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View Full Version : Weiss has apparently given up on PT... just does bracing(!)



Pooka1
07-05-2013, 08:12 PM
I guess ~30,000 patients don't lie.

(Partial) letter response to Ahmed from Weiss...


Hello,

we have a bracing practice, only, so if you want more intensive physiotherapy you may wish to contact the Asklepios clinic in Bad Sobernheim, however you will have to pay in advance and there will be no refund in case you want to leave earlier....

rohrer01
07-05-2013, 11:55 PM
Wow, I know, right? I was surprised when I read that, too!
It can't be true for JIS, though. Look at Tamzin's progress. Maybe it's just that Schroth alone doesn't work? Or the curve doesn't hold? I sure hope that Tamzin doesn't progress again. She's been working SO hard even though Tom says that she taught herself to auto-correct and doesn't spend hours a day. Still, I know they put a TON of work into her. It makes me worry in kind of a sad way. Isn't Dr. Weiss an orthopedic surgeon who promoted Schroth and bracing? I wonder why he doesn't do surgery anymore, or did he ever? After some of the videos that went around that he made, I'd steer clear of him anyway. I know he's famous for bracing and probably does a great job doing what he does. It's just weird to see him make that statement in his letter about PT.

Pooka1
07-06-2013, 08:55 AM
Wow, I know, right? I was surprised when I read that, too!

The point here is that Weiss had 10 years and ~30,000 patients to prove PT helps AIS and he failed. Given that time frame and that number of patients, I think it's not too early to say Schroth is a waste of money for AIS.


It can't be true for JIS, though. Look at Tamzin's progress.

JIS is clearly a different animal when it comes to response to conservative treatments. The jury is in on that.


Maybe it's just that Schroth alone doesn't work? Or the curve doesn't hold?

Well they realized PT alone doesn't work many years ago when they abandoned just PT and started with bracing in Schroth. Now they have gone one step better and abandoned the PT completely. Let's see if/when they abandon bracing. It may not happen because therea re big bucks in bracing people and most people don't understand evidence and think "it's worth a try." It may be but the over-treatment rate is so high, coupled with lack of evidence of long term benefit, explains the BrAIST study and such. There is a reason not bracing is ethical according to dozens of experienced orthopedic surgeons at over two dozen medical centers.


I sure hope that Tamzin doesn't progress again. She's been working SO hard even though Tom says that she taught herself to auto-correct and doesn't spend hours a day. Still, I know they put a TON of work into her.

It's hard to say because she hasn't gotten radiographs in a long time. Maybe Tom will allow them at some point to prove the efficacy of the method. But she probably has improved to the extent you can see that without radiographs.


It makes me worry in kind of a sad way. Isn't Dr. Weiss an orthopedic surgeon who promoted Schroth and bracing? I wonder why he doesn't do surgery anymore, or did he ever? After some of the videos that went around that he made, I'd steer clear of him anyway. I know he's famous for bracing and probably does a great job doing what he does. It's just weird to see him make that statement in his letter about PT.

Weiss is not a practicing orthopedic surgeon per what I have been told by someone who knows him. He is a rehab doctor. He does claim to be an orthopedic surgeon on his CV but I am guessing that is by med school training only or something. He promoted Schroth because he is the inventor's grandson. It is VERY significant that he has abandoned PT given that.

ETA: Here is his CV.

http://www.scoliosisxpert.com/uk/pageuk.php?va=1

He does list a 5 year residency in orthopedic surgery. But per someone who knows him, he does rehab medicine.

LindaRacine
07-06-2013, 02:42 PM
I guess I'm just a bit more skeptical, but when I read it, my first thought was "He's dropped Schroth because he can't make money at it for some reason."

Pooka1
07-06-2013, 03:12 PM
I guess I'm just a bit more skeptical, but when I read it, my first thought was "He's dropped Schroth because he can't make money at it for some reason."

Well, he may have abandoned PT BOTH because he couldn't make money AND because he tied and failed to prove it works. There may be many reasons he abandoned PT.

titaniumed
07-06-2013, 04:58 PM
Well, he may have abandoned PT BOTH because he couldn't make money AND because he tied and failed to prove it works. There may be many reasons he abandoned PT.
It’s hard when a young patient works so hard at PT and fails to have any improvement in correction.....or to have it progress like wildfire. Its almost like saying “Run around the world,(with a bad back)and you too can hit that goal” What goal? We will just about take any improvement.... Its all about hope.*

Being a driving force at this and having to “install” that hope, even if it doesn’t work, is a tough thing. Tears can flow, and I’m sure he saw them often....Its one thing to know when to fold the cards, its another when hope is the driving force. When you think about a century of effort, you cant say they didn’t try.

On another note....(time to cheer up)
In talking about hope, I have noticed that there is some action in Colombia.....
http://www.srs.org/professionals/global_outreach/site_information/Cali_Colombia.htm
http://www.srs.org/patient_and_family/patient_stories/Yessica.htm


Global scoliosis awareness is gathering speed. A good thing.*

Ed

TAMZTOM
07-09-2013, 02:35 PM
Came out of my cave because someone emailed me that my name was mentioned.

Sharon, the actions of one previously ridiculed for inconsistency, his 'video' career, and fly with the wind approach to making bucks now being quoted as authority for the proposition that SPECIFIC SCOLIOSIS EXERCISE doesn't work. C'monnnnnnnnnnnnn!!!

As I wrote nearly a year ago, Weiss and the family SOLD the Schroth clinic years ago. Weiss has hands in many pots (cf., recent retracted paper because of 'vested interests'). When the Braist study comes out full fledged, maybe he'll already have sold his bracing businesses and gone into special bells and whistles for surgery, another winning modality. Not.

Rohrer, I know you mean well, but statements such as "It makes me worry in kind of a sad way" indicate your own assumptions rather than the reality of my daughters life or treatment. Bit of responsibility and observance of facts here, no?


JIS is clearly a different animal when it comes to response to conservative treatments. The jury is in on that.

The jury has been chucked out on age-old assumptions about what AIS entails too. Read Stokes et al re. the increasing evidence of neurological causes for "AIS". Re. JIS being a different animal, JIS, especially Tamzin's version, is statistically more viciously progressive than AIS. (The distinction is convenient, by no means solid.) With stronger reason, what Tamzin HAS DONE works for the 'easier' (not easy) AIS.

You are correct re. Tamzin's curvature being capable of accurate assessment without x-rays, Sharon. The significance of Weiss abandoning "PT" is that he made lot of bucks flogging the clinic. "PT". Of course it doesn't work, it makes scoliosis worse. That's not the issue.

Ok, back to the cave :)

TAMZTOM
07-09-2013, 02:52 PM
PS: here's the paper I posted on Tamzin's thread many moons ago, Weiss at his best :)

http://www.scoliosisjournal.com/content/7/1/4

TAMZTOM
07-09-2013, 03:04 PM
Just so's I'm clear, scoliosis can be corrected, just not by the ulterior (or posterior!) motivated methods typically on offer.

AMom
07-09-2013, 09:17 PM
Came out of my cave because someone emailed me that my name was mentioned.

Sharon, the actions of one previously ridiculed for inconsistency, his 'video' career, and fly with the wind approach to making bucks now being quoted as authority for the proposition that SPECIFIC SCOLIOSIS EXERCISE doesn't work. C'monnnnnnnnnnnnn!!!

As I wrote nearly a year ago, Weiss and the family SOLD the Schroth clinic years ago. Weiss has hands in many pots (cf., recent retracted paper because of 'vested interests'). When the Braist study comes out full fledged, maybe he'll already have sold his bracing businesses and gone into special bells and whistles for surgery, another winning modality. Not.

Rohrer, I know you mean well, but statements such as "It makes me worry in kind of a sad way" indicate your own assumptions rather than the reality of my daughters life or treatment. Bit of responsibility and observance of facts here, no?



The jury has been chucked out on age-old assumptions about what AIS entails too. Read Stokes et al re. the increasing evidence of neurological causes for "AIS". Re. JIS being a different animal, JIS, especially Tamzin's version, is statistically more viciously progressive than AIS. (The distinction is convenient, by no means solid.) With stronger reason, what Tamzin HAS DONE works for the 'easier' (not easy) AIS.

You are correct re. Tamzin's curvature being capable of accurate assessment without x-rays, Sharon. The significance of Weiss abandoning "PT" is that he made lot of bucks flogging the clinic. "PT". Of course it doesn't work, it makes scoliosis worse. That's not the issue.

Ok, back to the cave :)

TAMZTOM, you know Schroth's results have little to do with your daughter's results. Like you said, Rohrer means well and was only worried that this news may be a red flag with regard to long term results.

For those of you new to scoliosis:
JIS is more likely to progress than AIS.
JIS more likely to progress to the point of requiring surgery than AIS.
JIS is known to respond better to bracing than AIS.
JIS has not been well separated from AIS during PT, so we don’t know if it responds differently than AIS (though I suspect JIS may respond better than AIS and in addition to in/consistent frequency and in/consistent quality of PT may contribute heavily to the discrepancy in results).
Any disorder with an accompanying dx has the potential to respond differently to treatment than a disorder with a single dx.

Cobb angles without x-rays are opinions rather than accurate assessments. If a doctor tells you the size of your curve based only on a visual and physical examination, then it is time to locate a more knowledgeable professional. –And on that note, I will start figuring out how to post x-rays without including personal data. (While the recent ones are digital, the older ones are films.)

A Mom

Pooka1
07-09-2013, 09:27 PM
Cobb angles without x-rays are opinions rather than accurate assessments. If a doctor tells you the size of your curve based only on a visual and physical examination, then it is time to locate a more knowledgeable professional.

Yes. But I have an open mind with JIS coupled with a potentially large correction in terms of perhaps eye-balling a change. It might be possible if it is large enough, not sure.

Had this been an AIS case, I flat out wouldn't believe a correction even with a radiograph. Well, I guess I would believe it but I would bet it was temporary. There is no evidence for correction through conservative methods in AIS to my knowledge. If Tom has some radiographs from some people he is working with, I am sure we all would look forward to seeing that. Or maybe he can tell us how many AIS cases he is helping and how many corrected on radiograph. What percentage of the kids with AIS improved?

For JIS, just in this sandbox, among braced kids we have several cases that had out of brace decreases. For PT, we have one case that might be a decrease and one case that has held somewhat steady or rather crept up only very very slowly. It's only two cases total though.

rohrer01
07-10-2013, 01:27 AM
Rohrer, I know you mean well, but statements such as "It makes me worry in kind of a sad way" indicate your own assumptions rather than the reality of my daughters life or treatment. Bit of responsibility and observance of facts here, no?


Tom, of course I mean well. Taken into context that a world renown scoliosis specialist has abandoned physical therapy is disturbing. I say I worry in a sad way because of the devastation it would cause to Tamzin and your whole family IF this doesn't work. The reality is that it is working and her neurological symptoms have abated, per you. I believe you 100%. That sad worry in the back of my mind is because this doctor gave up, making me wonder if this will be permanent. I know you can't live your life "what iffing" everything and every decision. We have to live in the here and now and make the best decisions that we can for our kids right now.

I have often referred people to your thread because of the success that you are having with Tamzin. But, let's face it, none of us want false hope, not implying that you are giving false hope. You just seem to be charting new waters by utilizing multiple methods. I sincerely hope that these waters prove fruitful for you and Tamzin. I will continue to refer people to your thread.

I make no assumptions about your daughter's treatment and I have no access to facts other than how you portray them. There's no bias on my part other than maybe I put Tamzin's case too high up on a pedestal. Dr. Weiss statement just rocked that pedestal and made me worry.

TAMZTOM
07-10-2013, 03:27 AM
Tom, of course I mean well.

Got you Rohrer, thanks for the clarification. To put your mind at rest, it affects me not a jot whether all non-invasive practitioners depart the scene. That might result in more kids being corrected.

Amom, x-rays mislead. Of course Schroth results have little to do with my daughter. TR results have little to do with your daughter's results either. Oh, and x-rays mislead, often so dangerously that people end up in surgery when they shouldn't. Oh, rotation is also important.

Nb: I knew it was a bad idea to come out of my cave.

Pooka1
07-10-2013, 06:54 AM
Any disorder with an accompanying dx has the potential to respond differently to treatment than a disorder with a single dx.

This is the other point that concerns me when case are discussed and this isn't mentioned. Chiari/SM is the only type of scoliosis that I am aware of that will sometimes INSTANTLY reduce just by draining the syrinx. That suggests that Chiari/SM, whatever the progression potential as against straight AIS or straight JIS, is less structural in some way than IS where you never see an instantaneous decrease apart from fusion or placement of growth rods and such.

This is one reason I have an open mind with PT + JIS + Chiari/SM. Maybe if you can get enough straightening to the point of the neuro systems abating, then maybe you have allowed some drainage of the syrinx which might result in an actual instantaneous decrease in the curve. So it is misleading to not mention the Chiari/SM when saying a child has JIS and that all JIS cases should not expect the same results if this biology is in play for Chiari/SM.

So it is probably misleading to not describe all these cases as much as possible as either straight AIS, AIS plus Chiari/SM, AIS/Marfans, straight JIS, JIS_CHiari/SM, JIS/Marfans, etc. etc. Lumping when there is evidence for splitting it to muddy the waters and is moving away from actually ever hoping to understand this issue.

TAMZTOM
07-10-2013, 09:06 AM
Chiari/SM is the only type of scoliosis that I am aware of that will sometimes INSTANTLY reduce just by draining the syrinx.
I've read of "spontaneous regression" of AIS, JIS, IIS. There are 1000s of cases where syrinx drainage AND the decompression make the scoliosis worse or make no difference at all to the curvature. "...sometimes instantly reduce..." doesn't really tell us much at all. Have you a link to anything substantial, Sharon? Was this an isolated case? Was the curvature <15 degrees? I wonder if you've read something about a baby or toddler?


That suggests that Chiari/SM...is less structural in some way than IS.
Invalid. The use of "less structural" is also misleading, although I know what you mean.


Maybe if you can get enough straightening to the point of the neuro systems abating, then maybe you have allowed some drainage of the syrinx which might result in an actual instantaneous decrease in the curve.
That reasoning is sound, apart from the "instantaneous decrease" bit. A curved spine doesn't just pop back into place, even if a presumed obstruction is removed. E.g., affected ligaments and other soft tissue contribute to holding the curve in misalignment. IVD shape and vertebral shape too would require remodeling. Again, I wonder if you've been reading infant cases? That remodeling of bone and soft tissue is a well known problem, cf., the recurring rib rotation, spine rotation and curvature, etc. common post-surgery.


So it is probably misleading to not describe all these cases as much as possible as either straight AIS, AIS plus Chiari/SM, AIS/Marfans, straight JIS, JIS_CHiari/SM, JIS/Marfans, etc. etc. Lumping when there is evidence for splitting it to muddy the waters and is moving away from actually ever hoping to understand this issue.
Or there are sufficient similarities between them all to argue for retaining all within the ambit so that we actually correct the condition. Have you read Stokes et al on the increasing likelihood that AIS has neuro roots?

...but I must move on. These are all interesting areas to discuss, but I spend my time actually fixing my daughter rather than dreaming about it.

The thread was about Weiss's possible departure from physiotherapeutic treatment of scoliosis. Some email from some unknown person tells me nothing. Interesting to note that in the paper I've linked above, he cites the TR research as being conducted on a group with a "20%" likelihood of progression!

TAMZTOM
07-10-2013, 09:34 AM
PS: an echo as I head deeper into my cave...

For those confused about the meaning of "structural curve", read the Maruyama papers cited by Weiss in the above paper, there go out yonder and feel how ADULT 60 degree + curves can "instantly correct" or how juvenile and adolescent 40 - 55 degree curves "instantly correct". Sustaining the correction is the challenge. Also consider that many posters in here fail to indicate relevant details fleshing out the bare Cobb angles measured from x-rays. E.g., how long out of brace was the person before the x-ray. What activities were they doing the day before, or that day: e.g., dancing, horse riding, gymnastics. How tired were they...did their posture collapse...were they tense during the x-ray...so how much of the 5 - 20 degree range of spinal movement were they using as the x-ray machine snapped an instant? For the 30 degree range of kids, were they ever in danger of progression??? How much growth did they have remaining? Did the bracing or PT worsen their rotation (i.e., make it more likely that the curves will progress after the main growth spurt period).

These questions are important, but to dump Chiari/SM related scoliosis from the AIS or JIS is as sensible as dumping the ballerina, horse rider, donut muncher and skateboarder related scoliosis from the search. My daughter's last spine surgeon, a reputable guy, categorically placed her in the JIS category. His published papers are well regarded. He works with cutting edge scientists such as Stokes, Dangerfield, Burwell et al. And he learns from parents too.

Pooka1
07-10-2013, 10:43 AM
My daughter's last spine surgeon, a reputable guy, categorically placed her in the JIS category.

Our surgeon categorically places Marfans in the AIS category despite the evidence straight AIS and Marfans scoliosis are known to differ in terms of brace treatment.

I suspect there is one way surgeons talk with parents and another way they talk with other researchers. It almost has to be the case because to not split is to ignore relevant evidence in hand on these issues and that is not happening among those guys.

TAMZTOM
07-10-2013, 11:14 AM
Our surgeon categorically places Marfans in the AIS category despite the evidence straight AIS and Marfans scoliosis are known to differ in terms of brace treatment.
I believe we discussed this splitting before, Sharon? It would be helpful to precisely define why THIS PERSON has scoliosis and treat accordingly. It hasn't and looks unlikely to happen this side of the 25C. We're not clever enough. Each person has crucial differences, knowledge of which can improve correction of the curves. Marfans kids, Chiari/SM kids, neuro, congenital, JIS, AIS, IIS all have differences, not necessarily aetiological. All have curved spines. Removing these cases from AIS/JIS can hinder insight into how to fix. Surgery, for example only (not to argue against it), focuses on the curved spine, one wee bit of the multifactorial scoliosis problem. They get in there regardless, doing what they consider is helping a part of the problem.


I suspect there is one way surgeons talk with parents and another way they talk with other researchers.
My best friend is one...he's a self-confessed arrogant, rude jerk :)


It almost has to be the case because to not split is to ignore relevant evidence in hand on these issues and that is not happening among those guys.
To not split indicates that they don't think the difference is relevant. The precise relevance of these differences is unknown, so those guys make decisions based on their limited knowledge.

On the alleged quote from a Weiss email, you are correct that there are many reasons for the statement. Based on what I've read, it seems likely that he's persuading folk to brace an do "Nu-Power Schroth" rather than dumping anything. His family sold the clinic in BS, which is now a competitor. That's explain the email, if it was indeed from Weiss, which I don't know is true.

Pooka1
07-11-2013, 09:27 PM
For completeness, I am referencing Ahmed's post with Weiss' response to his query...

http://www.scoliosis.org/forum/showthread.php?14374-These-are-my-X-Rays&p=152077#post152077

And here is the relevant text from that post...

==========


Also, I have contacted Dr.Weiss and this is his reply, I didn't know my angle at that time


Hello,

we have a bracing practice, only, so if you want more intensive physiotherapy you may wish to contact the Asklepios clinic in Bad Sobernheim, however you will have to pay in advance and there will be no refund in case you want to leave earlier....

But with a 50° curve you can certainly live like others and intensive PT will not drastically reduce the hump!


Mit freundlichen Grüßen / With kind regards


Folks are invited to ignore all the comments made by players in this sandbox and come to their own conclusions.