Kinesitherapeutic procedure in the treatment of scoliosis

Piotr Kwiatkowski, Magdalena Sobiech, Marek Fatyga, Andrzej Skwarcz

Piotr Kwiatkowski, Magdalena Sobiech, Marek Fatyga, Andrzej Skwarcz – Kinesitherapeutic procedure in the treatment of scoliosis. Fizjoterapia Polska 2001; 1(3); 298-302

Abstract

Varying kinesitherapeutic procedures are used In children with scoliosis, depending on whether the child is begin only by exercises, or by exercises and brace, or is begin prepared for surgery due to progressing deformation. In the case of children treated conservatively, primary emphasis is given to asymmetrical strengthening exercises for the dorsal muscles and peripheral joints, preceded by stretching exercises for antagonistic muscle groups. Simultaneously, exercises are performed to increase the range movement in the spine (kypholization of the thoracic spine, derotation of the thoraco-lumbar spine) and peripheral joints. In scoliosis exceeding 25-30° with documented progression, orthopedic braces are also used to prevent further progression of the curvature. In such cases it is a separate problem, when the child should exercise in the brace, and when without.Kinesitherapy in children being prepared for surgery differs significantly from that suitable for children in conservative treatment. Here the primary focus is on relaxing, elongating, and the spine. This is achieved by applying an autotraction bed for several hours, along with autocorrection of posture and passive chin-ups. By means of stretching, relaxing, and swimming poolexercises, along with the application of physical agents, the maximum relaxation of the spine’s active and passive apparatus is achieved, so that during surgery the maximum correction of curvature can be obtained while maintaining neurological safety.

Key words:
Scoliosis, kinesitherapeutic procedure, progressing deformation
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The social consequences of spinal pain in adult scoliosis patients treated surgically and conservatively

Hanna M. Tomczak

Hanna M. Tomczak – The social consequences of spinal pain in adult scoliosis patients treated surgically and conservatively. Fizjoterapia Polska 2001; 1(3); 280-282

Abstract

Curvature of the spine when diagnosed and treated in youth (surgically or conservatively) is subject to progression in adults and frequently causes pain symptoms. The present article evaluates the current clinical status of adult scoliosis patients who were treated surgically or conservatively in childhood. The parameters evaluated include the frequency of occurrence of intensified spinal pain and its impact on the professional and social situation of the persons tested.

Key words:
spinal pain, Scoliosis, social consequences
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The impact of musical performance on the occurence of selected disorders of body posture in children from a music school

Mirosław Janiszewski, Anna Kluszczyńska, Ireneusz Pieszyński

Mirosław Janiszewski, Anna Kluszczyńska, Ireneusz Pieszyński – The impact of musical performance on the occurence of selected disorders of body posture in children from a music school. Fizjoterapia Polska 2002; 2(1); 46-56

Abstract
Background. The aim of our study was to investigate the effects of long-term musical training on the genesis of defective posture. Material and methods. The study involved a group of 92 children who were tested twice, once in 1992 again in 1998, used a specially developed screening test. Results. A greater rate of occurrence of posture defects, including especially scoliosis, was found in children who were heavily involved in playing musical instruments. This type played was found to correlate with type and frequency of particular posture defects. Conclusion. Systematic long term of musical instruments may cause more frequent in posturogenesis and a higher rate of scoliosis.

Key words:
posture defects, scoliosis, music, screening test

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Changes of values of selected spirometric parameters in course of complex rehabilitation treatment in patients with scolioses of I° and II°

Rafał Gnat, Edward Saulicz, Marek Zięba, Paweł Ryngier

Rafał Gnat, Edward Saulicz, Marek Zięba, Paweł Ryngier – Changes of values of selected spirometric parameters in course of complex rehabilitation treatment in patients with scolioses of I° and II°. Fizjoterapia Polska 2003; 3(1); 21-29

Abstract
Both the values of the spirometric parameters in people with low-degree scoliosis and their changes in course of the rehabilitation treatment aiming to correct the body posture are subjects rarely mentioned in literature. Just sparse articles give evidence for the presence of respiratory disturbances even in early stages of the development of scoliosis. The hypothesis claiming that normalisation of the values of selected spirometric parameters, decreased earlier, during attempts of correction of the body posture could be obtained was brought forward for needs of the presented report. 60 children with scolioses of Ist and IInd degree and without any coexisting health problems participated. The evaluation of the values of selected spirometric parameters was performed twice: at the beginning of the treatment (initial test) and after its termination (final test). The time of therapeutic influence averaged 28,77 days (SD = 9,47) and daily load with corrective exercises about 3 hours with supplementary procedures. During the period of time between initial and final tests most of the assessed spirometric parameters showed significant improvement increasing their values and bringing them closer to standards (FVC EX, FVC IN, FEV1, PEF, PIF, VC, IC). The ERV parameter didn’t show any important alterations. The volumes TV and MV as well as Tiffeneau coefficient maintained their previous rise tendencies.According to the stated hypothesis the corrective rehabilitation treatment improved values of selected spirometric parameters, which were decreased in course of low-degree scoliosis. Basing on the results some practical clues concerning corrective treatment of this postural fault may also be formulated.

Key words:
Scoliosis, rehabilitation treatment, Spirometry, spirometric parameters

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Epidemiology of lateral curvature of the spine in children and adolescents

Michał Dziewulski, Waldemar Szymanik

Michał Dziewulski, Waldemar Szymanik – Epidemiology of lateral curvature of the spine in children and adolescents. Fizjoterapia Polska 2003; 3(2); 106-112

Abstract
Background. The primary purpose of this article is to draw attention to the problem of lateral scoliosis in children and adolescents, a serious issue in orthopedics. This subject should be of interest not only to orthopedists, but also to pediatricians, rehabilitation specialists, physiotherapists, family physicians, and even specialists in internal medicine. The authors’ goal is to focus on the basic facts concerning this disorder, its classification, and the epidemiology. Material and methods. In our clinical work over the last 30 years we have observed patients treated at the Rehabilitation Center in Konstancin, Poland. The rate of occurrence of scoliosis has been calculated, and the data broken down by sex, age, and residence (urban or rural). The goal was to point out any possible predisposition by gender, to discover whether the residence had any impact on the likelihood of diagnosis due to better facilities, and to specify the age at which there occurs the greatest risk of occurrence. Results. Despite a systematic increase in the number of patients admitted to our Center, there has not been a proportional increase in the number of patients with scoliosis, and in fact the number has diminished. A distinct tendency for scoliosis to appear in girls was noticed. Scoliosis is more often diagnosed in urban children and adolescents. Conclusions. More precise examination and diagnosis of children is required in respect to the possible occurrence of lateral scoliosis, especially in rural environments. Other aspects, such as gender-related trends and the most common type of scoliosis, do not differ from the data reported in the literature.

Key words:
body posture, scoliosis, gender, early diagnosis

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Some possibilities for using the Lehnert-Schroth concept during corrective exercises in stationary system

J. Nowotny, K. Czupryna, O. Nowotny-Czupryna

J. Nowotny, K. Czupryna, O. Nowotny-Czupryna – Some possibilities for using the Lehnert-Schroth concept during corrective exercises in stationary system. Fizjoterapia Polska 2003; 3(4); 412-419

Abstract

Corrective exercises constitute a basic element in the conservative treatment of lateral curvature of the spine. In recent years corrective breathing exercises based on the concepts of C. Lehnert-Schroth have proven to be especially valuable. It is a well-known fact that individual exercises are most effective, especially in advanced scoliosis: however, for epidemiological and organizational reasons it is not possible to extend such individual attention to all those who need it. As a result, group exercises are the dominant from of corrective procedure. It is important, however, for these types of exercises to be adapted to the individual needs of every participant. The only form that can meet this requirement is the so-called “stationary system”. The present authors have been advocating the use of this form for corrective exercises for many years. Given the value of corrective-breathing exercises and the need for these kinds of exercises to be conducted in a group system, the authors have presented here their own conception for rehabilitation, keeping both these elements in mind, including our own modifications of various exercises modeled on the Lehnert-Schroth method. These types of exercises have been woven into the entire system, supported by biofeedback, creating in turn circumstances conducive to shaping the habit of proper posture.

Key words:
Scoliosis, group exercises, stationary system
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Impact of musical performance on the frequency of postural abnormalities in children

Anna Kluszczyńska, Jolanta Kujawa, Mirosław Janiszewski, Ireneusz Pieszyński

Anna Kluszczyńska, Jolanta Kujawa, Mirosław Janiszewski, Ireneusz Pieszyński – Impact of musical performance on the frequency of postural abnormalities in children. Fizjoterapia Polska 2004; 4(2); 117-128

Abstract

Background. An increased load on components of the musculo-skeletal system caused by musical performance can lead to postural abnormalities and overstraining of the musculo-skeletal system in young performing artists. The aim of our research was to investigate the link over the long term between play on musical instruments by children, the type of musical performance, and disturbances of body posture. Material and methods. Our research involved a group of 113 primary music school pupils. The study was conducted in 1st, 2nd, and 3rd grade pupils, 7, 9 and 11 years of age respectively. The clinical examination consisted of a physical exam and an orthopedic evaluation of the musculo-skeletal system. A questionnaire indicating the type of instrument played and the body posture during play was also used. Results. The postural abnormalities found in this population included scoliotic posture, scoliosis, and thoracic muscle contraction. Many children showed several types of postural abnormalities coexisting. A statistically significant difference in the frequency of postural abnormalities was found, depending on how long the given musical instrument had been played after five years of attendance at the music school. Conclusions. Musical performance may increase the incidence and progression of some body posture disorders in music school pupils. The load imposed by the instrument being played leads to faster development of the clinical symptoms of scoliosis in girls than in boys. The appearance and progression of the body posture disorders may be contingent on how long the musical instrument is played. The progression of clinical symptoms in music school pupils depends on the type of music performance.

Key words:
scoliotic posture, scoliosis, thoracic muscle contracture
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Intraobserver and interobserver variability of the assessment of trunk rotation with Bunnell scoliometer in children with idiopathic scoliosis

Tomasz Kotwicki, Kamila Frydryk, Małgorzata Lorkowska, Aleksander Krawczyński, Andrzej Szulc

Tomasz Kotwicki, Kamila Frydryk, Małgorzata Lorkowska, Aleksander Krawczyński, Andrzej Szulc – Intraobserver and interobserver variability of the assessment of trunk rotation with Bunnell scoliometer in children with idiopathic scoliosis. Fizjoterapia Polska 2006; 6(2); 111-116

Abstract

Background. Idiopathic scoliosis is a three-dimensional deformity of the spine. The measurement of vertebral axial rotation is one of the most important parameters in the assessment of a scoliotic curve. Bunnell proposed a device — scoliometer in order to measure the angle of trunk rotation (ATR). Scoliometer has not been described in polish scientific literature. Material and methods. 50 patients (65 scoliotic curves) were examined with Bunnell scoliometer. In the forward bending test position the scoliometer was applied to the surface of the back in the region of maximum deformity, with its „zero” over spinous processes. The exam was made by four independent observers: three senior students of physiotherapy and one orthopaedic surgeon experienced in scoliosis management. One author performed the exam three times. lnterobserver and intraobserver agreement were checked with ANOVA. Rib hump height was measured in millimetres and the correlation with the angle of trunk rotation was calculated. Results. lnterobserver agreement revealed high concordance of measurements (ANOVA, p<0,01). Non-experienced observers demonstrated results parallel to those of an experienced specialist. lntraobserver agreement was also found very high (ANOVA, p<0,01). Strong positive correlation between the rib hump height measurement with a goniometer and the angle of trunk rotation measurement with a scoliometer was found (r=0,92, p<0,05) in thoracic curves (n=30). Conclusion. Scoliometer can be recommended for standard use in the checking of children and adolescents examined for scoliosis. Non-experienced paramedicals can correctly use the device.

Key words:
scoliosis, scoliometer, vertebral rotation
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