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Dingo
05-12-2010, 09:46 AM
There is debate about whether exercise and fitness helps children with Scoliosis. However exercise has been found to benefit patients who suffer from many different diseases. This includes diseases that on the surface don't appear to have any relationship to physical fitness.

Exercise Helps Protect Brain of Multiple Sclerosis Patients, Study Suggests (http://www.sciencedaily.com/releases/2010/02/100218141813.htm)


"We found that aerobic fitness has a protective effect on parts of the brain that are most affected by multiple sclerosis," said Ruchika Shaurya Prakash, lead author of the study and assistant professor of psychology at Ohio State University.


"Physically fit MS patients had fewer lesions compared to those who weren't as fit and the lesions they did have tended to be smaller," Prakash said. "This is significant and can help explain why the higher-fit patients did better on tests of brain functioning."

Schizophrenia: Regular Exercise Guidelines Still Apply (http://www.sciencedaily.com/releases/2010/05/100511192250.htm)


Regular exercise can play an important a role in improving the physical and mental wellbeing of individuals with schizophrenia, according to a review published in The Cochrane Library. Following a systematic review of the most up-to-date research on exercise in schizophrenia, researchers concluded that the current guidelines for exercise should be followed by people with schizophrenia just as they should by the general population.


The researchers found that exercise programmes improved mental state for measures including anxiety and depression, particularly when compared to standard care.

rohrer01
05-12-2010, 11:22 AM
We know that practically everyone can benefit by engaging in some form of physical fitness routine. I'm not quite following how you are linking these study articles to scoliosis.

Dingo
05-12-2010, 05:20 PM
rohrer01

It's fascinating to me that a high level of aerobic fitness would protect the brain from damage caused by MS. It's not something I would have put together.

But like you said,

We know that practically everyone can benefit by engaging in some form of physical fitness routine.

And you are right. The MS study shouldn't necessarily be a surprise. We don't always know the way in which fitness helps but the bias should always be in favor of it.

But have a quick read through the posts in this thread. (Torso Rotation Strength Training for Scoliosis (http://www.scoliosis.org/forum/showthread.php?t=8976)) For many people the bias is decisively against exercise. This is true even with multiple scientific studies that show a clear benefit to strength training. Morover evidence is mounting that the muscles in the spine may be the prime instigator for curve progression.

But inspite of that many people (including doctors) flat out reject exercise for Scoliosis. On my son's first visit to a spine specialist/surgeon I asked him if exercise would help and his answer was unequivocal. He shook his head and said, "exercise has no impact on Scoliosis."

No doubt there are probably many doctors who would say the same about exercise and Multiple Sclerosis.

rohrer01
05-12-2010, 06:47 PM
rohrer01

It's fascinating to me that a high level of aerobic fitness would protect the brain from damage caused by MS. It's not something I would have put together.

But like you said,


And you are right. The MS study shouldn't necessarily be a surprise. We don't always know the way in which fitness helps but the bias should always be in favor of it.

But have a quick read through the posts in this thread. (Torso Rotation Strength Training for Scoliosis (http://www.scoliosis.org/forum/showthread.php?t=8976)) For many people the bias is decisively against exercise. This is true even with multiple scientific studies that show a clear benefit to strength training. Morover evidence is mounting that the muscles in the spine may be the prime instigator for curve progression.

But inspite of that many people (including doctors) flat out reject exercise for Scoliosis. On my son's first visit to a spine specialist/surgeon I asked him if exercise would help and his answer was unequivocal. He shook his head and said, "exercise has no impact on Scoliosis."

No doubt there are probably many doctors who would say the same about exercise and Multiple Sclerosis.

Bold added by me. I was surprized to read this statement almost word for word on the SRS website. Since I was diagnosed in 1985, exercise was always pushed as the only treatment for me since I couldn't be braced. It didn't have much of an impact that I'm aware of except to prevent progression maybe. I can't even say that for sure, because I am progressing. However, maybe it slowed it down. I have always been a proponent for exercise. If a person just lays around being a slug, you can usually spot them. They are very flabby and unhealthy looking (whether thin or not). Even an overweight person that is active looks to have more tone and strength to them. Just my personal observation.
I have a quite unique situation with my curve, as I stated in a different thread I have only found one scoli doc that has ever seen a curve pattern similar to mine, and believe me, I have seen plenty. The PT's have had a hard time coming up with any exercises that have done me any good. Back when I was young, however, I did aerobic exercise and strength training. They had one piece of equipment that helped my pain and I have never seen it since. It was two uneven bars. One bar came across the pelvis and I can't remember if the other bar came across the ankle or the knee area. But anyway it was tilted a bit and you would just "lean over" and bring yourself back up using your back muscles. I don't know if I could even do it now because I have progressed 10* since then and am in a considerably more amount of pain.

I guess the reason for my story here is, I think they need to put more research into specific exercises for scoliosis, and more than that, they need to focus on specific curve patterns. I also find it hard to believe that exercise has no impact on scoliosis. That is unless a person quits. Then they can't expect the exercise they did as a kid to do them any good if they become a lazy adult. But, hey, look at the majority of the adult population. We are lazy and weak compared to children. I used to fly across the monkey bars. Today I can't even barely hang on. What happens to us? I often wondered if it was because we become lazy or is it that our body proportion changes so much that we are less able. A person "trained" in boot camp could certainly fly across the monkey bars right after they get out of training, but it doesn't last long after training because they don't keep it up.

This really is a good topic, I just didn't understand where you were going with it. We need to STAY as active as possible. The first thing I did when I found out I was progressing (after a good cry, of course) was to get more active. It's only common sense.

Pooka1
05-12-2010, 06:56 PM
Bold added by me. I was surprised to read this statement almost word for word on the SRS website.

As far as I now, PT is indicated for pain in subsurgical curves and non-progressing curves. I think it might have a better track record than surgery in these cases but I don't know that.

When the SRS says PT doesn't work I am very sure they mean there is no evidence it prevents progression. The only thing that has been shown to do that is fusion though I think VBS might have amassed enough evidence by now also.

To my knowledge there is no conservative treatment that has been shown to halt progression permanently. If there was then nobody would ever be fused.

rohrer01
05-12-2010, 07:32 PM
As far as I now, PT is indicated for pain in subsurgical curves and non-progressing curves. I think it might have a better track record than surgery in these cases but I don't know that.

When the SRS says PT doesn't work I am very sure they mean there is no evidence it prevents progression. The only thing that has been shown to do that is fusion though I think VBS might have amassed enough evidence by now also.

To my knowledge there is no conservative treatment that has been shown to halt progression permanently. If there was then nobody would ever be fused.
Bold added by me.
I disagree, sorry. Yes, there are those people that will need to be fused no matter what they try as I'm sure is the instance with your daughters. But you can't make a blanket statement for everyone. My son had a mild case of scoliosis at about age 8 and it is completely gone now.

The statement listed PT along with other alternative therapies. It basically stated that the only benefit from these methods were to treat pain symptoms. I'll have to go on their website and quote it again. I quoted it on another thread. I disagree with their statement, though. I honestly can't believe that they could just use a blanket statement like that, simply because they don't know who would benefit and who would not. I agree that there are cases that WILL progress no matter what other intervention is done. But I also believe that there are cases that could be held stable IF the person keeps up their routine of exercise. In MY particular case, there are few exercises that can strengthen the muscles around my curves as even Skevimc has recognized from what I have told him. No PT program has ever helped me. But my son's scoli is gone. Was it spontaneous or due to being physically active? How could one ever prove such a thing scientifically? I will say that I had no particular routine of exercise for him. He was just an active little boy and I promoted that with ALL of my children. My daughter progressed, but she is mild.

Here is the quote from the SRS:

"Alternative treatments to prevent curve progression or prevent further curve progression such as chiropractic medicine, physical therapy, yoga, etc. have not demonstrated any scientific value in the treatment of scoliosis. However, these and other methods can be utilized if they provide some physical benefit to the patient such as core strengthening, symptom relief, etc. These should not, however, be utilized to formally treat the curvature in hopes of improving the scoliosis."

I did have a few degrees of improvement with the electrostimulation. However, it was discontinued after a couple of months. I don't know the reason why. It could have been that my mother couldn't afford to keep taking me for therapy. PT has NEVER had any effect on my particular curve because they could never find an exercise to specifically target my problem area. In my case, it seems chiropractic was the culprit in causing curve progression, unless it was lifting my grandson on my now weaker muscles. I find that hard to believe, though.

I think more research needs to be done on specific exercises on specific curve patterns. I know that there has been some done already, but to make a blanket statement like that is pretty bold. It's like telling the rest of the scientific community, "Don't bother trying. It won't work." As you well know, scientists need to be very open minded people, but as you've also stated, not so open minded that your brain falls out. :D It's just after reading Skevimc's posts, I think there is a lot of research left to be pursued. I also believe that if exercise could be utilized in halting or reversing progression, the person would have to be 100% compliant their whole life. That is NOT likely to ever happen. I know I don't want to "live" my disease every day. Even though it is with me every day, sometimes I would just like to forget about it, especially on days when I don't hurt so much. So, maybe this is why they make that statement???

Bottom line is exercise is good for everyone whether it helps scoliosis or not.

Pooka1
05-12-2010, 09:07 PM
Bold added by me.
I disagree, sorry. Yes, there are those people that will need to be fused no matter what they try as I'm sure is the instance with your daughters. But you can't make a blanket statement for everyone. My son had a mild case of scoliosis at about age 8 and it is completely gone now.

Cases are known to stabilize, regress and even regress completely doing NOTHING. The Greek study documented this.


I honestly can't believe that they could just use a blanket statement like that, simply because they don't know who would benefit and who would not.

If the evidence isn't there then it is perfectly acceptable to make a blanket statement saying the evidence isn't there. That is all they are doing. The evidence either is in hand or it isn't. Not both.


But my son's scoli is gone. Was it spontaneous or due to being physically active? How could one ever prove such a thing scientifically?

Exactly.


Here is the quote from the SRS:

"Alternative treatments to prevent curve progression or prevent further curve progression such as chiropractic medicine, physical therapy, yoga, etc. have not demonstrated any scientific value in the treatment of scoliosis. However, these and other methods can be utilized if they provide some physical benefit to the patient such as core strengthening, symptom relief, etc. These should not, however, be utilized to formally treat the curvature in hopes of improving the scoliosis."

Completely defensible and totally in line with the data in hand. Anything else would be incorrect and inconsistent with the state of the evidence.


I think more research needs to be done on specific exercises on specific curve patterns. I know that there has been some done already, but to make a blanket statement like that is pretty bold. It's like telling the rest of the scientific community, "Don't bother trying. It won't work." As you well know, scientists need to be very open minded people, but as you've also stated, not so open minded that your brain falls out. :D It's just after reading Skevimc's posts, I think there is a lot of research left to be pursued.

The blanket statement concerned the state of evidence NOW, not whether that can or will ever change.


I also believe that if exercise could be utilized in halting or reversing progression, the person would have to be 100% compliant their whole life. That is NOT likely to ever happen. I know I don't want to "live" my disease every day. Even though it is with me every day, sometimes I would just like to forget about it, especially on days when I don't hurt so much. So, maybe this is why they make that statement???

Could be but I think some PT modalities do claim that lifelong PT is not required.

rohrer01
05-13-2010, 12:34 AM
I guess it is the way it is written that bothers me. It's like slamming the door, at least for the layman. In the scientific community I suppose people would automatically know that the statement really means:

"Alternative treatments to prevent curve progression or prevent further curve progression such as chiropractic medicine, physical therapy, yoga, etc. have not demonstrated any scientific value in current clinical studies in the treatment of scoliosis. However, these and other methods can be utilized if they provide some physical benefit to the patient such as core strengthening, symptom relief, etc. These should not, however, be utilized to formally treat the curvature in hopes of improving the scoliosis."

Bold is added by me.
I can't speak for everyone, but their statement may be technically allowable, but for us layman sounds like the other therapies can't have any value other than for palliative care, which is misleading, especially if something is found to help later on. Thank you for clarifying this for me. :)

jrnyc
05-13-2010, 12:59 AM
OK, maybe it's just been a long day...3 hours on the train to NYC, 4 & a half hours back (Amtrak, in the dark ages of 2010, was down to ONE track this evening for trains bound north towards MA :rolleyes:)...but i say..

exercise shmexercise! my curves progressed after herniating discs during a very minor movement, my pain then progressed to the point of going from 4 times a week exercising (for years) to zero times a week!

and this is my professional, personal, medical and well researched conclusion...and i know, you may say i didnt do the "right kind" of exercise, or you may say "well, it works for children"......or more likely because it is 2 a.m. on the east coast & i've had little sleep in the last 3 days....or because i've been in excruciating pain the last 10 days...but still i say....

exercise schmexercise!



jess

Pooka1
05-13-2010, 05:27 AM
exercise schmexercise!


This is in agreement with the SRS statement about the state of the evidence for PT permanently halting progression. :)

jrnyc
05-13-2010, 08:51 AM
aha...research proven by reality!

:)

Pooka1
05-13-2010, 09:05 AM
aha...research proven by reality!

:)

Very good!

I'm thinking an honorary doctorate might be in order... :)

skevimc
05-13-2010, 01:02 PM
Here is the quote from the SRS:

"Alternative treatments to prevent curve progression or prevent further curve progression such as chiropractic medicine, physical therapy, yoga, etc. have not demonstrated any scientific value in the treatment of scoliosis. However, these and other methods can be utilized if they provide some physical benefit to the patient such as core strengthening, symptom relief, etc. These should not, however, be utilized to formally treat the curvature in hopes of improving the scoliosis."



It is certainly an appropriate comment based on the current evidence. The problem I have with this statement/idea is that it creates a clinical dogma that has become extremely difficult to overcome. Or to put it another way, because most clinicians respond with "exercise won't help scoliosis" it makes it difficult to get a clinician on board with a controlled exercise trial (assuming the money was there, which is a big assumption).

From my own study, while the doctors and nurses supported the project, it was clear that the project was viewed as "Isn't that cute, a little exercise study". The study wasn't really given a chance to fail or succeed. I kind of got the 'left over' patients. Those that either outright refused a brace, poor brace candidates (high thoracic curves) or didn't have a high risk for progression. It frequently felt like "well, we're not sure what to do so let's try the exercise study."

Now I will say that I had/have a great relationship with the doctors in the study. They are excellent clinicians, surgeons and have published and progressed the management of scoliosis in major ways (not to mention they are genuinely good people). They have also been very supportive of my career and training efforts. So I don't want to seem like I'm criticizing them. I'm pointing out that, if these clinicians who were funding an exercise study weren't even willing to put a major recruitment effort into the study, how likely is a clinic to do this if they have NO financial investment?

All of that being said... I have no idea how organizations/websites should word their statement on exercise. I guess including a statement mentioning groups like SOSORT and the effort to study the effectiveness of conservative treatments, including a strong focus on exercise based therapies, would go a long way to begin changing the way clinicians view exercise, i.e. It's an ongoing question not an absolute certainty. I would definitely like to see a more proactive statement concerning exercise from the research societies, SRS, IRSSD, NSF(??). If the response to the question "will exercise training help my curve?" became "There aren't any well controlled studies to show that exercise therapies will affect curve progression. However, there are a number of groups that are actively studying this." To me, this would be a huge victory.

Just my $.02

Dingo
05-13-2010, 03:28 PM
Skevimc

Imagine the money and attention you would have received if your study (http://www.ncbi.nlm.nih.gov/pubmed/18600146) had been on a drug or surgery for Scoliosis and produced identical results.


For patients with 20 to 40-degree curves, survivorship from main curve progression of >or=6 degrees was 100% at 8 months

I've got nothing against VBS and if someday my son needs it I'll get it for him. But the survivorship for VBS is nowhere near 100% at 8 months. VBS probably costs $100,000, has all of the risks associated with surgery and the longterm risks are unknowable. Inspite of that guess where the research money flows? :)

Pooka1
05-13-2010, 03:41 PM
The survivorship (progress less than 6*) for ice cream therapy at 8 months for 15 patients with the same curves as in that study given the average rate of progression is probably 100% (or more).

If these kids were not in a growth spurt there is no a priori reason to think their curves would get worse during any 8 month period even doing nothing. My one kid had one documented 6 month period out of brace where her curve did not move and she didn't do a lick of PT much less targeted PT. She would have been counted as a "survivor" yet she didn't do any treatment whatsoever.

Control groups, a sense of the natural history of scoliosis, and a sense of proportion... more than just good ideas.

Pooka1
05-13-2010, 03:56 PM
All of that being said... I have no idea how organizations/websites should word their statement on exercise. I guess including a statement mentioning groups like SOSORT and the effort to study the effectiveness of conservative treatments, including a strong focus on exercise based therapies, would go a long way to begin changing the way clinicians view exercise, i.e. It's an ongoing question not an absolute certainty. I would definitely like to see a more proactive statement concerning exercise from the research societies, SRS, IRSSD, NSF(??). If the response to the question "will exercise training help my curve?" became "There aren't any well controlled studies to show that exercise therapies will affect curve progression. However, there are a number of groups that are actively studying this." To me, this would be a huge victory.

Just my $.02

That seems fair. I think they should adopt that statement or something like it.

But someone is first going to have to formally apologize for Schroth for being around ~90 years and still not having any evidence of efficacy. It's all downhill after that. :)

skevimc
05-13-2010, 04:35 PM
The survivorship (progress less than 6*) for ice cream therapy at 8 months for 15 patients with the same curves as in that study given the average rate of progression is probably 100% (or more).

If these kids were not in a growth spurt there is no a priori reason to think their curves would get worse during any 8 month period even doing nothing. My one kid had one documented 6 month period out of brace where her curve did not move and she didn't do a lick of PT much less targeted PT. She would have been counted as a "survivor" yet she didn't do any treatment whatsoever.

Control groups, a sense of the natural history of scoliosis, and a sense of proportion... more than just good ideas.

To clarify and address some of these points... Several of the girls were in a growth spurt and two of them were probably at peak height velocity. Growth/height did not dictate success or failure.

We compared our survivorship analysis to that of the Nachemson and Peterson brace study. They had an observation group, an e-stim group and a brace group. We just plugged our data into their graph and compared. It certainly has its weaknesses. But I think we generally believe the result. Especially since after 8 months our survivorship drops and follows the reported natural history line. So basically, once treatment stopped, everything went back to the way it was. Take that as you will.



That seems fair. I think they should adopt that statement or something like it.

But someone is first going to have to formally apologize for Schroth for being around ~90 years and still not having any evidence of efficacy. It's all downhill after that. :)

I'm with you on that one. They have the patients. The staff. The money. The know-how. For some reason they just lack the desire to do a controlled trial. I remember when I toured the facility I was looking at the number of patients and thinking... if I had my equipment I could finish my dissertation in a week.

Dingo
05-13-2010, 06:12 PM
Skevimc

Treatment of adolescent idiopathic scoliosis with quantified trunk rotational strength training: a pilot study. (http://www.ncbi.nlm.nih.gov/pubmed/18600146)


CONCLUSIONS: Quantified trunk rotational strength training significantly increased strength. It was not effective for curves measuring 50 to 60 degrees. It appeared to help stabilize curves in the 20 to 40-degree ranges for 8 months, but not for 24 months. Periodic additional supervised strength training may help the technique to remain effective, although additional experimentation will be necessary

Can I just add that those are the 5 most unfortunate words in the history of Scoliosis research. :)

People who haven't read your study have used that phrase on this board to argue that TRS only works for a few months. Most people don't take the time to read the study and learn that TRS therapy lasted just 4 short months.

I must admit that when I was scanning abstracts my stomach fell when I read that. I thought it was proof that TRS was only short term. Months later I read the actual study and realized the point you were making.

Dingo
05-13-2010, 06:19 PM
Skevimc


Growth/height did not dictate success or failure.

That is outstanding!

Dingo
05-13-2010, 06:36 PM
This is a link to the original Vert Mooney study on TRS

The Role of Measured Resistance Exercises in Adolescent Scoliosis (http://www.medxonline.com/downloads/articles/measuredresistanceinscoliosis.pdf)

Out of 20 kids
16 experienced a curve reduction
3 were stable
1 child with a 60 degree curve experienced progression

Has there ever been a credible (or uncredible) brace study that produced such amazing results? What about VBS? Nope.

The fact that Dr. Mooney discovered a way to treat Scoliosis is great news for parents like me. But this study also told researchers something important about the nature of Scoliosis.

Pooka1
05-13-2010, 07:08 PM
To clarify and address some of these points... Several of the girls were in a growth spurt and two of them were probably at peak height velocity. Growth/height did not dictate success or failure.

We compared our survivorship analysis to that of the Nachemson and Peterson brace study. They had an observation group, an e-stim group and a brace group. We just plugged our data into their graph and compared. It certainly has its weaknesses. But I think we generally believe the result. Especially since after 8 months our survivorship drops and follows the reported natural history line. So basically, once treatment stopped, everything went back to the way it was. Take that as you will.


Okay that is defensible in my little opinion. :)

So did any of the compliant patients achieve a permanent reduction or halting of their curve if they continued TRS until their growth was complete? Or do these patients have to do it the rest of their lives to maintain the reduction/stability?

What did Mooney say about that if you know? We already know you disagree with him about bracing being obviously unnecessary during the growth spurt.

skevimc
05-14-2010, 12:40 AM
Is there any credible (or uncredible) brace study that produced such amazing results? What about VBS? Nope.

The fact that Dr. Mooney discovered a way to treat Scoliosis is great news for parents like me. But this study also told researchers something important about the nature of Scoliosis.

Just for clarity, that is his second article not the first. The first had 12 subjects and four regressed, and 1 >60 progressed. The rest stayed stable during the treatment window ~4-6 months.

Regardless, his work is what got Dr. Asher excited and spawned our subsequent project (and allowed me to get my PhD). But I wouldn't compare that preliminary work with the long-term studies done on bracing. Even those studies have several weaknesses. Those preliminary studies are just that. Preliminary. I was very disappointed that the second paper was so thin. Repeating the same data (which is big no-no) unless you report further follow-up, was a missed opportunity, IMO.



Okay that is defensible in my little opinion. :)

So did any of the compliant patients achieve a permanent reduction or halting of their curve if they continued TRS until their growth was complete? Or do these patients have to do it the rest of their lives to maintain the reduction/stability?

What did Mooney say about that if you know? We already know you disagree with him about bracing being obviously unnecessary during the growth spurt.

Nobody that I know of continued TRS until maturity. The one or two patients that I think probably did continue, I'm not sure what their status is. Basically, I know very little about any of them aside from what we published. I contacted Dr. Asher a few months ago and asked about doing a follow-up study or contacting the patients to get an update. He's curious as well. I doubt we could publish on anything, but it would be nice to know.

I can't find anything that Mooney says regarding the long-term necessity for exercise.

rohrer01
05-14-2010, 12:57 AM
Do a study on us "older" folks with larger progressvie HT curves that doctors refuse to operate on, even though it is inevitable and they just want to "wait" until your health fails to do the surgery. I am beginning to hate the word "wait"! Let me participate, that way I can feel like I'm at least doing something while I am being miserable! JK

Sorry, I'm feeling a little catty. :rolleyes:

So frustrated with the dead ends I keep running up against. It seems that all the exercise that I do now just aggrivates my already painful muscle spasms. I'd bet you could pierce me through with those EMG wires and crank up the juice and I wouldn't feel a thing. Then you could take a picture and say I was a true case of dystonia with scoliosis! I know, it's not funny, really. I just have to keep a sense of humor (even if it is a little demented!) to keep myself going! :eek:

rohrer01
05-14-2010, 12:59 AM
I guess it's time for me to TRY to get some sleep! My brain feels like it's been on the same train as jrnyc!:p

jrnyc
05-14-2010, 02:53 AM
hey rohr
thought i saw you on that train...Amtrak # 98 :rolleyes:

when you reach your point of pain...where exercise just adds to the pain....you have come to the research point of ...schmexercise!!

:)

Pooka1
05-14-2010, 06:03 AM
Just for clarity, that is his second article not the first. The first had 12 subjects and four regressed, and 1 >60 progressed. The rest stayed stable during the treatment window ~4-6 months.

Did any of these exercise to maturity?

What is your personal feeling about needing to exercise only to the point of maturity or the rest of a person's life with TRS?


Regardless, his work is what got Dr. Asher excited and spawned our subsequent project (and allowed me to get my PhD). But I wouldn't compare that preliminary work with the long-term studies done on bracing. Even those studies have several weaknesses.

To say the bracing studies merely had weaknesses is an understatement in my little opinion. I don't think they can conclude anything relevant in principle due to the limitations of medical studies in general. Not being able to control the studies is a reason but it isn't an excuse. It isn't even a reason in my field where you can't publish an uncontrolled study. Given that, it should not be jaw-dropping when we see a paper explaining why most published research results are false.


Those preliminary studies are just that. Preliminary. I was very disappointed that the second paper was so thin. Repeating the same data (which is big no-no) unless you report further follow-up, was a missed opportunity, IMO.


Since Mooney was well established in his field, perhaps we can conclude he didn't double-publish data to bolster his C.V.. :D So there must be another reason. Perhaps he didn't have follow up or just didn't like the follow up he had in hand. When the majority of data in a second paper has already been published 3 years earlier, a suitable time for follow up, perhaps we can draw our own conclusions about the long term for that set of 20 patients.

But I find it beyond interesting that he simply started with 8 more new patients and then combined those data with the data from the 12 from 3 years earlier. That is a result in itself.

It's possible that you just can't get people to exercise even to possibly avoid fusion. That is an important conclusion if true.


Nobody that I know of continued TRS until maturity. The one or two patients that I think probably did continue, I'm not sure what their status is. Basically, I know very little about any of them aside from what we published. I contacted Dr. Asher a few months ago and asked about doing a follow-up study or contacting the patients to get an update. He's curious as well. I doubt we could publish on anything, but it would be nice to know.

I can't find anything that Mooney says regarding the long-term necessity for exercise.

Do you consider the situation at maturity with these TRS patients to be the $64,000 question as opposed to, oh let's say, what is happening at the 8 month mark? Is the situation at 8-months necessarily dispositive of anything given you have some data for 24 months? Is there anything harder than explaining science to lay people? :eek:

skevimc
05-14-2010, 12:48 PM
Did any of these exercise to maturity?

What is your personal feeling about needing to exercise only to the point of maturity or the rest of a person's life with TRS?


He didn't report any follow-up so I'm not sure how long they continued. I think I have heard through various sources that they claim that the initial strengthening period is all that is necessary. But I might be wrong about that.

My opinion is that, assuming TRS works, that using the strength training machines to increase strength and stability and then using a home-ex program the rest of the time with strength checks during doctor's visits until skeletal maturity. Switching back to supervised strengthening if asymmetry develops again.

I think stopping exercise at skeletal maturity would have a similar effect as stopping the brace at skeletal maturity. Some would probably progress some won't. I would hypothesize that the need to be aggressive with strengthen wouldn't be as necessary after skeletal maturity mainly because the progression is much slower. But the spine would still have altered biomechanics which could theoretically affect spinal stability. Better safe than sorry.



To say the bracing studies merely had weaknesses is an understatement in my little opinion.


Indeed. I was just responding to Dingo's remark about no bracing or VBS studies matching Mooney's results.




Since Mooney was well established in his field, perhaps we can conclude he didn't double-publish data to bolster his C.V.. :D So there must be another reason. Perhaps he didn't have follow up or just didn't like the follow up he had in hand. When the majority of data in a second paper has already been published 3 years earlier, a suitable time for follow up, perhaps we can draw our own conclusions about the long term for that set of 20 patients.

But I find it beyond interesting that he simply started with 8 more new patients and then combined those data with the data from the 12 from 3 years earlier. That is a result in itself.

It's possible that you just can't get people to exercise even to possibly avoid fusion. That is an important conclusion if true.


I found it interesting that I spoke to him in 2002 to discuss his protocol and say that we were starting our own project. He was nice and glad that someone was continuing with the work but couldn't answer my specific questions about the training. Then a few months later I see his 2003 work. After the conclusion of our study, we sent the abstract to Mooney to get his input (Dr. Asher had a lot of respect for V Mooney and knew him for many years). Since our study wasn't reporting 100% effectiveness he suggested that our training protocol was too different and a few other comments that didn't make much sense. Shortly after that, Med-X began marketing the rotational machine as a scoliosis treatment.

Certainly conceivable that this stuff was already in the works. The time line is certainly interesting though.

It is still being marketed. But now that I have my appointment at Stanford, this is the quote: http://www.fitstrength.com/Non%20Surgical%20Scoliosis%20Treatment.htm

In 2008 several studies from Stanford have also validated that Rotational Exercise prevents the increase in curvature of the spine in Adolescent Scoliosis.

I've asked them to remove Stanford's name from the website because the studies weren't done at Stanford. I suppose I'll have to ask again.

Things get ugly and motives get questioned when money becomes a motivator. I hate it. It actually encourages me to work hard on a home program using theraband.

Dingo
05-14-2010, 01:28 PM
Skevimc


It actually encourages me to work hard on a home program using theraband.

Film the "at home" exercise and put it on YouTube. Maybe link back to a simple webpage with supplementary information.

Tens of thousands of patients will see it around the world. Home run! :)

Pooka1
05-14-2010, 01:46 PM
I found it interesting that I spoke to him in 2002 to discuss his protocol and say that we were starting our own project. He was nice and glad that someone was continuing with the work but couldn't answer my specific questions about the training. Then a few months later I see his 2003 work. After the conclusion of our study, we sent the abstract to Mooney to get his input (Dr. Asher had a lot of respect for V Mooney and knew him for many years). Since our study wasn't reporting 100% effectiveness he suggested that our training protocol was too different and a few other comments that didn't make much sense. Shortly after that, Med-X began marketing the rotational machine as a scoliosis treatment.

Certainly conceivable that this stuff was already in the works. The time line is certainly interesting though.

You're not kidding. That is extremely interesting.


It is still being marketed. But now that I have my appointment at Stanford, this is the quote: http://www.fitstrength.com/Non%20Surgical%20Scoliosis%20Treatment.htm

I've asked them to remove Stanford's name from the website because the studies weren't done at Stanford. I suppose I'll have to ask again.

Things get ugly and motives get questioned when money becomes a motivator. I hate it. It actually encourages me to work hard on a home program using theraband.

Wow I think the Better Business Bureau might want to know about all the false claims on that page. That's outrageous!

dailystrength
05-20-2010, 10:20 PM
But inspite of that many people (including doctors) flat out reject exercise for Scoliosis. On my son's first visit to a spine specialist/surgeon I asked him if exercise would help and his answer was unequivocal. He shook his head and said, "exercise has no impact on Scoliosis."

No doubt there are probably many doctors who would say the same about exercise and Multiple Sclerosis.

Just for the record, my Dr. said I had made improvement in the curve based on my exercising. He commented that the muscles hold the spine.

dailystrength
05-20-2010, 10:26 PM
The first thing I did when I found out I was progressing (after a good cry, of course) was to get more active. It's only common sense.

Oh, I hear you there (with the good cry) and GOOD FOR YOU for doing all you could. Thanks for all you add to this forum.