with specific Scoliosis Specific SEAS exercises. Instrumentation SEAS exercises are scoliosis-specific exercises. In adult patients they are aimed to recover postural collapse, postural control and vertebral stability through an active self-correction. Postural integration is a key element, including the neuromotor integration of correct postures and an ergonomic education program. Therapy includes at least two weekly exercise sessions each lasting 45 min. Outcome measures Radiographic progression was the main outcome and it was analysed as a continuous variable. Statistics One way ANOVA and paired t-test were applied for continuous data, while chi-square test was applied for categorical data. Alpha was set at 0.05. Results The mean Cobb angle of the patients included into the present study, was 55.8 ± 13.2 °. Fifteen patients had previous x-rays testifying scoliosis progression: the average curve progression (worsening) was 9.8 ± 6.6 ° at a median of 25 (range 17–48) years. The remaining were characterized by more severe curves, exceeding 40 ° Cobb (mean curvature 50.9 ± 13.6) but it was not possible to prove that the curves had progressed in these cases. After an average period of 2 years of treatment (range 1-18y), 68 % of the patients experienced an improvement in their scoliosis. However in one patient (3 %) the scoliosis worsened by 5 ° in 18 years (progression rate reduced from 0.5 ° to 0.27 ° per year). Patients improved 4.6 ± 5.0 ° Cobb (P < 0.05), with no differences based on the localization of the curve, gender, age, length of treatment, Cobb degrees at the start of observation or treatment. Conclusions Scoliosis Specific SEAS Exercises proved to be superior to natural history in ADIS, at least in individual cases and should be considered as a first line treatment especially in patients refusing scoliosis surgery.
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Affiliation(s)
- Alessandra Negrini
- ISICO (Italian Scientific Spine Institute), Via R. Bellarmino 13/1, Milan, 20141 Italy
| | | | - Sabrina Donzelli
- ISICO (Italian Scientific Spine Institute), Via R. Bellarmino 13/1, Milan, 20141 Italy
| | - Michele Romano
- ISICO (Italian Scientific Spine Institute), Via R. Bellarmino 13/1, Milan, 20141 Italy
| | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), Via R. Bellarmino 13/1, Milan, 20141 Italy
| | - Stefano Negrini
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy ; IRCCS Fondazione Don Gnocchi, Milan, Italy
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Negrini S, Minozzi S, Bettany‐Saltikov J, Chockalingam N, Grivas TB, Kotwicki T, Maruyama T, Romano M, Zaina F. Braces for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev 2015; 2015:CD006850. [PMID: 26086959 PMCID: PMC10616811 DOI: 10.1002/14651858.cd006850.pub3] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Idiopathic scoliosis is a three-dimensional deformity of the spine. The most common form is diagnosed in adolescence. While adolescent idiopathic scoliosis (AIS) can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. OBJECTIVES To evaluate the efficacy of bracing for adolescents with AIS versus no treatment or other treatments, on quality of life, disability, pulmonary disorders, progression of the curve, and psychological and cosmetic issues. SEARCH METHODS We searched CENTRAL, MEDLINE, EMBASE, five other databases, and two trials registers up to February 2015 for relevant clinical trials. We also checked the reference lists of relevant articles and conducted an extensive handsearch of grey literature. SELECTION CRITERIA Randomized controlled trials (RCTs) and prospective controlled cohort studies comparing braces with no treatment, other treatment, surgery, and different types of braces for adolescent with AIS. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS We included seven studies (662 participants). Five were planned as RCTs and two as prospective controlled trials. One RCT failed completely, another was continued as an observational study, reporting also the results of the participants that had been randomized.There was very low quality evidence from one small RCT (111 participants) that quality of life (QoL) during treatment did not differ significantly between rigid bracing and observation (mean difference (MD) -2.10, 95% confidence interval (CI) -7.69 to 3.49). There was very low quality evidence from a subgroup of 77 adolescents from one prospective cohort study showing that QoL, back pain, psychological, and cosmetic issues did not differ significantly between rigid bracing and observation in the long term (16 years).Results of the secondary outcomes showed that there was low quality evidence that rigid bracing compared with observation significantly increased the success rate in 20° to 40° curves at two years' follow-up (one RCT, 116 participants; risk ratio (RR) 1.79, 95% CI 1.29 to 2.50). There was low quality evidence that elastic bracing increased the success rate in 15° to 30° curves at three years' follow-up (one RCT, 47 participants; RR 1.88, 95% CI 1.11 to 3.20).There is very low quality evidence from two prospective cohort studies with a control group that rigid bracing increases the success rate (curves not evolving to 50° or above) at two years' follow-up (one study, 242 participants; RR 1.50, 95% CI 1.19 to 1.89) and at three years' follow-up (one study, 240 participants; RR 1.75, 95% CI 1.42 to 2.16). There was very low quality evidence from a prospective cohort study (57 participants) that very rigid bracing increased the success rate (no progression of 5° or more, fusion, or waiting list for fusion) in adolescents with high degree curves (above 45°) (one study, 57 adolescents; RR 1.79, 95% CI 1.04 to 3.07 in the intention-to-treat (ITT) analysis).There was low quality evidence from one RCT that a rigid brace was more successful than an elastic brace at curbing curve progression when measured in Cobb degrees in low degree curves (20° to 30°), with no significant differences between the two groups in the subjective perception of daily difficulties associated with wearing the brace (43 girls; risk of success at four years' follow-up: RR 1.40, 1.03 to 1.89). Finally, there was very low quality evidence from one RCT (12 participants) that a rigid brace with a pad pressure control system is no better than a standard brace in reducing the risk of progression.Only one prospective cohort study (236 participants) assessed adverse events: neither the percentage of adolescents with any adverse event (RR 1.27, 95% CI 0.96 to 1.67) nor the percentage of adolescents reporting back pain, the most common adverse event, were different between the groups (RR 0.72, 95% CI 0.47 to 1.10). AUTHORS' CONCLUSIONS Due to the important clinical differences among the studies, it was not possible to perform a meta-analysis. Two studies showed that bracing did not change QoL during treatment (low quality), and QoL, back pain, and psychological and cosmetic issues in the long term (16 years) (very low quality). All included papers consistently showed that bracing prevented curve progression (secondary outcome). However, due to the strength of evidence (from low to very low quality), further research is very likely to have an impact on our confidence in the estimate of effect. The high rate of failure of RCTs demonstrates the huge difficulties in performing RCTs in a field where parents reject randomization of their children. This challenge may prevent us from seeing increases in the quality of the evidence over time. Other designs need to be implemented and included in future reviews, including 'expertise-based' trials, prospective controlled cohort studies, prospective studies conducted according to pre-defined criteria such as the Scoliosis Research Society (SRS) and the international Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) criteria. Future studies should increase their focus on participant outcomes, adverse effects, methods to increase compliance, and usefulness of physiotherapeutic scoliosis specific exercises added to bracing.
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Affiliation(s)
- Stefano Negrini
- University of Brescia ‐ IRCCS Fondazione Don Gnocchi MilanPhysical and Rehabilitation MedicineViale EuropaBresciaItaly25121
| | - Silvia Minozzi
- Lazio Regional Health ServiceDepartment of EpidemiologyVia di Santa Costanza, 53RomeItaly00198
| | - Josette Bettany‐Saltikov
- University of TeessideSchool of Health and Social CareVictoria RoadMiddlesbroughClevelandUKTS13BA
| | | | - Theodoros B. Grivas
- "Tzanio" General Hospital of PiraeusDepartment of Trauma and OrthopaedicsPiraeusAtticaGreece18536
| | - Tomasz Kotwicki
- University of Medical SciencesDepartment of Pediatric Orthopedics and Traumatologyul. 28 Czerwca 1956 nr 135PoznanPoland61‐545
| | - Toru Maruyama
- Saitama Medical UniversityDepartment of Orthopaedic Surgery1981 KamodaKawagoeSaitamaJapan350‐8550
| | - Michele Romano
- ISICO (Italian Scientific Spine Institute)Via Roberto Bellarmino 13/1MilanItaly20141
| | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute)Via Roberto Bellarmino 13/1MilanItaly20141
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Dovorany B, Morningstar MW, Stitzel C, Siddiqui A. Results of chiropractic scoliosis rehabilitation treatment at two years post-skeletal maturity in identical female twins. J Bodyw Mov Ther 2014; 19:592-6. [PMID: 26592215 DOI: 10.1016/j.jbmt.2014.11.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 11/17/2014] [Accepted: 11/18/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Scoliosis treatment guidelines for non-operative management suggest that patients should be followed for two years beyond skeletal maturity to appropriately evaluate treatment effect. This report outlines the results of identical twin girls' treatment with chiropractic rehabilitation treatment at two years post skeletal maturity. FINDINGS The twins participated in a treatment lasting two weeks, followed by home care maintenance and periodic follow-ups for they reached skeletal maturity. Two year follow up showed reduced Cobb angles of 19° and 15°, respectively. CONCLUSION Identical twin girls who were evaluated two years after skeletal maturity showed clinically significant improvements in Cobb angle measurements. Controlled, prospective study design for future patients treated in this manner will provide greater insight into how the treatment may have impacted the observed changes.
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Affiliation(s)
- Brian Dovorany
- Private Practice of Chiropractic Medicine, 2031 S Webster Avenue, Green Bay, WI 54301, USA
| | - Mark W Morningstar
- Private Practice of Chiropractic Medicine, 8293 Office Park Dr, Grand Blanc, MI 48439, USA.
| | - Clayton Stitzel
- Private Practice of Chiropractic Medicine, 504 W Orange St, Lititz, PA 17543, USA
| | - Aatif Siddiqui
- Private Practice of Chiropractic Medicine, 2 W 45th Street, 4th Floor, New York, NY 10036, USA
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Płaszewski M, Bettany-Saltikov J. Non-surgical interventions for adolescents with idiopathic scoliosis: an overview of systematic reviews. PLoS One 2014; 9:e110254. [PMID: 25353954 PMCID: PMC4213139 DOI: 10.1371/journal.pone.0110254] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 09/08/2014] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Non-surgical interventions for adolescents with idiopathic scoliosis remain highly controversial. Despite the publication of numerous reviews no explicit methodological evaluation of papers labeled as, or having a layout of, a systematic review, addressing this subject matter, is available. OBJECTIVES Analysis and comparison of the content, methodology, and evidence-base from systematic reviews regarding non-surgical interventions for adolescents with idiopathic scoliosis. DESIGN Systematic overview of systematic reviews. METHODS Articles meeting the minimal criteria for a systematic review, regarding any non-surgical intervention for adolescent idiopathic scoliosis, with any outcomes measured, were included. Multiple general and systematic review specific databases, guideline registries, reference lists and websites of institutions were searched. The AMSTAR tool was used to critically appraise the methodology, and the Oxford Centre for Evidence Based Medicine and the Joanna Briggs Institute's hierarchies were applied to analyze the levels of evidence from included reviews. RESULTS From 469 citations, twenty one papers were included for analysis. Five reviews assessed the effectiveness of scoliosis-specific exercise treatments, four assessed manual therapies, five evaluated bracing, four assessed different combinations of interventions, and one evaluated usual physical activity. Two reviews addressed the adverse effects of bracing. Two papers were high quality Cochrane reviews, Three were of moderate, and the remaining sixteen were of low or very low methodological quality. The level of evidence of these reviews ranged from 1 or 1+ to 4, and in some reviews, due to their low methodological quality and/or poor reporting, this could not be established. CONCLUSIONS Higher quality reviews indicate that generally there is insufficient evidence to make a judgment on whether non-surgical interventions in adolescent idiopathic scoliosis are effective. Papers labeled as systematic reviews need to be considered in terms of their methodological rigor; otherwise they may be mistakenly regarded as high quality sources of evidence. PROTOCOL REGISTRY NUMBER CRD42013003538, PROSPERO.
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Affiliation(s)
- Maciej Płaszewski
- Faculty of Physical Education and Sport in Biała Podlaska, University School of Physical Education, Warsaw, ul. Akademicka 2, Biała Podlaska, Poland
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Evidence-based of nonoperative treatment in adolescent idiopathic scoliosis. Asian Spine J 2014; 8:695-702. [PMID: 25346826 PMCID: PMC4206823 DOI: 10.4184/asj.2014.8.5.695] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 06/08/2014] [Accepted: 06/08/2014] [Indexed: 11/09/2022] Open
Abstract
Until now because there are many published journals with a variety of opinions so I will stratify these articles by giving weighted value on grade evaluation which depend on each institution (written author and co-authors) and external evaluate status (SCI, SCIE, impact factor) rather than the outcomes provided by each article. Consequently, before evaluating publicized papers, study quality assessment of each interesting paper should be performed by mean of gauging the quality of evidence. Reviewing these articles, a grade of medical literature was divided into the following 5 levels as level I (randomized controlled study), level II (non-randomized controlled study), level III (case-control study), level IV (case series), and level V (expert opinions). However, in present article I concluded only involved medical literatures with weighted value of level I and II evidence.
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Ćosić V, Day JA, Iogna P, Stecco A. Fascial Manipulation® method applied to pubescent postural hyperkyphosis: A pilot study. J Bodyw Mov Ther 2014; 18:608-15. [DOI: 10.1016/j.jbmt.2013.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 12/08/2013] [Accepted: 12/14/2013] [Indexed: 10/25/2022]
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Affiliation(s)
- Eugene J Carragee
- From the Stanford University School of Medicine, Stanford, CA (E.J.C.); and the Walter Reed National Military Medical Center, Bethesda, MD (R.A.L.)
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Lee M, Hwang J, Seo B, Im G, Jeon N, Yang H, Kim T, Kim H, Han D. The Effects of the Core Muscle Release Technique on Scoliosis. J Phys Ther Sci 2013. [DOI: 10.1589/jpts.25.445] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Myounggi Lee
- Department of Physical Therapy, Woori Spine Hospital
| | - Jinseok Hwang
- Department of Oriental Medicine, Bon Oriental Hospital
| | - Byungdo Seo
- Department of Physical Therapy, College of Health and Welfare, Kyungwoon University
| | - Gyudon Im
- Department of Physical Therapy, Dr Chuck Chuck Spinecare Hospital
| | - Nakyu Jeon
- Department of Oriental Medicine, Madi75 Oriental Hospital
| | - Hyunho Yang
- Department of Oriental Medicine, Jangseong Oriental Hospital
| | - Taeho Kim
- Department of Neurosurgery, Allbareun Neurosurgery Hospital
| | - Hyungguen Kim
- Department of Physical Therapy, Faculty of Health Science, Hallym University
| | - Dongwook Han
- Department of Physical Therapy, College of Medical and Life Science, Silla University: 700 beon-gi, 140 Baegyang-daero, Sasang-gu, Busan 617-736, Republic of Korea
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Villafañe JH, Silva GB, Dughera A. Manipulative and rehabilitative therapy as a treatment of idiopathic scoliosis without psychological sequelae: a case report. J Chiropr Med 2012. [PMID: 23204954 DOI: 10.1016/j.jcm.2012.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The purpose of this case report is to describe management and outcomes of a patient with scoliosis. CLINICAL FEATURES A 9-year-old female patient with a double curve pattern with Cobb angles of 18° and 24° (thoracic/thoracolumbar) compatible with scoliosis presented for physical therapy treatment. INTERVENTION AND OUTCOME Physiotherapy treatment with a combination of manipulative and rehabilitation techniques was used. After finishing the treatment, the patient had Cobb angles of 7° and 11°, an improvement of 55% and 54%, respectively. After 6 months, these effects were maintained, as the patient had Cobb angles of 11° and 11°. The clinical appearance of the patient improved after the course of care. The patient was evaluated for psychological outcomes by applying the following tests: Scoliosis Research Society 22, Bad Sobernheim Stress, and the Brace Questionnaire The patient had the maximum score in all tests at the conclusion of therapy. CONCLUSION The patient responded favorably to manipulative and rehabilitation techniques. At the end of care, the patient did not show psychological sequelae with selected outcome measures.
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Affiliation(s)
- Jorge H Villafañe
- Physical Therapist, Department of Physical Therapy, Residenze Sanitarie Assistenziali "A. Maritano," Sangano, Italy
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Negrini S, Aulisa AG, Aulisa L, Circo AB, de Mauroy JC, Durmala J, Grivas TB, Knott P, Kotwicki T, Maruyama T, Minozzi S, O'Brien JP, Papadopoulos D, Rigo M, Rivard CH, Romano M, Wynne JH, Villagrasa M, Weiss HR, Zaina F. 2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth. SCOLIOSIS 2012; 7:3. [PMID: 22264320 PMCID: PMC3292965 DOI: 10.1186/1748-7161-7-3] [Citation(s) in RCA: 251] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 01/20/2012] [Indexed: 11/21/2022]
Abstract
BACKGROUND The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), that produced its first Guidelines in 2005, felt the need to revise them and increase their scientific quality. The aim is to offer to all professionals and their patients an evidence-based updated review of the actual evidence on conservative treatment of idiopathic scoliosis (CTIS). METHODS All types of professionals (specialty physicians, and allied health professionals) engaged in CTIS have been involved together with a methodologist and a patient representative. A review of all the relevant literature and of the existing Guidelines have been performed. Documents, recommendations, and practical approach flow charts have been developed according to a Delphi procedure. A methodological and practical review has been made, and a final Consensus Session was held during the 2011 Barcelona SOSORT Meeting. RESULTS The contents of the document are: methodology; generalities on idiopathic scoliosis; approach to CTIS in different patients, with practical flow-charts; literature review and recommendations on assessment, bracing, physiotherapy, Physiotherapeutic Specific Exercises (PSE) and other CTIS. Sixty-five recommendations have been given, divided in the following topics: Bracing (20 recommendations), PSE to prevent scoliosis progression during growth (8), PSE during brace treatment and surgical therapy (5), Other conservative treatments (3), Respiratory function and exercises (3), Sports activities (6), Assessment (20). No recommendations reached a Strength of Evidence level I; 2 were level II; 7 level III; and 20 level IV; through the Consensus procedure 26 reached level V and 10 level VI. The Strength of Recommendations was Grade A for 13, B for 49 and C for 3; none had grade D. CONCLUSION These Guidelines have been a big effort of SOSORT to paint the actual situation of CTIS, starting from the evidence, and filling all the gray areas using a scientific method. According to results, it is possible to understand the lack of research in general on CTIS. SOSORT invites researchers to join, and clinicians to develop good research strategies to allow in the future to support or refute these recommendations according to new and stronger evidence.
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Affiliation(s)
- Stefano Negrini
- Physical and Rehabilitation Medicine, University of Brescia, Italy
- Don Gnocchi Foundation, Milan, Italy
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | - Angelo G Aulisa
- Orthopaedics and Traumatology Division, Bambino Gesù Children's Hospital, Institute of Scientific Research, Piazza San Onofrio 4, 00165, Rome, Italy
| | - Lorenzo Aulisa
- Department of Orthopaedics, Catholic University of the Sacred Heart, University Hospital 'Agostino Gemelli', L.go F. Vito, 1-00168 Rome, Italy
| | - Alin B Circo
- Sainte Justine Hospital, University of Montreal, Canada
| | | | - Jacek Durmala
- Department of Rehabilitation, Medical University of Silesia and University Hospital, Katowice, Poland
| | - Theodoros B Grivas
- Department of Trauma and Orthopaedics, "Tzanio" General Hospital, Tzani and Afendouli 1 st, Piraeus 18536, Greece
| | - Patrick Knott
- Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, 60064, USA
| | - Tomasz Kotwicki
- Spine Disorders Unit, Department of Pediatric Orthopedics and Traumatology, University of Medical Sciences, Poznan, Poland
| | - Toru Maruyama
- Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, Japan
| | - Silvia Minozzi
- Cochrane Review Group on Drugs and Alcohol. Department of Epidemiology. Lazio Region. Via di Santa Costanza, 53. 00198 Rome. Italy
| | | | - Dimitris Papadopoulos
- Spondylos Laser Spine Lab, Orthopaedic Facility and Rehabilitation Center, 74, Messogion Ave, 115 27, Athens, Greece
| | - Manuel Rigo
- Institut Elena Salvá. Vía Augusta 185. 08021 Barcelona, Spain
| | | | - Michele Romano
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | | | | | - Hans-Rudolf Weiss
- Gesundheitsforum Nahetal. Alzeyer Str. 23. D-55457 Gensingen, Germany
| | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), Milan, Italy
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Morningstar MW. Outcomes for adult scoliosis patients receiving chiropractic rehabilitation: a 24-month retrospective analysis. J Chiropr Med 2011; 10:179-84. [PMID: 22014907 DOI: 10.1016/j.jcm.2011.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 12/01/2010] [Accepted: 01/06/2011] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVES The purpose of this study was to retrospectively report the results of patients who completed an exercise-based chiropractic program and its potential to alter the natural progression of adult scoliosis at 24 months after the clinic portion of treatment was concluded. METHODS A retrospective chart review was conducted at 2 spine clinics in Michigan, USA. Each clinic uses the same chiropractic rehabilitation program to treat patients with adult scoliosis. Multidimensional patient outcomes included radiographic, respiratory, disability, and pain parameters. Outcomes were measured at baseline, at end of active treatment, and at long-term follow-up. RESULTS A total of 28 patients fit the inclusion criteria for the study. The average beginning primary Cobb angle was 44° ± 6°. Patients received the same chiropractic rehabilitation program for approximately 6 months. At the end of active treatment, improvements were recorded in Cobb angle, pain scores, spirometry, and disability rating. All radiographic findings were maintained at 24-month follow-up. CONCLUSION This report is among the first to demonstrate sustained radiographic, self-rated, and physiologic benefits after treatment ceased. After completion of a multimodal chiropractic rehabilitation treatment, a retrospective cohort of 28 adult scoliosis patients reported improvements in pain, Cobb angle, and disability immediately following the conclusion of treatment and 24 months later.
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Wittman RA, Vallone SA. Inclusion of chiropractic care in multidisciplinary management of a child with Prader-Willi syndrome: a case report. J Chiropr Med 2011; 8:193-9. [PMID: 19948310 DOI: 10.1016/j.jcm.2009.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Revised: 07/30/2009] [Accepted: 08/07/2009] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The purpose of this paper is to present a case of a child with Prader-Willi syndrome and the observed improvement in the degree of scoliosis, immune function, and behavior documented during the course of her treatment. CLINICAL FEATURES A 7-year-old girl presented to Kentuckiana Children's Center with a 15 degrees lumbar levoscoliosis and diagnosis of Prader-Willi syndrome. INTERVENTION AND OUTCOME The treatment plan consisted of chiropractic adjustments, craniosacral therapy, movement therapy, and nutritional therapy. Over the course of treatment, her muscle strength, tone, and motor activity increased. She improved in coordination of gait and balance. Over the course of 3 years, her scoliosis decreased to 4 degrees to 5 degrees . Improvements in immune function and a reduction in anxiety type behaviors were documented by the parents and doctor of chiropractic over the course of 5 years. CONCLUSIONS This case report describes the improvements and progression of one female child with Prader-Willi syndrome under chiropractic and multidisciplinary care.
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Affiliation(s)
- Rebekah A Wittman
- Clinic Doctor, Kentuckiana Children's Center, Kentuckiana Center for Education, Health, and Research, Inc., Louisville, KY 40206
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29
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Green BN, Johnson C, Moreau W. Is physical activity contraindicated for individuals with scoliosis? A systematic literature review. J Chiropr Med 2011; 8:25-37. [PMID: 19646383 DOI: 10.1016/j.jcm.2008.11.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Revised: 11/24/2008] [Accepted: 11/25/2008] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The purpose of this study was to perform a systematic review of the literature and other authoritative sources for recommendations regarding the appropriateness of physical and sporting activity for those with scoliosis. METHODS The literature was systematically searched in PubMed, the Cumulative Index to Nursing and Allied Health Literature, the Index to Chiropractic Literature, and the National Guidelines Clearinghouse from the earliest date of each database through July 2008. All languages and research designs were included. Web sites of respected organizations were searched for position/white papers on scoliosis and physical activity. Included articles were rated using the Oxford Centre for Evidence-Based Medicine criteria, and recommendations for physical activity were made using the Oxford Centre's criteria for grades of recommendation. RESULTS Of 42 articles retrieved, 11 met the inclusion criteria. The Internet review of 18 organizations yielded no previous guidelines or position papers for physical activity and scoliosis. Recommendations were made from 3 level 3b studies and 8 level 5 studies; they include the following: (1) brace-treated and surgically treated scoliosis patients have demonstrated that they can physically participate in physical activities at the same level as nonsurgical patients (grade C recommendation); (2) nonsurgically treated patients are encouraged to participate in sports and physical activity and (3) scoliosis is not a contraindication to participation in most sports (grade D recommendation); (4) brace-treated scoliosis patients are encouraged to exercise with their brace on; however, exercise may also be done outside of the brace (grade D recommendation); and (5) physical activity may be commenced after surgery for scoliosis; however, no high-quality evidence exists that guides the timing of return to physical activity (grade D recommendation). A potential association between elite-level competition in specific sports at an early age and an increased prevalence of scoliosis has been reported (grade C recommendation). CONCLUSION This article offers evidence-based guidance to health care providers and to patients with scoliosis when making decisions to participate in physical and sporting activities.
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Affiliation(s)
- Bart N Green
- Chiropractor, Chiropractic Division, Department of Physical and Occupational Therapy, Naval Medical Center San Diego, San Diego, CA; Associate Editor, National University of Health Sciences, Lombard, IL
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Morningstar MW, Strauchman MN. Management of a 59-year-old female patient with adult degenerative scoliosis using manipulation under anesthesia. J Chiropr Med 2011; 9:77-83. [PMID: 21629554 DOI: 10.1016/j.jcm.2010.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Revised: 01/15/2010] [Accepted: 02/03/2010] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Manipulation under anesthesia (MUA) is an outpatient procedure that is performed to restore normal joint kinematics and musculoskeletal function. This article presents a case of a patient with idiopathic lumbar degenerative scoliosis who developed intractable pain as an adult and reports on the outcomes following a trial of MUA. CLINICAL FEATURES A 59-year-old female patient presented to a chiropractic office with primary subjective symptoms of lower back and bilateral hip pain. Numerical pain rating scores were reported at 8 of 10 for the lower back and 9 of 10 for the sacroiliac joint/gluteal region. A disability score using a functional rating index demonstrated a score of 26 of 40 (or 64% disability). Over the preceding 5 years, the patient had tried a number of conservative therapies to relieve her pain without success. INTERVENTION AND OUTCOME The patient was evaluated for MUA. The patient was scheduled for a serial MUA over 3 days. Numerical pain rating scores 8 weeks after the MUA were 1 of 10 for the lower back and 3 of 10 for the sacroiliac joint. Her disability rating decreased to 11 of 40 (28%). Radiological improvements were also observed. These outcomes were maintained at 6-month follow-up. CONCLUSION Pain, functional, and radiographic outcomes demonstrated improvements immediately following treatment for this patient.
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Negrini S, Minozzi S, Bettany-Saltikov J, Zaina F, Chockalingam N, Grivas TB, Kotwicki T, Maruyama T, Romano M, Vasiliadis ES. Cochrane Review: Braces for idiopathic scoliosis in adolescents. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/ebch.620] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
STUDY DESIGN Cochrane systematic review. OBJECTIVE To evaluate the efficacy of bracing in adolescent patients with adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA AIS is a 3-dimensional deformity of the spine. Although AIS can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. Braces are traditionally recommended to stop curvature progression in some countries and criticized in others. They generally need to be worn full time, with treatment extending over years. METHODS The following databases (up to July 2008) were searched with no language limitations: the Cochrane Central Register of Controlled Trials, MEDLINE (from January 1966), EMBASE (from January 1980), and CINHAL (from January 1982), and reference lists of the articles. An extensive handsearch of the gray literature was also conducted. Randomized controlled trials (RCTs) and prospective cohort studies were searched for comparing braces with no treatment, other treatment, surgery, and different types of braces. Two review authors independently assessed trial quality and extracted data. RESULTS We included 2 studies. There was very low quality evidence from 1 prospective cohort study with 286 girls that a brace curbed curve progression at the end of growth (success rate, 74% [95% confidence interval {CI}: 52%-84%]), better than observation (success rate, 34% [95% CI: 16%-49%]) and electrical stimulation (success rate, 33% [95% CI: 12%-60%]). There is low-quality evidence from 1 RCT with 43 girls that a rigid brace is more successful than an elastic one (SpineCor) at curbing curve progression when measured in Cobb degrees, but there were no significant differences between the 2 groups in the subjective perception of daily difficulties associated with wearing the brace. CONCLUSION There is very low quality evidence in favor of using braces, making generalization very difficult. Further research could change the actual results and our confidence in them; in the meantime, patients' choices should be informed by multidisciplinary discussion. Future research should focus on short- and long-term patient-centered outcomes, in addition to measures such as Cobb angles. RCTs and prospective cohort studies should follow both the Scoliosis Research Society and Society on Scoliosis Orthopedic and Rehabilitation Treatment criteria for bracing studies.
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Hasler C, Schmid C, Enggist A, Neuhaus C, Erb T. No effect of osteopathic treatment on trunk morphology and spine flexibility in young women with adolescent idiopathic scoliosis. J Child Orthop 2010; 4:219-26. [PMID: 21629373 PMCID: PMC2866846 DOI: 10.1007/s11832-010-0258-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Accepted: 03/31/2010] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Brace treatment is the gold standard for patients with mild adolescent idiopathic scoliosis (Cobb angle 20°-40°). However, negative psychosocial impacts, physical constraints and incompliance cause many patients and parents to seek for so-called holistic and apparently less harmful approaches within the field of complementary and alternative medicine (CAM). Osteopathy-manual interventions on the viscera and locomotor system-is widely used for scoliosis. There is, however, a complete lack of evidence regarding its efficacy. We, therefore, tested the hypothesis that osteopathy alters trunk morphology, a prerequisite to unload the concave side of the scoliosis, and that it halts curve progression. METHODS This was a prospective, controlled trial of 20 post-pubertal young women (20°-40° idiopathic scoliosis) randomly allocated to an observation (group 0) or osteopathic treatment (group 1). The latter comprised three sessions (5 weeks). Trunk morphology (clinical examination, video rasterstereography) and spine flexibility (MediMouse(®)) were assessed at a pre- and post-intervention with a 3-month interval (blinded examiner). We chose scoliometer measurement (rib hump, lumbar prominence) as the main outcome parameter. RESULTS Two patients in the treatment group refused further treatment and the final examination, as they felt no benefit after two osteopathic treatments. Regression analysis for repeat measurements (independent statistician) revealed no therapeutic effect on rib hump, lumbar prominence, plumb line, sagittal profile and global spinal flexibility. CONCLUSIONS We found no evidence to support osteopathy in the treatment of mild adolescent idiopathic scoliosis. Therefore, we caution against abandoning the conventional standard of care for mild idiopathic scoliosis. As for other CAM therapies, the use of osteopathy as a treatment option for scoliosis still needs to be clearly defined.
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Affiliation(s)
- Carol Hasler
- />Orthopaedic Department, University Children’s Hospital, Roemergasse 8, 4005 Basel, Switzerland
| | - Caius Schmid
- />Corpo Sana, Training and Therapy, Münchensteinerstrasse 220, 4053 Basel, Switzerland
| | - Andreas Enggist
- />Enggist Medical Fitness, Bahnhofstrasse 43, 9470 Buchs, Switzerland
| | - Conny Neuhaus
- />Division of Physiotherapy, University Children’s Hospital, Roemergasse 8, 4005 Basel, Switzerland
| | - Thomas Erb
- />Division of Anaesthesiology, University Children’s Hospital, Roemergasse 8, 4005 Basel, Switzerland
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Negrini S, Grivas TB. Introduction to the "Scoliosis" Journal Brace Technology Thematic Series: increasing existing knowledge and promoting future developments. SCOLIOSIS 2010; 5:2. [PMID: 20205874 PMCID: PMC2827401 DOI: 10.1186/1748-7161-5-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Accepted: 01/28/2010] [Indexed: 11/15/2022]
Abstract
Bracing is the main non-surgical intervention in the treatment of idiopathic scoliosis during growth, in hyperkyphosis (and Scheuermann disease) and occasionally for spondylolisthesis; it can be used in adult scoliosis, in the elderly when pathological curves lead to a forward leaning posture or in adults after traumatic injuries. Bracing can be defined as the application of external corrective forces to the trunk; rigid supports or elastic bands can be used and braces can be custom-made or prefabricated. The state of research in the field of conservative treatment is insufficient and while it can be stated that there is some evidence to support bracing, we must also acknowledge that today we do not have a common and generally accepted knowledge base, and that instead, individual expertise still prevails, giving rise to different schools of thought on brace construction and principles of correction. The only way to improve the knowledge and understanding of brace type and brace function is to establish a single and comprehensive source of information about bracing. This is what the Scoliosis Journal is going to do through the "Brace Technology" Thematic Series, where technical papers coming from the different schools will be published.
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Affiliation(s)
- Stefano Negrini
- ISICO (Italian Scientific Spine Institute), Via R Bellarmino 13/1, 20141 Milan, Italy
| | - Theodoros B Grivas
- Orthopaedic and Trauma Department, "Tzanio" General Hospital of Piraeus, Piraeus, Greece
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35
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Negrini S, Minozzi S, Bettany-Saltikov J, Zaina F, Chockalingam N, Grivas TB, Kotwicki T, Maruyama T, Romano M, Vasiliadis ES. Braces for idiopathic scoliosis in adolescents. Cochrane Database Syst Rev 2010:CD006850. [PMID: 20091609 DOI: 10.1002/14651858.cd006850.pub2] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Adolescent Idiopathic Scoliosis (AIS) is a three-dimensional deformity of the spine. While AIS can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased. Braces are traditionally recommended to stop curvature progression in some countries and criticized in others. They generally need to be worn full time, with treatment extending over years. OBJECTIVES To evaluate the efficacy of bracing in adolescent patients with AIS. SEARCH STRATEGY The following databases (up to July 2008) were searched with no language limitations: the Cochrane Central Register of Controlled Trials, MEDLINE (from January 1966), EMBASE (from January 1980), CINHAL (from January 1982) and reference lists of articles. An extensive handsearch of the grey literature was also conducted. SELECTION CRITERIA Randomised controlled trials and prospective cohort studies comparing braces with no treatment, other treatment, surgery, and different types of braces. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial quality and extracted data. MAIN RESULTS We included two studies. There was very low quality evidence from one prospective cohort study with 286 girls that a brace curbed curve progression at the end of growth (success rate 74% (95% CI: 52% to 84%)), better than observation (success rate 34% (95% CI:16% to 49%)) and electrical stimulation (success rate 33% (95% CI:12% to 60%)). There is low quality evidence from one RCT with 43 girls that a rigid brace is more successful than an elastic one (SpineCor) at curbing curve progression when measured in Cobb degrees, but there were no significant differences between the two groups in the subjective perception of daily difficulties associated with wearing the brace. AUTHORS' CONCLUSIONS There is very low quality evidence in favour of using braces, making generalization very difficult. Further research could change the actual results and our confidence in them; in the meantime, patients' choices should be informed by multidisciplinary discussion. Future research should focus on short and long-term patient-centred outcomes, in addition to measures such as Cobb angles. RCTs and prospective cohort studies should follow both the Scoliosis Resarch Society (SRS) and Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) criteria for bracing studies.
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Affiliation(s)
- Stefano Negrini
- ISICO (Italian Scientific Spine Institute), Via Roberto Bellarmino 13/1, Milan, Italy, 20141
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Brooks WJ, Krupinski EA, Hawes MC. Reversal of childhood idiopathic scoliosis in an adult, without surgery: a case report and literature review. SCOLIOSIS 2009; 4:27. [PMID: 20003501 PMCID: PMC2808297 DOI: 10.1186/1748-7161-4-27] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Accepted: 12/15/2009] [Indexed: 12/19/2022]
Abstract
BACKGROUND Some patients with mild or moderate thoracic scoliosis (Cobb angle <50-60 degrees) suffer disproportionate impairment of pulmonary function associated with deformities in the sagittal plane and reduced flexibility of the spine and chest cage. Long-term improvement in the clinical signs and symptoms of childhood onset scoliosis in an adult, without surgical intervention, has not been documented previously. CASE PRESENTATION A diagnosis of thoracic scoliosis (Cobb angle 45 degrees) with pectus excavatum and thoracic hypokyphosis in a female patient (DOB 9/17/52) was made in June 1964. Immediate spinal fusion was strongly recommended, but the patient elected a daily home exercise program taught during a 6-week period of training by a physical therapist. This regime was carried out through 1992, with daily aerobic exercise added in 1974. The Cobb angle of the primary thoracic curvature remained unchanged. Ongoing clinical symptoms included dyspnea at rest and recurrent respiratory infections. A period of multimodal treatment with clinical monitoring and treatment by an osteopathic physician was initiated when the patient was 40 years old. This included deep tissue massage (1992-1996); outpatient psychological therapy (1992-1993); a daily home exercise program focused on mobilization of the chest wall (1992-2005); and manipulative medicine (1994-1995, 1999-2000). Progressive improvement in chest wall excursion, increased thoracic kyphosis, and resolution of long-standing respiratory symptoms occurred concomitant with a >10 degree decrease in Cobb angle magnitude of the primary thoracic curvature. CONCLUSION This report documents improved chest wall function and resolution of respiratory symptoms in response to nonsurgical approaches in an adult female, diagnosed at age eleven years with idiopathic scoliosis.
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Affiliation(s)
| | | | - Martha C Hawes
- Division of Plant Pathology and Microbiology, School of Plant Sciences, University of Arizona, Tucson AZ 85721, USA
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