Torso Rotation Strength Training for Scoliosis [Archive] - Page 2

mamamax

12-11-2009, 06:11 AM

Dingo - interested in your thoughts.

This review article will present our work regarding osteopontin (OPN) function in bone remodeling and its application to tissue engineering in bone. OPN, one of the major non-collagenous bone proteins, has an important role in bone remodeling. Our study suggested that OPN acts not only as a trigger for osteoblast early differentiation but activates osteoclast resorption.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6TXG-4477YVM-6&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=07ba32dbb9c4ccb3609357877c450b98

There seems to be a phenomenology that relates to bone remodeling and some observations that have been made (references below).

Bone remodeling is triggered “flexure” vs stress

Repetitive dynamic loads placed on bone trigger remodeling

Dynamic bone remodeling may apply to the vertebra of the spine in that maintaining equal pressures on both sides of the vertebra during motion may work towards modeling into more normal shape (for both children and adults).

This may help explain why some things (depending upon application) work, why some don't??

REFERENCES (If anyone can find these full articles, I would like to read them)

Frost, H. M., Bone remodeling and its relation to metabolic bone diseases, C. Thomas, Springfield, IL, 1973.

Frost, H. M., Bone modeling and skeletal modeling errors, C. Thomas, Springfield, IL, 1973.

txmarinemom

12-11-2009, 07:08 AM

Okay, so ... I'm out the door to take my last final of the semester, but ...

I was just running some quick searches and found some interesting information that kind of ties into this. I'll have to look more when I get home from school.

I'm sure there's more current info out there, but here's an abstract that makes a link between rhBMP-2 (the bone morphogenetic protein many adult patients receive during fusion) osteogenesis (bone formation, simply put) and osteopontin. (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WBK-4J9MWRC-8&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1131941789&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=019797ed098bd3956933d4caaf6f4a28)

Like I said, I'm in a rush, but I'll pull the full article when I get home. Maybe it's relevant, maybe not. I'm not even sure what it might be relevant TO (heh), but you can kick it around in my absence. :)

Mamamax, I should have access to the article you're looking for too if you want me to try to get it.

Pam

oojackapivvy

12-11-2009, 07:15 AM

If I'm not completely misunderstanding (which is entirely possible as I've not had time to think about it - I'm actually at work :o) that's interesting, as it would potentially support the supposedly debunked idea that regular assymetric loading (such as the abominably heavy bag I used to carry 2 miles each way from school) would exacerbate any predisposition to development of curvature. It also seems to me it would easily figure into the question of when/why "gravity" takes over and causes curve progression in the absence of other exacerbating factors (eg continued deterioration after skeletal maturity).

Over the years there have been many discussions I recall which have gone along the lines of someone asking could this have caused it, and a load of people saying no, it's been disproved and anyway if it did cause it everyone would get curves, which have been deeply unsatisfying exchanges as it doesn't answer whether there is an interaction of poor biomechanics and predisposition.

I'm actually more or less certain that while diagnosed as adolescent, my curvature was juvenile, as hindsight makes it clear it was not present to a noticeable extent prior to 7 but by the end of my first primary school year was apparent (my auntie used to make clothes for me, but didn't for a long time after having mum complain that she'd made my skirt uneven as it did not hang right - I wore it and the matching blouse to the school disco, and danced to Stand and Deliver in it, which was a very new song at the time :D) - also quite abruptly I went from long bodied and slender looking to "short waisted" and having a pooch belly which didn't go away however hard I dieted and however much weight I lost.

However, it was distinctly non-aggressive, as it didn't really change much as far as I can tell through until my later teens, including no significant change during a period in my teens when I grew in excess of 3 inches in a matter of months, but the lie of clothing didn't change and I had no significant posture change or anything else. At that point I was still lightly loaded, just carrying exercise books to and fro much of the time. The heavy loading coincided with another growth spurt, and I did have changes going on, but was told it was normal and that clearly I was stopping growing because when you're nearly stopped it's only the long bones that continue so that was why my legs and arms were getting longer and longer but my body was not. So who knows, it's just as likely all unrelated, but I doubt I'll stop being curious about the coincidences of it.

Dingo

12-11-2009, 08:34 AM

Mamamax

Dynamic bone remodeling may apply to the vertebra of the spine in that maintaining equal pressures on both sides of the vertebra during motion may work towards modeling into more normal shape (for both children and adults).

HOLY FREAKIN' MOLY!

Torso rotation may tell the nervous system where the abnormalities are and then the body uses OPN to repair/correct them. That might explain the entire mystery on why it works!!! HOLY FREAKIN' MOLY! (I had to say that again)

Where is that paragraph? I can't find it.

tonibunny

12-11-2009, 09:04 AM

It doesn't always work though, does it? :( I wonder why it doesn't, if bone can be remodelled. Any theories as to why not?

ETA perhaps, during a growth spurt, the body grows faster than the rate at which bone can be remodelled by exercise?

oojackapivvy

12-11-2009, 09:29 AM

I wonder whether osteopenia has any role to play in that - admittedly it's been so long since I have read anything on the incidence of osteopenia in people with scoliosis that I can't remember the numbers other than I have a feeling some studies found the link to be quite strong (but have no idea the quality of those studies even if I've remembered correctly), but perhaps the combination of osteopenia and growth spurts would provide a challenge beyond that which torso rotation can cope? Also, I wonder how strongly magnitude of starting curvature affects things?

tonibunny

12-11-2009, 09:35 AM

oojackapivvy

12-11-2009, 10:21 AM

mamamax

12-11-2009, 06:41 PM

mamamax

12-11-2009, 07:07 PM

Mamamax

HOLY FREAKIN' MOLY!

Torso rotation may tell the nervous system where the abnormalities are and then the body uses OPN to repair/correct them. That might explain the entire mystery on why it works!!! HOLY FREAKIN' MOLY! (I had to say that again)

Where is that paragraph? I can't find it.

Dingo -

I thought that would peak your interest :-)

Peaked mine too. The information you're looking for is supposed to be in the Frost papers (referenced below).

IF there is something to this dynamic bone remodeling (by applying and maintaining equal pressures on both sides of the vertebra during motion) that results in a more normal shape - well that could be significant to us all. The human body does attempt to repair itself and looks like OPN plays an important role. Note Pam's contribution up thread. I hope she can find the Frost papers and I would also be very interested in reading the one she mentions specific to surgical patients.

I don't want to speculate too far without reading more but maybe this will help towards understanding why some non surgical methods effect some curves in a good way (but not others) .. possibly something to do with the many variations there may be in curvatude combined with the many variations there be in applying and maintaining equal pressures during motion. I don't know - but I'm darn curious about it.

Looking for the Frost papers:

Frost, H. M., Bone remodeling and its relation to metabolic bone diseases, C. Thomas, Springfield, IL, 1973.

Frost, H. M., Bone modeling and skeletal modeling errors, C. Thomas, Springfield, IL, 1973.
Edit/Delete Message

Pooka1

12-11-2009, 07:16 PM

IF there is something to this dynamic bone remodeling (by applying and maintaining equal pressures on both sides of the vertebra during motion) that results in a more normal shape - well that could be significant to us all.

Isn't this close to or exactly the claim of how Spinecor works?

I don't want to speculate too far without reading more but maybe this will help towards understanding why some non surgical methods affect some curves in a good way (but not others) .. possibly something to do with the many variations there may be in curvatude combined with the many variations there be in applying and maintaining equal pressures during motion. I don't know - but I'm darn curious about it.

Some here have said they were specifically told never to do torso rotational exercises as that would exacerbate the curves. Now. At this point, it would be nice to know why they were told that and what the evidence is for torso rotation making curves worse.

Looking for the Frost papers:

Frost, H. M., Bone remodeling and its relation to metabolic bone diseases, C. Thomas, Springfield, IL, 1973.

Frost, H. M., Bone modeling and skeletal modeling errors, C. Thomas, Springfield, IL, 1973.

(almost 37 years old)

mamamax

12-11-2009, 07:35 PM

Dingo -

Turns out I'm not looking for papers - I'm looking for books!

http://www.amazon.com/Harold-M-Frost/e/B001HQ0MR2/ref=ntt_athr_dp_pel_pop_1

Written by an American orthopedist and surgeon! http://en.wikipedia.org/wiki/Harold_Frost

Oh my ... won't be getting to the bottom of this one anytime too soon.

Sharon - I am curious as hell! And according to Frost - there may be more to "flexation" (applying and maintaining equal pressures on both sides of the vertebra during motion) than rotation, though there is flexation in torso rotation .. this may not be the only way to achieve it. Very interesting (and acknowledged as important) contributions made by Frost. http://www.scangrants.com/grant/2010/3/24/american-society-for-bone-and-mineral-research-harold-m-frost-young-investigator-award.aspx

Frost may have certainly been in the research mix when Riviard and Colliard came up with Spincor. I don't know, but it looks promising ;)

You reminded me that I was told (by the orthopedic specialist/surgeon) not to do wide sweeping torso rotation exercises - but was told that exercises involving very short rotational moves, would not hurt. "In general" information from him based upon my curvatude of two.

Pam - would still be very interested in reading the paper you referenced :-)

mamamax

12-11-2009, 08:41 PM

I was just thinking that - surely it would be easier for smaller curves to be remodelled than larger ones. In which case, torso rotation exercises might be a good choice for people if they manage to catch scoliosis when it's still very mild, but not for those with more serious curves.

I would agree with that Tonibunny, and that may be why torso rotation is successful for some. I have more serious curves actually, and was told not to do wide sweeping torso rotation exercises - but that exercises involving short rotation would not hurt. If the torso rotation machine could be adjusted to do very short versions of the norm - would it help someone like me .. I wonder.

Pooka1

12-11-2009, 08:48 PM

I would agree with that Tonibunny, and that may be why torso rotation is successful for some.

But most (~90%) of small curves never become big curves and some resolve completely all with just ice cream therapy or watching and waiting.

The challenge with claims about treatments avoiding small curves becoming large curves when treating at the small curve stage will be to see if that ~10% that goes on to surgery territory is reduced by the treatment. And when you are dealing with an inherently variable condition like scoliosis, you will be hard pressed to ever show it.

So while it might save a few kids who would have gone on to surgery, you will likely never be able to show it.

All these treatments that claim to "cure" most kids at the early stages have to show they are curing more kids over and above the ~90% that wouldn't reach surgery territory no matter what they do or don't do. I think the people who make claims specifically about treating curves when they are small know these odds and are being deliberately deceptive about their "cure" rates.

mamamax

12-11-2009, 08:59 PM

I don't think anyone, here, is claiming cures. But any observed change is certainly worth investigating - the why of the why, so to speak.

In speaking of success, I guess, I should clarify that I'm talking about any change for the better.

Eventually, we may find - that when one thing works for only a few, that there are answers of some kind in that - by asking what was it those few had in common and how did they differ from others. If that makes any sense? Probably not, I'm multi tasking too many things at the moment.

Pooka1

12-11-2009, 09:49 PM

I don't think anyone, here, is claiming cures.

I think people here are claiming cures. I can name a few.

But any observed change is certainly worth investigating - the why of the why, so to speak.

Yes you need to investigate any change. But you have to have some way of figuring out what caused the change... the treatment or just a spontaneous resolution. Not to beat a dead horse but without large groups of treatment and control patients, you can't hope to know that.

In speaking of success, I guess, I should clarify that I'm talking about any change for the better.

I define success as a permanent reduction in the curve after treatment ends. All these PT therapies can claim temporary changes... that is not in question.

Eventually, we may find - that when one thing works for only a few, that there are answers of some kind in that - by asking what was it those few had in common and how did they differ from others. If that makes any sense? Probably not, I'm multi tasking too many things at the moment.

Yes but you have to have some way of showing it. When you are dealing with a very variable condition wherein still only ~10% ever reach surgery no matter what yo do or don't do, that is a very tall order. Any treatment that doesn't show some statistically larger "success" rate than ~90% can't be said to be helping a single person. This is NOT semantics... it is reality.

Some people are very fond of saying, "all big curves start out as small curves" implying that you better damn well treat them when they are small to avoid them getting big. But of course that statement implies an unproven assumption that some treatment we have now can stop a small curve from getting large. There is no proof of that. It could be that virtually all kids are treated uselessly prior to fusion. That is a valid conclusion from the data in hand.

mamamax

12-11-2009, 09:54 PM

If so, and if it is effective enough, it would be a really good argument at last for campaigning for the re-introduction of screening. As it currently stands, with few places (talking about UK here) offering anything except observation and eventual surgery if required, I eventually reached the conclusion I can't see the point in screening. The traditional figures say that only a small proportion of cases ever get as far as needing treatment, so I can well see the point that all the rigmarole of doctors, xrays, stress, and nothing being done other than comments that it's got a bit worse or that it's stayed the same, is pointless, whereas if something could be offered which allows the potential of stabilisation and even reversal, regular screening to discover curves as early and as small as possible (and then perhaps monitor them periodically with a scoliometer and photography of posture rather than radiation and only xray again if there is a change beyond certain criteria) would become a worthwhile thing.

I think your suggestion makes a lot of sense. Basically keep the screening (in a manner of speaking), and apply less invasive monitoring till such point that something else needs to be done. It seems a lot of people have been told their curves would not progress only to be sadly disappointed many years later, a monitoring campaign like yours could avoid that - and maybe even provide a lot of useful information if the monitoring results were fed into an international data base.

mamamax

12-11-2009, 10:07 PM

It could be that virtually all kids are treated uselessly prior to fusion. That is a valid conclusion from the data in hand.

I don't know about that, I really don't. And if that may be a valid conclusion from the data on hand - I would have to question the data .. or lack thereof. What I mean by that is: I just don't see that all bases have been fully covered, sufficiently enough, to make that conclusion without question in all cases. But then again, I'm just a patient and certainly no expert.

Pooka1

12-11-2009, 10:13 PM

I don't know about that, I really don't. And if that may be a valid conclusion from the data on hand - I would have to seriously question the data .. or lack thereof actually. What I mean by that is: I just don't see that all bases have been fully covered, sufficiently enough, to make that conclusion without question.

Okay which conservative treatments do we know keep kids out of surgery for life who would otherwise have progressed to surgery? Please list them below.

If you can't list anything then my conclusion remains consistent with the data in hand though of course that doesn't mean is is correct. That is an important distinction. All anyone can do is work with the data in hand which in that case may or may not be incomplete with respect to PT permanently reducing curves when the treatment is stopped.

Pooka1

12-11-2009, 10:16 PM

mamamax

12-11-2009, 10:32 PM

Okay which conservative treatments do we know keep kids out of surgery for life who would otherwise have progressed to surgery? Please list them below.

If you can't list anything then my conclusion remains consistent with the data in hand though of course that doesn't mean is is correct. That is an important distinction. All anyone can do is work with the data in hand which in that case may or may not be incomplete with respect to PT permanently reducing curves when the treatment is stopped.

My list always begins with Joe O'Brien who kept two kids out of surgery with bracing. Unfortunately, we do not have an international data bank that would prove a sufficient expanded listing for this discussion. But his story is played out every day among other families. And in this we find the missing data.

Does this mean all kids can be kept out of surgery with bracing? No. But it does mean some can.

Pooka1

12-11-2009, 10:37 PM

My list always begins with Joe O'Brien who kept two kids out of surgery with bracing.

You can't prove that. All you can say from that is that the kids didn't get surgery to date.

Science 101.

mamamax

12-11-2009, 11:13 PM

Oh that's great - then bottom line is ... there is no proof that bracing works and there is no proof that it does not (basing proof on cradle to grave statistics). I'm glad we solved that one! Someone alert the press.

Science 102

Pooka1

12-11-2009, 11:23 PM

Oh that's great - then bottom line is ... there is no proof that bracing works and there is no proof that it does not (basing proof on cradle to grave statistics).

Correct.

I'm glad we solved that one! Someone alert the press.

Science 102

Some among the press have known that for years. All who are familiar with the literature have known that for years. Not news.

txmarinemom

12-11-2009, 11:25 PM

My list always begins with Joe O'Brien who kept two kids out of surgery with bracing. Unfortunately, we do not have an international data bank that would prove a sufficient expanded listing for this discussion. But his story is played out every day among other families. And in this we find the missing data.

Does this mean all kids can be kept out of surgery with bracing? No. But it does mean some can.

Maxene,

Joe's kids might (operative word) have stayed out of surgery with Spinecor, any brace - or no brace. You keep bringing up his family, and I'm sure you want to believe there are givens there (I wish I could), but there's NO *definitive* proof bracing is what tipped the scale.

There's just NOT.

If I can, I'll grab the full paper for you tomorrow. I could be delayed as I'm getting ready for my Marine to come home on leave (out of Afghanistan safely a few weeks ago). Lots to do this weekend! :)

Pam

txmarinemom

12-11-2009, 11:37 PM

Yes Please! I would like the full article of the abstract you mention - so, that is something given to adult surgical patients, how often?

rhBMP-2 is used fairly often these days (at least I know my surgeon uses it) in adult fusions. I received it in Feb 2008 - and my surgery photos show the placement via absorable collagen sponges very clearly.

I will always feel it cut my restriction/recovery time dramatically, and at 22 months out my fusion is solid.

jrnyc

12-11-2009, 11:37 PM

Dear Pam
how wonderful that you have a marine, your marine, coming home safely!

what a great holiday gift!

best regards
jess

mamamax

12-11-2009, 11:44 PM

Maxene,

Joe's kids might (operative word) have stayed out of surgery with Spinecor, any brace - or no brace. You keep bringing up his family, and I'm sure you want to believe there are givens there (I wish I could), but there's NO *definitive* proof bracing is what tipped the scale.

There's just NOT.

If I can, I'll grab the full paper for you tomorrow. I could be delayed as I'm getting ready for my Marine to come home on leave (out of Afghanistan safely a few weeks ago). Lots to do this weekend! :)

Pam

Hey Pam! Look forward to the paper. Let the Marine know we are grateful! Have a super weekend. As for proof - dang, it's so subjective! But I don't really want to debate it :-) We could just go round and round eternally/infernally. Not too supportive to those patients & parents involved in bracing treatment, and in the end .. we really just don't have enough data to make definitive statements either way. Hence, the BrAIST study in the never ending quest to know for sure. Just my opinion :-)

mamamax

12-11-2009, 11:47 PM

rhBMP-2 is used fairly often these days (at least I know my surgeon uses it) in adult fusions. I received it in Feb 2008 - and my surgery photos show the placement via absorable collagen sponges very clearly.

I will always feel it cut my restriction/recovery time dramatically, and at 22 months out my fusion is solid.

Maybe it should be used in adult bracing :D

Seriously, I look forward to reading it - thanks!

hdugger

12-11-2009, 11:51 PM

mamamax

12-11-2009, 11:56 PM

Did I just hear the voice of reason enter the room?

Pooka1

12-11-2009, 11:57 PM

Well, I think we know that there simply aren't enough controlled studies to be able to answer this question one way or another. It would take something extraordinary (a curve reduction) to be able to address this question given the state of the literature.

Yes exactly my point.

But, the problem is clearly the state of the literature. Even a great alternative treatment, so long as it simply stopped progression and didn't reduce a curve, would be unknown given the state of the literature.

Yes. Consider the following:

1. My one kid was stable while in the 30s for at least 6 months while out of brace. Had she happened to be enrolled in that torso rotation study she would be considered a success. Yet she went on to fusion later.

2. Pam stopped wearing her brace and got to ~50* as a teenager and then STAYED there for about 2 decades. Had she been wearing a brace as directed that would have been considered a bracing success.

3. Your own son is stable absent brace or PT.

Proponents of conservative treatments will have to somehow control for these types of cases if they are going to claim efficacy.

hdugger

12-12-2009, 12:02 AM

Another thought - if the course of JIS is as serious as stated (90% progressing) then a study which simply accepted every JIS patient and showed no progression among any of them would be promising. Not definitive by any means, but certainly promising.

But, not among AIS patients, given the large percentage that don't progress. Among them, there would either have to be a reduction (almost an impossible request) or a really good controlled study.

This, the other side of the coin, is the reason why I don't understand how people can reject alternative treatments because they haven't shown a clear result. A clear result is extremely hard to show, since the most likely result of a good intervention is simply that a curve does not progress, and one can always say that maybe it wouldn't have progressed anyway. Even a controlled studied is so likely to mix in patients with different kinds of etiologies, curves, ages, etc.

hdugger

12-12-2009, 12:09 AM

Proponents of conservative treatments will have to somehow control for these types of cases if they are going to claim efficacy.

That's alot to ask of alternative treatments, which aren't generally offered by the kinds of people who normally do studies. Even medical people who do studies have not designed a really good evaluation of the one non-surgical treatment they offer (bracing). And the one definitive experiment they planned now appears to be becoming non-randomized.

I'm not trying to give all alternative treatments a pass - it's very likely that most of them do not work. But, even a very effective treatment would get lost in this muddle.

So, how do we go about figuring out what works? I'd hate to think that there's something out there which will lie unrecognized simply because we're lacking the tools to see it clearly in the muddle?

txmarinemom

12-12-2009, 12:16 AM

Maybe it should be used in adult bracing :D

Seriously, I look forward to reading it - thanks!

rhBMP-2 doesn't even remotely apply to bracing. It requires bone fusion.

Care to have your vertebrae scraped before bracing?

I think not.

mamamax

12-12-2009, 12:26 AM

rhBMP-2 doesn't even remotely apply to bracing. It requires bone fusion.

Care to have your vertebrae scraped before bracing?

I think not.

I wasn't being serious Pam - was just trying to make a lighthearted joke & lighten things up a litle - sorry :o

mamamax

12-12-2009, 12:29 AM

But, the problem is clearly the state of the literature. Even a great alternative treatment, so long as it simply stopped progression and didn't reduce a curve, would be unknown given the state of the literature.

True - with the exception of - Martha Hawes. An isolated case some may say - but representative perhaps, of many undocumented cases. Even more noteworthy - that she is an adult case which not only stopped progression but reduced curvature significantly.

hdugger

12-12-2009, 12:31 AM

And the yoga woman, and one older teeneger on this forum (whose reduction was still holding the last time I checked). All exercise-related.

One other interesting thing about Hawes and the yoga person is that they did quite a lot of massage. Hawes, I think, was having mainly massage and manipulation during those 4 hours a day. (At least, I recall it being more that than exercise).

So, if those are the tip of the iceberg, then there are likely a much larger group of people who have not have curve reductions but who have not progressed when they otherwise would have. How to discover them, though, is the issue.

With the exception of - Martha Hawes. An isolated case some may say - but representative perhaps, of many undocumented cases. Even more noteworthy - that she is an adult case which not only stopped progression but reduced curvature significantly.

mamamax

12-12-2009, 12:40 AM

And the yoga woman, and one older teeneger on this forum (whose reduction was still holding the last time I checked). All exercise-related.

One other interesting thing about Hawes and the yoga person is that they did quite a lot of massage. Hawes, I think, was having mainly massage and manipulation during those 4 hours a day. (At least, I recall it being more that than exercise).

So, if those are the tip of the iceberg, then there are likely a much larger group of people who have not have curve reductions but who have not progressed when they otherwise would have. How to discover them, though, is the issue.

Exactly, the field is fertile but the literature woefully lacking. What is interesting about Martha is, she used many methods. If I remember correctly (will have to check my books), her greatest improvement came when she was working with an osteopath. According to her memoir she maintains her correction with 1 hour of exercise a day. There are many who make such exercise a way of life - would the same correction be maintained with half an hour three times a week? Who knows, its possible I guess.

tonibunny

12-12-2009, 02:21 AM

I would agree with that Tonibunny, and that may be why torso rotation is successful for some. I have more serious curves actually, and was told not to do wide sweeping torso rotation exercises - but that exercises involving short rotation would not hurt. If the torso rotation machine could be adjusted to do very short versions of the norm - would it help someone like me .. I wonder.

I should qualify this by saying that I have yet to see proof that torso rotations can be successful. Dingo is very satisfied with how is son is doing, which is encouraging, and I'm following his progress with interest. I do believe that if torso rotations can be beneficial, it will be in cases such as his with very minor curves.

The one other person that I knew who tried torso rotations was a teenage girl, who used the method in conjunction with the Spinecor brace, and she ended up having surgery despite being very dedicated to avoiding fusion. So I do know for sure that sadly it does not *always* work. This is just one case, but it tells me that the method is not 100% failsafe.

mamamax

12-12-2009, 10:50 AM

The one other person that I knew who tried torso rotations was a teenage girl, who used the method in conjunction with the Spinecor brace, and she ended up having surgery despite being very dedicated to avoiding fusion. So I do know for sure that sadly it does not *always* work. This is just one case, but it tells me that the method is not 100% failsafe.

And that is the unfortunate part about it all. Nothing is 100% failsafe for 100% of all people. It's as if every spine is as unique as its owner - and we have not enough knowledge to know, in advance, what will prove adequate and what will prove harmful throughout the entirety of any one lifetime. I personally face thoughts like that every single day. It helps me enormously to know of those like Martha Hawes, and Elise Browning Miller. There was a time when we were told that such things as they have achieved, were unquestionably impossible, and yet as it turns out - the literature was simply lacking (and largely remains so in this area).

This morning I found myself thinking about cases which have spontaneously resolved and I can't help but wonder if the answers in the future will come from more in-depth knowledge of how and why that occurs.

Pooka1

12-12-2009, 11:10 AM

It helps me enormously to know of those like Martha Hawes, and Elise Browning Miller. There was a time when we were told that such things as they have achieved, were unquestionably impossible, and yet as it turns out - the literature was simply lacking (and largely remains so in this area).

Hang out with a more informed crowd. A rational person would never say it is impossible to temporarily reduce a curve with PT. I know for a fact Hawes has radiographic proof and I suspect the yoga woman does also that show an exercise-dependent temporary reduction their curves. You can also temporarily reduce a curve by standing funny or wearing a brace.

None of this is on the table or in question. What is in question is ever being able to stop the PT, bracing, standing funny, etc. and maintaining the reduction or even halting the curve especially against a backdrop of bone fide cases of these things occurring spontaneously or due to ice cream consumption. :)

Pooka1

12-12-2009, 11:19 AM

And that is the unfortunate part about it all. Nothing is 100% failsafe for 100% of all people.

And some things aren't even 5% failsafe for 100% of people.

hdugger

12-12-2009, 11:28 AM

Pooka1

12-12-2009, 11:41 AM

No, I don't think that's true at all. To the best of my knowledge, the literature only recently stated that it was possible to temporarily hold a curve with exercise. Before that, what we heard is that exercise has no effect at all. That people can hold a curve for months or years is a recent breakthrough, again, to the best of my knowledge.

Well when did Hawes get her radiographic proof of temporary reduction? Wasn't it at least 10 years ago? I could be wrong.

More importantly, a hold requiring ongoing exercise most emphatically *is* on the table. Go back and read Pam's posts - she would have been willing to exercise for 4 hours a day if it would have held her curve.

I'm almost 100% sure Hawes's radiographic evidence was known before Pam's surgery.

The teenager on this forum who is holding her curve is exercising for one hour a day - how many people on the forum would be willing to do that, if it meant that they would avoid surgery.

What do you mean by "on the table?" I assume most if not all people who do targeted exercises 4 hours a day can temporarily reduce their curve. If Hawes can do it why not everyone? Yes I am assuming that and have no evidence but I would be surprised if that were not the case.

And even if you can get people to exercise for 4 hours a day for several years just to get to a (This is not necessarily a fact... it is second hand)to maintain it, even if you can get people to try to do that, life's vagaries will eventually intervene. I have used the example of when I had Dengue Fever. Or people who have emergency surgery. I had a ruptured ectopic and had a quick cut through all my stomach muscles. I couldn't straighten up for a few weeks much less do PT. Combine that with the time it takes to lose muscle tone (less than 2 weeks) and you have people failing for no fault of their own. Nobody seems to want to recognize that.

I don't know where you're getting your information that an unnaturally straight spine held in place by surgery is 100% preferred to a naturally straight spine held in place by exercise, but I would very much like to see the data.

Never said that. I said surgery is the only proven way to permanently reduce a curve. You eventually get released by the surgeon. I do not consider PT a permanent solution because you can never stop it if you want to maintain the correction. Dr. Samdani, as of ~2009, claims there is no proof PT can permanently reduce a curve. He could be wrong but at least this is his game.

hdugger

12-12-2009, 12:39 PM

Never said that. I said surgery is the only proven way to permanently reduce a curve. You eventually get released by the surgeon. I do not consider PT a permanent solution because you can never stop it if you want to maintain the correction. Dr. Samdani, as of ~2009, claims there is no proof PT can permanently reduce a curve. He could be wrong but at least this is his game.

I don't think I'd realized before that this was your entire argument - that exercise is not a solution because it must be continued in order to maintain the cure.

You could say the same thing about many disorders - for example, people must exercise and watch their diet to maintain their weight. We are not, in the latter example, saying that stomach stapling is the only avenue because continual diet and exercise are too much to ask of people. We assume that the "natural" method of diet and exercise, even though difficult for some, is preferred to a risky surgery that forever changes the way the body operates. Certainly, we do not say that every overweight person should have their stomachs stapled - we save that for those who have been shown unable to effectively use diet and exercise to maintain a healthy weight. Same thing here - if exercise is actually effective in holding a curve, you'd strongly recommend that everyone exercise and save surgery for those for whom the exercise regime failed.

As to what happens if you have a period when you can't exercise - well, you start exercising again afterward and regain the muscle tone. I'm not certain why this would be an argument for surgery.

BTW, this is not my argument against exercise. My argument is that I don't believe we've yet found an exercise regime that will hold a curve even if followed faithfully. But, should we find one, I believe it would be offered as an acceptable alternative to surgery, just as diet and exercise are now offered as an acceptable treatment for many disorders.

hdugger

12-12-2009, 12:57 PM

Well when did Hawes get her radiographic proof of temporary reduction? Wasn't it at least 10 years ago? I could be wrong.

I'm almost 100% sure Hawes's radiographic evidence was known before Pam's surgery.

I'd consider that recent. You suggested that a rational person would know that exercise could temporarily reduce a curve. I was saying that, in fact, through years and years of rational literature the exact opposite was stated - that exercise had no effect.

The problem with Hawes results are that she doesn't really know exactly what she did "right." If she had a clearly outlined set of steps that people could successfully follow, I'm certain at least some people would follow them.

And even if you can get people to exercise for 4 hours a day for several years just to get to a point where you "only" have to exercise one hour a day to maintain it, even if you can get people to try to do that, life's vagaries will eventually intervene.

And, to return to the topic at hand, that's why the torso rotational studies are interesting. If one could exercise for 15 minutes a day and hold a curve, I think many people would find that attractive. I know that that is not always the case, as Toni noted. But I would like to hear from more people who have tried it to get a sense of what the limits are.

mamamax

12-12-2009, 03:55 PM

Mamamax

HOLY FREAKIN' MOLY!

Torso rotation may tell the nervous system where the abnormalities are and then the body uses OPN to repair/correct them. That might explain the entire mystery on why it works!!! HOLY FREAKIN' MOLY! (I had to say that again)

Where is that paragraph? I can't find it.

Dingo -

Attached is a paper I found that may help explain some of Frost's work (which appears to have been continued throughout the last few years). I'll be away from forum for a few days but thought you would want this.

ABSTRACT
The view that nonmechanical agents dominate control of osteoblasts and osteoclasts and thus postnatal changes in bone strength and mass (agent-effector cells-disease) is obsolete. Nonmechanical agents include hormones, calcium, vitamin D, cytokines, gender, genetics, etc. This paradigm overlooks all tissue level features, biomechanics and relationships found after 1960. This more recent information led to the Utah paradigm of skeletal physiology, proposed by Harold Frost in 1995. The Utah paradigm's view is that mechanical factors dominate control of the biologic mechanisms that control changes in postnatal bone and mass. Nonmechanical agents could help or hinder the influence of the mechanical factors but could not replace them. The simplified scheme is as follows:

Who is Harold M Frost: http://en.wikipedia.org/wiki/Harold_Frost
One of the most often cited investigators in skeletal research according to Science Citation Index

Pooka1

12-12-2009, 03:56 PM

I don't think I'd realized before that this was your entire argument - that exercise is not a solution because it must be continued in order to maintain the cure.

You could say the same thing about many disorders - for example, people must exercise and watch their diet to maintain their weight. We are not, in the latter example, saying that stomach stapling is the only avenue because continual diet and exercise are too much to ask of people. We assume that the "natural" method of diet and exercise, even though difficult for some, is preferred to a risky surgery that forever changes the way the body operates. Certainly, we do not say that every overweight person should have their stomachs stapled - we save that for those who have been shown unable to effectively use diet and exercise to maintain a healthy weight. Same thing here - if exercise is actually effective in holding a curve, you'd strongly recommend that everyone exercise and save surgery for those for whom the exercise regime failed.

I would say FAR more is involved with maintaining a reduction in a large curve than in anything you mentioned. It isn't even close if Hawes is typical.

And I would add that there are people with large or agressively progressive curves who likely would not respond even to hours and hours of exercise a day. Those are similar to your stomach stapling patient example.

As to what happens if you have a period when you can't exercise - well, you start exercising again afterward and regain the muscle tone. I'm not certain why this would be an argument for surgery.

Well what if you had to start all over from the beginning... four hours a days for several years just to get back to the point of "only" being able to do one hour a day (This is not necessarily a fact, it is second hand)? Nobody knows.

BTW, this is not my argument against exercise. My argument is that I don't believe we've yet found an exercise regime that will hold a curve even if followed faithfully. But, should we find one, I believe it would be offered as an acceptable alternative to surgery, just as diet and exercise are now offered as an acceptable treatment for many disorders.

Doesn't Hawes claim to still be holding her reduction with the one hour of PT a day? Maybe not.

Pooka1

12-12-2009, 04:01 PM

I'd consider that recent. You suggested that a rational person would know that exercise could temporarily reduce a curve. I was saying that, in fact, through years and years of rational literature the exact opposite was stated - that exercise had no effect.

Wait a minute. Am I wrong in assuming Schroth has ponied up radiographic evidence at points in their ~90 year existence that they reduced curves (temporarily)? I think they have.

The problem with Hawes results are that she doesn't really know exactly what she did "right." If she had a clearly outlined set of steps that people could successfully follow, I'm certain at least some people would follow them.

But what if everything in that 4 hour regime was required? I mean I'm sure she didn't just pick 4 hours out of the blue. I suspect she kept adding things until she saw a reduction and was at the four hour mark when it happened. And even then it took several years.

And, to return to the topic at hand, that's why the torso rotational studies are interesting. If one could exercise for 15 minutes a day and hold a curve, I think many people would find that attractive. I know that that is not always the case, as Toni noted. But I would like to hear from more people who have tried it to get a sense of what the limits are.

Yes I think plenty of people would find that attractive. But if Hawes had to do so much more then I wonder how likely it is that only 15 minutes of a relatively easy exercise a day could possibly work even temporarily.

Pooka1

12-12-2009, 04:39 PM

hdugger

12-12-2009, 06:02 PM

I think there may be a semantics problem here. I think experts might sometimes say PT has no effect meaning no PERMANENT effect. In that sense it has no benefit up against fusion. It's cumbersome to have to keep repeating the "permanently" part, something I noticed even in my short blurbs on this newsgroup.

Yes, I don't think I'd understood how you meant "no permanent reduction" before. You mean that the exercise must be continued in order to maintain the reduction. For you (I'm assuming) that's not an acceptable treatment. For me, depending importantly on the amount of time per day it took to maintain the curve, continued exercise would seem far preferable to surgery, and I'd consider both long term treatments. I'm not sure I can consider either permanent - we'll have to see how the newer hardware turns out and how exercise holds a curve.

Is your sense that exercise is not an acceptable treatment solely dependent on the amount of time it takes? If one could hold a curve with 30 minutes a day, would it seem like a valid alternative? Or are there additional criteria?

Pooka1

12-12-2009, 06:24 PM

Yes, I don't think I'd understood how you meant "no permanent reduction" before. You mean that the exercise must be continued in order to maintain the reduction. For you (I'm assuming) that's not an acceptable treatment. For me, depending importantly on the amount of time per day it took to maintain the curve, continued exercise would seem far preferable to surgery, and I'd consider both long term treatments. I'm not sure I can consider either permanent - we'll have to see how the newer hardware turns out and how exercise holds a curve.

No this is apples and oranges.

The potential problems with fusion are not holding the curve, especially with BMP for adults and low intrinsic pseudoarthrosis rates in kids. You usually get a good fusion and revisions for pseudoarthrosis are known to be low with pedicle screw constructs, especaiily in kids, as far as I know. The issue with surgery is achieving balance in three planes as it affects unfused areas and the potential need to extend the fusion.

So even in the case of revision surgery, it is still a discrete "permanent" treatment (you are eventually discharged), unlike PT. Apples and oranges.

Is your sense that exercise is not an acceptable treatment solely dependent on the amount of time it takes? If one could hold a curve with 30 minutes a day, would it seem like a valid alternative? Or are there additional criteria?

First, it isn't "my" sense. This isn't my game. My lay opinion on this is worthless (though the factual material I posted, if it is factual, is not). You should instead listen to what Samdani says on that torso rotation video IN THE FACE of the 8* reduction the girl achieved.

In re amount of time I personally would find acceptable (don't know why that's relevant to anything), I would have to think about it. But given what Hawes did, the amount of time is going to be more than I think many people will tolerate. I think Hawes is not unique in her result but rather her willingness and ability to put in so much time. When she was diagnosed, the surgical procedures weren't as good as they are now. As they get better and better, the amount of time the average person is willing to spend in daily PT will go down and down. That is my prediction.

Pooka1

12-12-2009, 06:41 PM

hdugger

12-12-2009, 06:57 PM

Let's take Type I diabetes.

Let's assume some day there is an operation available to obviate the need for multiple daily insulin injections, maybe transplanting cadaver pancreases coupled with some slick one-time way to avoid organ rejection.

Now. How many people would choose that operation over daily insulin injections?

That's more of an apples to apples comparison as I understand this.

Yes, I think that's pretty good. And the answer is, I'm not sure. Certainly not all of them would get the surgery, and maybe not even 60%, based on the risks of the surgery and the risk of ongoing complications. But, that's just a guess.

For the scoliosis comparison, you'd have to also add into the "no surgery" group those who preferred controlling the curve themselves with no apparent medical intervention. That's a major difference between exercise and insulin shots.

But, we could get even better numbers just by taking an informal poll here. How many pre-surgical patients would choose an effective course of exercise if it took 30 minutes a day? 1 hour? 4 hours? How many young people might choose it to delay surgery until they were into their 40s or 50s?

Pooka1

12-12-2009, 07:14 PM

But, we could get even better numbers just by taking an informal poll here. How many pre-surgical patients would choose an effective course of exercise if it took 30 minutes a day? 1 hour? 4 hours? How many young people might choose it to delay surgery until they were into their 40s or 50s?

That would be interesting. I hope lots of people play.

While not technically "presurgical," I have a natural fusion in my lumbar that is really acting up of late. I can't stand without getting pain for more than a little while. I don't know what is going on and it isn't bad enough yet to compel me to get a radiograph... I can still ride and sit pain free. It's just standing I can't do much of without moving around.

Now if I was told a lumbar fusion wouldn't affect my riding and was likely a one-stop shopping deal, I would tolerate only about 15 minutes a day of PT tops to avoid the surgery. If it was a problem in the thoracic, it would be less than 15 minutes. As far as I know, most of even the old Harrington rod T fusions are stable and those people are having no issues even years out; add in pedicle screws and the decision is easier because better balance and derotation can be achieved. Balance is the game in fusion.

hdugger

12-12-2009, 07:23 PM

Yes, I have a similar problem (the result of being run over by a car when I was a toddler). Unless I do regular stretches, I get knee injuries that make it very difficult to walk.

I can't imagine what problems I'd have to suffer from before I decided to take a surgical route to fix it, but it would have to be pretty seriously worse then this - something like debilitating pain or the inability to walk. I'd do up to an hour a day gladly. But, I hate surgery. My mom choose to be virtually disabled - she walks very slowly with a walker - rather then get hip surgery. We can't be the only cowards out there :)

Pooka1

12-12-2009, 07:34 PM

We can't be the only cowards out there :)

No you are certainly not. That is an emotional reaction and no emotional reaction is wrong.

The hope is that people trying to decide have the correct, up-to-date statistics on safety and efficacy of the surgical procedure in question. And unless it is no risk whatsoever, you will always have people opting out, even those in very dire straights.

Surgery is not for the faint of heart and things can and do go awry but the prize is big. And some have no real choice like both my daughters. Choice is a luxury or a burden depending on how you approach it. For us it was a luxury that we didn't have. We were spared the burden of dithering in a grey area.

LindaRacine

12-12-2009, 09:02 PM

As far as I know, Martha Hawes has not published anything to show that her correction has been maintained. I believe Mamamax claims that Martha maintains her correction with 1 hour of exercise a day, but I don't know where she got that information.

I think there are some who would be willing to do 1 hour of exercise a day, but I doubt that many would go beyond that. And, one would have to wonder what happens if the person gets ill and can't exercise for a period of time. Do they then have to go back to 4 hours a day? Or, will they end up having to have surgery anyway?

The Schroth method has been around for a very long time. It seems to me that if people were able to maintain correction (with or without maintenance), it would have been published by now. There's not even an anecdotal paper on the subject. The fact that there is no long term outcome study is really the only proof I need.

Pooka1

12-12-2009, 09:17 PM

Okay I didn't realize much of that. I wish we could find out if Hawes maintained her reduction and how much exercise she does now.

I thought Hawes said she was doing an hour. If is was Mamamax then I'm going to edit that out of my posts right now.

hdugger

12-14-2009, 02:11 PM

I believe it's from Hawes' memoir (according to Mamamax in another topic) - "Same thing happened with Martha Hawes (who maintains her success with 1 hr of exercise daily per her memoir)"

Okay I didn't realize much of that. I wish we could find out if Hawes maintained her reduction and how much exercise she does now.

I thought Hawes said she was doing an hour. If is was Mamamax then I'm going to edit that out of my posts right now.

Pooka1

12-14-2009, 02:25 PM

I believe it's from Hawes' memoir (according to Mamamax in another topic) - "Same thing happened with Martha Hawes (who maintains her success with 1 hr of exercise daily per her memoir)"

Question for Mamamax or someone with Hawes' memoir... When was her memoir written and how long had she maintained the correct with one hour of exercise at the point of writing?

hdugger

12-15-2009, 04:12 PM

As far as I know, Martha Hawes has not published anything to show that her correction has been maintained. I believe Mamamax claims that Martha maintains her correction with 1 hour of exercise a day, but I don't know where she got that information.

I just wrote to Martha. She confirms that she's holding her correction. She does one hour of exercise a day and nothing else special, but, obviously, has no way of knowing if the exercise is the reason her correction has held.

hdugger

12-15-2009, 04:20 PM

Martha also reminds me of the SEAS study which shows a decrease in curve in an adult with 30 minutes of exercise a day. Length of study: 1 year

That's four data points so far.

Pooka1

12-15-2009, 07:42 PM

I just wrote to Martha. She confirms that she's holding her correction. She does one hour of exercise a day and nothing else special, but, obviously, has no way of knowing if the exercise is the reason her correction has held.

Wow.

I'd like to know:

1. how long she has maintained the correction
2. how often she obtains radiographs to confirm she is holding with the one hour
3. how she knew she when she could drop down from 4 hours (for several years) to just one hour.

Obviously the PT is holding the curve or she would stop exercising or maybe exercise not quite so much.

hdugger

12-15-2009, 07:52 PM

Wow.

I'd like to know:

1. how long she has maintained the correction
2. how often she obtains radiographs to confirm she is holding with the one hour
3. how she knew she when she could drop down from 4 hours (for several years) to just one hour.

Obviously the PT is holding the curve or she would stop exercising or maybe exercise not quite so much.

Wow, indeed. Elise Miller reports the same, according to the communication posted on the forum. One hour a day of scoliosis-specific exercise. It certainly is a tantalizing glimmer.

It's not obvious to me that PT is what's holding the curve, although I strongly suspect. I walk for 30 minutes a day to ward off leg injuries - but it's based 1 part on evidence and 3 parts on "faith". Likely we all do some mix of effective and ritual activities to keep ourselves healthy. But, yes, it certainly does seem likely that it's some kind of intentional muscle action that's keeping the reduction in place.

Pooka1

12-15-2009, 08:05 PM

Wow, indeed. Elise Miller reports the same, according to the communication posted on the forum.

See this comports with my feeling that it's not the result that is unique but rather the willingness/ability to do endless hours of PT that is unique.

hdugger

12-15-2009, 08:10 PM

See this comports with my feeling that it's not the result that is unique but rather the willingness/ability to do endless hours of PT that is unique.

One hour.

I don't think we have enough evidence to say - so far, I just have 4 data points of anyone saying they've had any reduction in their curve. The time given to maintain that correction is one hour (for two of them) and 30 minutes (for the other). Are there other long-term studies of curve reduction? More data points would certainly help.

Pooka1

12-15-2009, 08:14 PM

I was referring to four hours for years.

Again, it is not likely she immediately tried four hours and that was right. I bet she ratcheted it up from one to two to three to four until she was seeing a result.

I don't think she is claiming she could have reduced that curve that much starting at one hour. If she could do that why was she doing four hours? For years?

That woman is a tenured professor in plant pathology or something like that. She was working during this I'm sure.

And she is probably lucky she never had Dengue Fever or needed emergency abdominal surgery if that isn't part of the reason why she needed several years of the four hours..

Dingo

12-15-2009, 09:51 PM

hdugger

Are there other long-term studies of curve reduction?

There will never be a large, well done, longterm study on the effects of exercise on Scoliosis after skeletal maturity. It's very hard to find people with enough mental discipline to stick to an exercise plan like Martha. Like you said this stuff has to be accepted on faith.

Ya know, many people reject Martha Hawe's concepts just like many people rejected Jack LaLanne's concepts. In Jack's case he is 95 and his critics are long dead.

hdugger

12-15-2009, 10:07 PM

I was referring to four hours for years.

Again, it is not likely she immediately tried four hours and that was right. I bet she ratcheted it up from one to two to three to four until she was seeing a result.

I'd have to go back and look at her book. My memory is that she started having spasms and many of those hours were spent manipulating/massaging the area because it bothered her. That is, I think the time spent was due to trying to alleviate a symptom, not trying to reduce a curve, at least at the start. But, I don't recall exactly.

That's one data point. And another (Elise Miller) who also spent alot of time at first and then went down to an hour.

But there are two more data points that did not have years of more than an hour a day.

We're just not nearly far enough along in gathering data to be able to draw any conclusion, IMO. All we know so far is that it is possible to reduce a curve and maintain a reduction through exercise. Everything else is an unknown.

hdugger

12-15-2009, 10:09 PM

There will never be a large, well done, longterm study on the effects of exercise on Scoliosis after skeletal maturity. It's very hard to find people with enough mental discipline to stick to an exercise plan like Martha. Like you said this stuff has to be accepted on faith.

If it's a reduction it doesn't have to be large or well done, since the natural course of scoliosis never shows a reduction in a significant curve. It would be good, though, if it was longterm - at least a year, and preferably more.

Do any of the existing studies meet that criteria? I'm hungry for data points :)

Writer

12-16-2009, 01:04 AM

mamamax

12-16-2009, 05:47 AM

Quite by chance, there is a new publication at Scoliosis Journal in which Martha Hawes brings her case up to date. It appears that she cut her curves in half, or at least by a quarter, depending on measurement methodology. She gives the data on her exercises, the X-rays, and other information including over a hundred references to supporting literature.

http://www.scoliosisjournal.com/content/pdf/1748-7161-4-27.pdf

Thank you for posting this Writer.

This 26 page follow up helps answer questions and dispel some myths about the case of Martha Hawes.

Table 2 which shows cobb measurements (using three comparative methods) from 1990-2005 clearly shows a progressive reduction in curvatude - hdugger reports from a recent email to Martha, that she continues to maintain her correction with 1 hour of exercise daily (as is outlined in her memoir).

Table 1 outlines her methods of treatment - none of which involve 4 hours a day of exercising for years and years - a myth that I'm glad to see set to rest in this report. From 1964-1974 she used calisthenics for about 30 minutes daily; 1974-1991Calisthenics, stretching, plus aerobics (biking, jogging) 60 min daily; 1991 Deep tissue massage 60 min daily; 1992-2001 Daily home mobilization exercises (no strengthening or aerobic) + some other intermittent therapy; 2001-2005 daily mobilization, strengthening & aerobic exercise 40-50 min daily.

The work of Martha Hawes not only demonstrates that contrary to past opinion, adult curves can be reduced significantly through non surgical methods - and that reduction can be maintained.

One may only speculate: If we have this well documented case report - how many undocumented cases exist?

Pooka1

12-16-2009, 06:02 AM

Okay I thought there was far more than >10* reduction in Cobb angle reported in the earlier paper.

You can achieve that difference by standing differently, no exercise, no brace although some of that might be asymmetrical muscle development in compensation I am guessing.

I'm sure she is much more aerobically fit with all that PT. I'm amazed that she never relented on surgery even at the point of needing psychotherapy for the pain.

I'll bet she will never stop the PT.

And I would like to know if surgeons think there is anything to be learned here.

Pooka1

12-16-2009, 06:05 AM

Table 1 outlines her methods of treatment - none of which involve 4 hours a day of exercising for years and years - a myth that I'm glad to see set to rest in this report. From 1964-1974 she used calisthenics for about 30 minutes daily; 1974-1991Calisthenics, stretching, plus aerobics (biking, jogging) 60 min daily; 1991 Deep tissue massage 60 min daily; 1992-2001 Daily home mobilization exercises (no strengthening or aerobic) + some other intermittent therapy; 2001-2005 daily mobilization, strengthening & aerobic exercise 40-50 min daily.

Compare this to what was written in the earlier paper and see if you think they agree.

Pooka1

12-16-2009, 06:10 AM

Also, this paper was published this year yet the last radiograph is from 2005.

Pooka1

12-16-2009, 06:14 AM

1992-2001 Daily home mobilization exercises (no strengthening or aerobic) + some other intermittent therapy;

No duration listed for this one. Why?

hdugger

12-16-2009, 10:59 AM

That is very interesting. Thanks so much for posting the report, Writer.

A few other points I'm pulling out of the report:

* She may have had JIS rather than AIS - asymmetry noted by age 6, 45 degree curve by age 11. Based on the bulk of JIS reports I've seen, it's very likely she would have progressed to surgery.

* She may have some mild connective tissue disorders. At the least, she mentions pectus excavatum which, along with scoliosis, is seen in some connective tissue disorder.

* Based on the age at which she was diagnosed at 45 degrees, it is equally interesting that she managed to maintain her curvature without progressing.

* She lays out in report a fairly clear summary (on page 5) of the exercises she performed when young to maintain her curve.

* Activity between 1992 and 2001 are detailed in the paper (and, I believe, also covered in detail in her previous report)

hdugger

12-16-2009, 11:11 AM

One last idea/hypothesis

When we talk about the number of hours that Elise Miller and Martha Hawes spent initially reducing their curve, I think we forget that they were researchers and not practioners. That is, they were trying all kinds of different things to figure out what worked for them. I don't believe the amount of time they spent accurately reflects the amount of time needed to reduce/maintain a curve once we understand exactly what exercise are needed.

There's also no way of knowing how much of the one hour of daily exercise is actually necessary to maintain the reduction. We have two other data points that suggest that less time is needed. As we learn more, we may be able to hone in exactly which exercises are reducing the curve and maintaining the reduction. Until then, it's likely that all of these amounts of time include as least some unnecessary exercises.

Pooka1

12-16-2009, 01:24 PM

From the 2009 paper on Hawes...

Table 1 outlines her methods of treatment - none of which involve 4 hours a day of exercising for years and years - a myth that I'm glad to see set to rest in this report. From 1964-1974 she used calisthenics for about 30 minutes daily; 1974-1991Calisthenics, stretching, plus aerobics (biking, jogging) 60 min daily; 1991 Deep tissue massage 60 min daily; 1992-2001 Daily home mobilization exercises (no strengthening or aerobic) + some other intermittent therapy; 2001-2005 daily mobilization, strengthening & aerobic exercise 40-50 min daily.

From the previous article:

http://www.scoliosis.org/resources/spinalconnection_spr2002.pdf

From January 1993, one of the authors (WJB) provided instruction, support, and evaluation of posture and movement. Sustained pressure applied directly to muscle spasms, or manual traction to stretch the torso,was used by the patient to relieve pain as needed ( 4 h daily through 1997).

Okay so she did this for FOUR hours every day for FIVE years. The daily effort spent on this component of her treatment is the ONLY one left out of the table and is therefore conspicuous by its absence. I don't know why it was omitted from the table.

And I don't know why the dates for the various treatments don't match exactly between the two papers. Seems strange.

Hawes is a plant science professor and therefore NOT a nut. I will give her the benefit of the doubt on any differences between the two papers.

But let's not go on saying the 4 hours a day for years is a myth, shall we?

oojackapivvy

12-17-2009, 12:10 PM

Off on a slight tangent, something I've often said over the years that I'd like to see in a good quality study of exercise based therapies (should such a thing be done) is bending xrays done before commencement of the therapy, as I'd like to see the correlation between that and the success of the therapies. If it would give a measure of the potential for success (which Cobb angles alone clearly will not), that could be valuable, perhaps particularly in cases where the curve is not showing signs of being progressive in adulthood, but the person is concerned with the cosmesis.

hdugger

12-17-2009, 12:28 PM

Yes, that's a very good point. In the SEAS study, they suggest something similiar. They show a graphic of a hypothetical curve measured in three postures - standing (hypothetically 40 degrees), lying (hypothetically 30 degrees), and lying while braced (hypothetically 20 degrees).

And the attribute the following effects on each measurement:

When standing (SR), the curve is effected by posture, ligaments, and the underlying bony curve.

When lying out of brace (LR), the postural element is removed an the curve is affected by the ligaments and the underlying bony curve.

When lying in brace (CR), both the postural and the ligament elements are removed and the curve is affected only by the underlying bony curve.

What they therefore claim is that, while you cannot correct the fixed bony curve, you can use exercise to affect the postural collapse. In adults, the idea is that reversing the postural collapse will reduce the amount of further bony degeneration.

Again, this is all hypothetical, but it does make some intuitive sense. It would also mean, I think, that those most likely to show a great curve reduction with surgery would also show the greatest improvement with exercise, although I *think* that surgery takes you back to the CR curve, while exercise would only take you back to the LR curve.

Off on a slight tangent, something I've often said over the years that I'd like to see in a good quality study of exercise based therapies (should such a thing be done) is bending xrays done before commencement of the therapy, as I'd like to see the correlation between that and the success of the therapies. If it would give a measure of the potential for success (which Cobb angles alone clearly will not), that could be valuable, perhaps particularly in cases where the curve is not showing signs of being progressive in adulthood, but the person is concerned with the cosmesis.

oojackapivvy

12-17-2009, 04:29 PM

Ah, that ties in well then with what I have often said over the years which is that it would not surprise me if exercise therapies can/do work on the postural element.

Another tangent, what is it with xray techs who insist on trying to make you straight? I'm truly fed up with fighting them! In particular, because I have such severe sagittal imbalance (it's got to be close to 30cm again), serious coronal imbalance and massive rotation, if I'm made to stand with my knees and hips bent to bring my spine vertical, and my right knee especially bent to drop my right hip and re-centre my weight with my head over my sacrum, this gives a totally artificial picture of things.

I find myself wondering is it any surprise that they did not restore enough lordosis in my 2002 revision, given that they were relying on the xray I had done prior to it, where I had to fight with the tech to be allowed to stand with my knees even partially straightened, as she insisted that I'd hang off the film and refused to do 2. The result is that they worked from a measurement of 19.7cm of sagittal imbalance (as I finally found out earlier this year), when it was definitely over 30cm.

As it happens, the technical issues of having an un-removable anterior rod, and having a short, sharp 45 degree kyphosis over T10-L3, meant it was almost impossible to restore enough lordosis no matter what measurement they worked from, but had they had the accurate measurement, perhaps they'd have fused to the sacrum then, rather than only L4, and I might well not be facing a second full magnitude revision. Mind you, if they had, perhaps I'd now be whining that I wished they could have stopped short and left me some flex ;)

In any case, I'm certainly not at all surprised to read that you can get significantly different measurements based on the posture even while standing. How many times does it make the difference between surgery or not - and that can actually be just as bad a thing if it means spending more time classed as borderline and being refused as if it gets you over-measured and rushed off too soon.

Dingo

12-17-2009, 10:35 PM

Swiss researchers appear to be wrapping up a study on strength training and Scoliosis. My sense is that this is another torso rotation study.

The effect of asymmetrical weight training on paraspinal muscle activity in scoliosis (http://www.researchportal.ch/unizh/p7882.htm)

Paraspinal EMG measurements on the convex side of the scoliotic curve have been demonstrated to be enhanced. At present, most scoliotic patients are trained symmetrically which possibly further enhances the muscular imbalance. The present study therefore aims to investigate whether asymmetrical training will be superior compared to symmetrical training in terms of muscle balance in the spine of scoliotic patients. The project is divided into two studies: The first study investigates the immediate changes in paraspinal EMG in scoliotic patients during symmetrical vs. asymmetrical exercises. In the second study, scoliotic patients will be randomly assigned to a symmetrical or an asymmetrical weight training for 3 months and functional outcome, pain, paraspinal EMG, trunk strength/endurance will be compared.

hdugger

12-17-2009, 11:00 PM

Hey, you've been hiding data points from me, back there in the initial post of this discussion :)

From http://www.medxonline.com/downloads/articles/measuredresistanceinscoliosis.pdf

Two data points

14 years old - original curve 45, final curve 32
14 years old - original curve 50, final curve 32
Length of study - four months

Pooka1

12-18-2009, 05:22 AM

I don't think surgeons say temporary reductions are impossible. I don't think any surgeon would claim they never occur. There are too many of them, even one in this little sandbox to have remained unknown to the orthopedic community. It strains credulity to suggest that.

ETA: Spontaneous reductions and complete resolutions have been known for some years. I think the thing that surgeons claim has no evidence is the exercise-induced claim of reduction and the complete lack of evidence that it is a permanent reduction even if it can be shown to be due to exercise.

Recall Samdani was completely unfazed by that girl's 8* reduction from torso rotation. It wasn't like he was wowed and then said he didn't think it was permanent. It was like he simply doesn't think these cases are dispositive of anything.

Just my impression.

jrnyc

12-18-2009, 08:45 AM

re: latest publication concerning martha hawes...thoracic, thoracic, thoracic...any evidence anywhere of curve reduction of LUMBAR...??!!!!

just askin'......:confused:

jess

Dingo

12-18-2009, 09:14 AM

jrnyc

Check out page 4 of the Vert Mooney study. It appears to work for just about any curve type. However this was in children, I'm not sure about adults.

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

Dingo

12-18-2009, 09:16 AM

hdugger

Hey, you've been hiding data points from me, back there in the initial post of this discussion :)

Yeah at this point the links are scattered over pages of this thread.

I'm going to make a website that contains all of this info. Hopefully it will be done in a few weeks.

hdugger

12-18-2009, 10:26 AM

I would be very interested in hearing an orthopedic surgeon's opinion on this issue. I never see reductions of any kind in a large curve in a mature spine - temporary or permanent - noted as a possible occurrence in any of the literature.

As to the 8 degree reduction, that was in a small curve in a young patient. Yes, reductions absolutely happen in those curves - that's been noted in the literature. That's why we're only looking at significant curves in AIS or adult scoliosis cases.

If someone can find me a case of a spontaneous reduction lasting several months or years of a significant curve in an AIS or, preferrably, adult spine, I would very much like to see it.

I don't think surgeons say temporary reductions are impossible. I don't think any surgeon would claim they never occur. There are too many of them, even one in this little sandbox to have remained unknown to the orthopedic community. It strains credulity to suggest that.

ETA: Spontaneous reductions and complete resolutions have been known for some years. I think the thing that surgeons claim has no evidence is the exercise-induced claim of reduction and the complete lack of evidence that it is a permanent reduction even if it can be shown to be due to exercise.

Recall Samdani was completely unfazed by that girl's 8* reduction from torso rotation. It wasn't like he was wowed and then said he didn't think it was permanent. It was like he simply doesn't think these cases are dispositive of anything.

Just my impression.

hdugger

12-18-2009, 10:27 AM

I thought the SEAS study and the patient on this forum both reduced lumbar curves, but I don't have the time right now to go back and check.

re: latest publication concerning martha hawes...thoracic, thoracic, thoracic...any evidence anywhere of curve reduction of LUMBAR...??!!!!

just askin'......:confused:

jess

Pooka1

12-18-2009, 02:24 PM

I would be very interested in hearing an orthopedic surgeon's opinion on this issue. I never see reductions of any kind in a large curve in a mature spine - temporary or permanent - noted as a possible occurrence in any of the literature.

Wait a minute. If us bunnies have read the two articles on Hawes and one on the SEAS woman, what would prevent surgeons from reading/knowing that?

Also, if we have heard anecdotal reports on here about temporary reductions of large curves in adults, doesn't seem likely surgeons have heard it by now also?

So it is obviously possible.

Again, when surgeons say mature (or young) curves can't be reduced with PT (or bracing) I think they mean "permanently" reduced. I think most people can reduce their Cobb angle just by standing funny.

Ballet Mom

12-18-2009, 02:46 PM

Wait a minute. If us bunnies have read the two articles on Hawes and one on the SEAS woman, what would prevent surgeons from reading/knowing that?

Also, if we have heard anecdotal reports on here about temporary reductions of large curves in adults, doesn't seem likely surgeons have heard it by now also?

So it is obviously possible.

Again, when surgeons say mature (or young) curves can't be reduced with PT (or bracing) I think they mean "permanently" reduced. I think most people can reduce their Cobb angle just by standing funny.

I suspect that surgeons don't bother themselves too much with studies that are considered outside the normal scope of the standard of care. Too many quacks out there to look into it all and it's really the Europeans and other countries that are interested in exercises to control progression, not the U.S.

By the way, I am definitely NOT saying that these exercises don't work. I'm just explaining the difference in outlook between US surgeons and others. It may very well turn out that the other countries end up being correct.

Anyhow, when you say that surgeons say that young curves can't be reduced with bracing, that is incorrect. I have found any number of young curves that have been reduced by bracing in studies on the internet. Even the Charleston Bending Brace has a case in a presentation on the internet somewhere that shows a kid that reduced back to "no scoliosis" which was presented by an orthopedist at a medical conference. I think it's just not typical. I think they purposely try not to get people's hopes up like the chiropractic industry seems to, because it is relatively rare.

And, our orthotist said when my daughter was given the Charleston Bending Brace that with a good correction, and consistent wearing, she could expect a few degrees of decrease in the curve....which is exactly what has happened.

txmarinemom

12-18-2009, 04:06 PM

Again, when surgeons say mature (or young) curves can't be reduced with PT (or bracing) I think they mean "permanently" reduced. I think most people can reduce their Cobb angle just by standing funny.

I think that's exactly correct.

To my knowledge, exercise/PT is rarely (or never) prescribed over bracing as an alternative conservative intervention option. To me, that indicates surgeons view bracing (which is of somewhat questionable efficacy) as the more viable treatment.

Someone tell me if I've missed some vital point in this discussion.

Do we know of surgeons who prescribe exercise instead of bracing?

If there were reproducible data exercise worked, for what possible reason would it be withheld as a treatment?

And, yes ... bending films prove Cobb angle can be temporarily altered, it's just a question of how much. :)

Regards,
Pam

mariaf

12-18-2009, 04:15 PM

And, yes ... bending films prove Cobb angle can be temporarily altered, it's just a question of how much. :)

I agree completely. I would grant that perhaps a curve can be altered or corrected TEMPORARILY - but how long before it reverts back to it's original position? That's the big question. And of course, there is a huge difference between correcting a curve permanently and correcting it temporarily, the latter of which doesn't serve much purpose (except perhaps to see if one's curve is flexible or not).

Dingo

12-18-2009, 04:44 PM

MariaF

If you read the three studies on torso rotation strength training there is every reason to suspect that the correction is essentially permanent.

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

After 4 months of unsupervised home strength training their strengths were unchanged. The 3 patients with baseline curves of 50 to 60 degrees all had main or compensatory curve progression and 2 had surgery. For patients with 20 to 40-degree curves, survivorship from main curve progression of >or=6 degrees was 100% at 8 months, but decreased to 64% at 24 months.

These kids did supervised strength training for 4 months. 4 additional months after training stopped (the 8 month mark) the 12 patients with 20 to 40 degree curves had the same strength and no curve progression. This suggests that the impact of strength training lasts quite a while. BTW if you read the study it indicated that only a few kids did any of the home strength training exercises once the gym strength training was over.

As for a permanent correction in adults I have no idea.

txmarinemom

12-18-2009, 05:30 PM

These kids did supervised strength training for 4 months. 4 additional months after training stopped (the 8 month mark) the 12 patients with 20 to 40 degree curves had the same strength and no curve progression. This suggests that the impact of strength training lasts quite a while. BTW if you read the study it indicated that only a few kids did any of the home strength training exercises once the gym strength training was over.

As for a permanent correction in adults I have no idea.

Dingo,

I hate to point out this detail, but 4 months (or even 8 months) isn't permanent - and I don't know why you have "every reason to suspect" it is.

Certainly, I can understand why you'd want it to be. There's nothing wrong with that.

Regardless, it isn't anywhere NEAR a fact at this point in time. If it *becomes* a fact, I'd expect the medical community to give those studies more weight.

In the meantime, there's nothing wrong with exercise ... it just isn't a cure.

Regards,
Pam

Pooka1

12-18-2009, 05:47 PM

\

I hate to point out this detail, but 4 months (or even 8 months) isn't permanent - and I don't know why you have "every reason to suspect" it is.

There's a reason why there are no follow studies in some of these cases.

hdugger

12-18-2009, 05:49 PM

If there were reproducible data exercise worked, for what possible reason would it be withheld as a treatment?

I don't think we're at the "reproducible data" stage for exercise - I think we're at the "an interesting thing which has recently been seen in case studies" stage. I am somewhat surprised, though, that doctors are not following up on the work as, again, it is the first time that significant curves in mature spines have shown a reduction, to the best of my knowledge. But, no, I don't think there is a set course of exercise that can be prescribed yet. Still just glimmers.

But, if there were all manner of things that would decrease a curve on xray - like standing funny or eating ice cream - then we'd have people coming in here all the time telling us that there curve had suddenly measured 20 degrees less. To my knowledge, that has never happened, except in these few cases where some form of exercise appears to have made a difference.

Pooka1

12-18-2009, 05:52 PM

I don't think we're at the "reproducible data" stage for exercise -

But Schroth surely is! They have been around for circa 90 years!!!

What's their excuse???

Pooka1

12-18-2009, 05:55 PM

I
But, if there were all manner of things that would decrease a curve on xray - like standing funny or eating ice cream - then we'd have people coming in here all the time telling us that there curve had suddenly measured 20 degrees less. To my knowledge, that has never happened, except in these few cases where some form of exercise appears to have made a difference.

In my opinion, the reason they aren't crawling out of the woodwork and researchers are not clamoring to publish it is because it is temporary. That is essentially an interim finding that as far as anyone knows is NOT related to the final result absent continued ice cream eating, standing funny, PT, rakish angle breathing, etc. etc.

hdugger

12-18-2009, 06:00 PM

Again, when surgeons say mature (or young) curves can't be reduced with PT (or bracing) I think they mean "permanently" reduced.

I think we use the term "permanently" differently, but I have not read in the regular medical literature that curves can be reduced for long periods of time by continued exercise. If I'm missing mainstream literature that includes this caveat, I'd appreciate some links.

txmarinemom

12-18-2009, 06:04 PM

But Schroth surely is! They have been around for circa 90 years!!!

What's their excuse???

Thank you for not making me say that.

hdugger

12-18-2009, 06:17 PM

The reason they aren't crawling out of the woodwork and researches are not clamoring to publish it is because it is temporary (in my opinion). That is an interim finding that as far as anyone knows is NOT related to the final result absent continued ice cream eating, standing funny, PT, rakish angle breathing, etc. etc.

We only have the tools we have. Right now, the standard tool for measuring curve progression, stabilization, or reduction, is the Cobb angle. If, as in at least three of these data points, repeated xrays show a Cobb angle reduced by more than 10 degrees, it is assumed that something has reduced the curve. If you're finding that people eating ice cream are showing a sustained reduction in their curve of more than 10 degrees, I encourage you to publish your findings. Right now, though, the only reports I'm reading of a sustained reduction sans surgery are in these few data points who all attribute it to exercise.

As to the continued exercise, that's all I'm looking for. A curve reduction sustained by continued exercise. Maybe that doesn't interest any other researchers, but it certainly interests me.

hdugger

12-18-2009, 06:23 PM

But Schroth surely is! They have been around for circa 90 years!!!

What's their excuse???

One of our data points is using Schroth to reduce her curve and hold the reduction.

As to the general state of publishing, though, it's what we've talked about all along--it's almost impossible to prove that a treatment has held a curve. That's why we're looking at these extreme cases - where a treatment actually reduces a curve. It's the only thing that can be heard in all this noise.

Pooka1

12-18-2009, 06:27 PM

One of our data points is using Schroth to reduce her curve and hold the reduction.

Yes. So the success rate for a temporary reduction using Schroth is:

1/5,000* = 0.02%.

At that rate it is MORE likely that it was NOT due to the treatment.

* My guess as to how many people tried Schroth.

hdugger

12-18-2009, 06:29 PM

hdugger

12-18-2009, 06:34 PM

Yes. So the success rate for a temporary reduction using Schroth is:

1/5,000* = 0.02%.

At that rate it is MORE likely that it was NOT due to the treatment.

* My guess as to how many people tried Schroth.

I'm only looking for data points, not success rates. I can get to those later. Right now, my only question is "is it possible?"

Again, recall that we started this discussion thinking that it couldn't be done, or could only be done with some Herculean effort. Now, again, we've progressed to complaining that it's not happening often enough with 30 minutes of exercise a day.

Pooka1

12-18-2009, 06:35 PM

I don't think that's right, Dingo. I think they did exercises under supervision for the first four months, and then did an additional 4 months at home, so, at the 8 month mark, they had just finished their home exercise.

hdugger, do you think the results of that particular study fall under any rational definition of "permanent?"

Also what do you mean by "permanent?"

Pooka1

12-18-2009, 06:38 PM

Again, recall that we started this discussion thinking that it couldn't be done, or could only be done with some Herculean effort. Now, again, we've progressed to complaining that it's not happening often enough with 30 minutes of exercise a day.

Are you talking about swimmergirlsmom's daughter? Do we know how much she exercised?

Pooka1

12-18-2009, 06:42 PM

hdugger

12-18-2009, 06:48 PM

hdugger, do you think the results of that particular study fall under any rational definition of "permanent?"

Also what do you mean by "permanent?"

I do not mean by permanent that a thing is done once and never again and it holds the curve. I mean "a reasonable course of treatment that can keep the curve from progressing". Specifically, I mean anything that I could reasonably see my son doing for the rest of his life to maintain his spine.

For my son, I suspect it would have to be 30 minutes or less, and it would have to allow him to easily regain the reduction if he let up for a week or so.

If the torso rotation did not seem to only work for smaller curves (less than my son's 50 something degree curve) it would fit my requirements perfectly. It's *possible* that it might work for a bigger curve, like his, that is no longer quickly progressing. Possible enough that I might check out the machines up here.

So, yes, this is the kind of thing that I mean by permanent. What I *don't* mean is some kind of maybe passive stretching thing where you stand up afterward and feel very straight but then collapse again within 5 minutes. And I also don't mean a brace that's so uncomfortable to wear that he could not conceive of having it for a lifetime. But, a course of treatment he could easily follow that would keep his spine from hurting him or from going down into the lumbar region is all I need.

hdugger

12-18-2009, 06:49 PM

Are you talking about swimmergirlsmom's daughter? Do we know how much she exercised?

Yes, we know. Around 30 minutes a day.

hdugger

12-18-2009, 06:55 PM

By the way we also don't know that a million people didn't try to reduce their curve with 30 minutes a day and fail. The failure rate is important if not more important than the success rate for this type of thing. I suspect there would be more cases if it was only 30 minutes a day for most people. Maybe some small fraction can achieve a reduction with that amount.

Again, I'm not really looking for a reduction. I'm using that as a data point to indicate a course of treatment that might be effectively holding a curve for many people, but which, due to the awful state of medical research, will never effectively prove that it can stop progression.

Also, I do not necessarily think that anyone has all the right answers. I suspect some part of the Schroth thing is working, but I have no idea how much. Honestly, I'm rooting for the SEAS treatment because, naturally, I wouldn't want my son to travel to Italy all alone for treatment :)

No, actually I think the SEAS people sound saner than anyone else in this field. They seem very open to all forms of treatment, each in their own place. Or, again, maybe it's just because I like Italians :)

hdugger

12-18-2009, 06:59 PM

To swim back to something that Pam asked, during the more aggressive part of progression, I think even the exercise practitioners feel that a child should be braced. Noone, to the best of my knowledge, thinks that exercise can hold an aggressively progressing spine.

Pooka1

12-18-2009, 07:06 PM

But, a course of treatment he could easily follow that would keep his spine from hurting him or from going down into the lumbar region is all I need.

I assume he has a compensatory curve in his lumbar, yes?

How stable is that expected to be over time absent reduction of the top curve and overall balance of the entire spine?

As far as I can tell, some say the amount of correction is related to the overall health of the lumbar below a T fusion but others say it is the overall balance and not the degree of correction.

I suppose if your son's curve is balanced now then his lumbar is likely to not be adversely affected. I'd like to know the rate of problems of any type below well-balanced T fusions and well balanced unfused large curves.

Just for nothing and you may have noticed but I have been banging on about lowering the surgical trigger angle for T curves if there is any chance whatsoever of having to fuse further into the lumbar. I think it is unethical to have a T trigger angle wherein even some fusions end up entering the lumbar until it can be shown the pedicle screw constructs have obviated the previous lumbar problems.

Having gone through the two cases of my daughters, I have A LOT of questions, especially on my second daughter, about not fusing her earlier and possibly not involving L1.

I don't know if there is some relationship between waiting and longer fusion into the lumbar for T fusions but it certainly seems so in some cases I would certainly like to know. That would be a big consideration for me if I had another kid with a T curve.

hdugger

12-18-2009, 07:56 PM

I assume he has a compensatory curve in his lumbar, yes?

How stable is that expected to be over time absent reduction of the top curve and overall balance of the entire spine?

I'm hoping we can get good numbers in his appointment on Tuesday. When he first went in, he had a triple curve - 35, 22, 20 - or something like that. His T curve is *very* high - it's almost but not quite into his cervical vertebrae. Over time, his T increased and (it looks) like the other two decreased so that now they look almost straight to me. Or, maybe it's just that his top one is so big that the other two look small by comparison :)

I don't know if there is some relationship between waiting and longer fusion into the lumbar for T fusions but it certainly seems so in some cases I would certainly like to know. That would be a big consideration for me if I had another kid with a T curve.

Yes, it's the lumbar thing that worries me. I just wish I understood the mechanics better than I do.

txmarinemom

12-18-2009, 09:38 PM

When he first went in, he had a triple curve - 35, 22, 20 - or something like that. His T curve is *very* high - it's almost but not quite into his cervical vertebrae. Over time, his T increased and (it looks) like the other two decreased so that now they look almost straight to me. Or, maybe it's just that his top one is so big that the other two look small by comparison :)

hdugger,

What are/is the apices/apex of structural curvature?

hdugger

12-18-2009, 09:47 PM

hdugger,

What are/is the apices/apex of structural curvature?

You'd think I'd know, but I'm not really sure - it's a vertebrae or two beneath his shoulder blade - maybe T3 or T4? Let me see if I can post an xray or two.

txmarinemom

12-18-2009, 09:53 PM

You'd think I'd know, but I'm not really sure - it's a vertebrae or two beneath his shoulder blade - maybe T3 or T4? Let me see if I can post an xray or two.

Okay ... and as a point of reference, T9 is typically about nipple level. My structural curve apex was @ T9. This was the only curve that required fusion.

And have you been told all 3 curves are structural?

hdugger

12-18-2009, 10:08 PM

Here's the xray from 2008

http://www.flickr.com/photos/45701845@N05/4195964145/

hdugger

12-18-2009, 10:09 PM

Okay ... and as a point of reference, T9 is typically about nipple level. My structural curve apex was @ T9. This was the only curve that required fusion.

And have you been told all 3 curves are structural?

No, only the top one is structural, as far as we know.

Dingo

12-19-2009, 08:34 AM

hdugger

I don't think that's right, Dingo. I think they did exercises under supervision for the first four months, and then did an additional 4 months at home, so, at the 8 month mark, they had just finished their home exercise.

You are correct but the problem that Dr. McCintire ran into was that the children didn't do their home exercises. This is from the study.

Home Strength Exercise Protocol
The goal of the home strength exercise protocol was to maintain any strength gains obtained after supervised training. The home protocol consisted of trunk rotations using gold-colored Thera-Band (The Hygenic Corp, Akron, OH) for resistance. According to the manufacturer’s specifications, it is reported to need 88.96N (20 lb) of force to double its starting length. With the Thera-Band attached at one end directly behind the patient at the same level as her/his shoulders and held at its other end by the subject across the upper arm, an approximately 15.24 cm (6 inch) moment arm was produced in applying the resistive torque to the spine (Fig. 3). The resultant beginning torque was about 13.34Nm (10 lb ft) if the Thera-Band was stretched to double its original length. The spine had to overcome this resistance at the beginning of its opposite rotation. The resistance increased as the spine further rotated to the opposite side. This was an approximation of the resistive torque because a precise estimation could be quite complex.49,50 Practically, the subject could adjust the sitting position to change the starting length of the Thera-Band to find an appropriate resistive torque. The home strength exercise was simply a full range of trunk rotational motion while holding the Thera-Band. Patients were instructed to perform 3 sets of 15 repetitions to the left and to the right 3 to 5 times a week.

Although the patients were instructed in the home-based strength exercise program previously described, we did not effectively monitor their compliance. Our impression through retrospective inquiries was that only about one-third of them were reasonably compliant. Thus, it seemed that the supervised strength training effect lasted at least 4 months.

mamamax

12-19-2009, 02:33 PM

re: latest publication concerning martha hawes...thoracic, thoracic, thoracic...any evidence anywhere of curve reduction of LUMBAR...??!!!!

just askin'......:confused:

jess

Hi Jess - she has a thoracic and a lumbar curve - reduction in both.

Xray and 2009 info in table form attached.

2001 Reference
http://www.scoliosis.org/resources/spinalconnection_spr2002.pdf

2005 Reference (published in 2009):
http://www.scoliosisjournal.com/content/pdf/1748-7161-4-27.pdf
Attached Images

txmarinemom

12-19-2009, 03:02 PM

Hi Jess - she has a thoracic and a lumbar curve - reduction in both.

Maxene, I think maybe (at least that's how I understood her question) Jess is asking about improvements in structural lumbar curves. I'm guessing from the appearance of Hawes curve that her lumbar is compensatory. Improvement in a compensatory curve would naturally follow structural improvement, so I'm not sure it's significant.

At any rate, change in a compensatory lumbar isn't the same as change in a structural lumbar. Surgeons don't even typically measure compensatory curves unless they fall in the range of double major/double structural.

Oh, and FYI ... your report links are broken.

Pam

mamamax

12-19-2009, 03:50 PM

Maxene, I think maybe (at least that's how I understood her question) Jess is asking about improvements in structural lumbar curves. I'm guessing from the appearance of Hawes curve that her lumbar is compensatory. Improvement in a compensatory curve would naturally follow structural improvement, so I'm not sure it's significant.

At any rate, change in a compensatory lumbar isn't the same as change in a structural lumbar. Surgeons don't even typically measure compensatory curves unless they fall in the range of double major/double structural.

Oh, and FYI ... your report links are broken.

Pam

I agree Pam, that the lumbar curve appears compensatory. I believe she speaks of her thoracic as structural in both the literature and her book. I'll have to check. With me, the thoracolumbar curve appears the structrual and the thoracic compensatory. I was once told that the curve involving the less number of vertebra is usually the compensatory - but I don't know.

What is curious about Martha's case is - reduction continues after 2001. I wonder if she plans publishing every four years - if so, we may see more in 2012. Will fix those links - thanks.

Nim

12-21-2009, 03:16 PM

I'm new here and this is my first post. And I have a question....Has anyone on this board felt they have had success following the Schroth method?

hdugger

12-21-2009, 03:23 PM

Welcome Nim,

We have several people here who have used Schroth - one of them should reply. I just wanted to say hi.

Nim

12-21-2009, 03:47 PM

Hi! Thanks for the welcome! If anyone has tried the Schroth method, did any of you see Marian H. Wade in New York City?

MissEmmyF

12-21-2009, 04:09 PM

I almost saw her - I had been emailing back and forth with her right before I learned Schroth and was maybe going to see her. However, her mother died at that time, so she decided to take a couple months off. So, I ended up seeing Dr. Moramarco in MA instead.

Nim

12-21-2009, 10:19 PM

And what did you think of the Schroth method? Did you have any luck with it? How long did you follow it, if you did follow it, that is. Thanks!

MissEmmyF

12-22-2009, 09:24 AM

And what did you think of the Schroth method? Did you have any luck with it? How long did you follow it, if you did follow it, that is. Thanks!

Well, I learned it back in mid-May (of this year) and I've been doing it ever since. I went back after 3 months (in Aug.) to check in and make sure I was doing all the exercises correctly - I was. Once you learn how to do it, it's actually pretty easy. In my particular case, it was exactly what I was looking for. I'm not at a surgical level, but I do have pain/tightness/etc. associated with my scoliosis. So, my current Schroth exercise regime is targeted, specific, and alleviates a lot of that. Don't get me wrong - it's not like I feel like I have a straight spine now, but it helps the pain a lot. I do the exercises 4-5 days per week for about a half hour to 45 minutes each day. If you're looking for an exercise-based program, I don't think anything can beat it. I've tried yoga for scoliosis and traditional PT. Schroth is the best by far.

Nim

12-22-2009, 10:13 AM

Thanks, Miss Emmy.......I realize now...I posted on the wrong thread....this is for my 14 year old daughter...she has just been diagnosed with scoliosis....because I saw the shoulder blade pop out, and then our family doc agreed.....We have not done anything yet...I have been reading and researching, and learning....I like to put all the pieces on the table and then look at what seems best...I do like what I have read about Schroth. She has not been x-rayed yet...but you can feel how the spine is straight until about 8 inches past her waist, then it veers to the right and you are not feeling bone any more.

I spoke with Marian Wade, and we now have an appointment, so I will, I'm sure, learn more about Schroth. Might make an appointment with one of the big hospitals near me:Children's Hospital of Philadelphia, Shriner's or NYU to see what they say. She is not in any pain....She was completely oblivious to it, until I saw it......Thanks for your response....anything you think that would be good for me to know or think about, I would be open to and appreciate....so please post with anything.....Thanks so much!

Bigbluefrog

01-02-2010, 01:18 PM

My 5 year old uses a large exercise ball and rotates left to right 50 times in the morning and 50 times before he goes to bed. He wears ankle weights to keep him steady and I stand behind him to make sure he goes equal distances in both directions. Unfortunately I haven't found a safe and practical way to stabilize his pelvis.

Just a thought...how about having your son sit on a chair backwards..straddling it. Use a chair with a low profile back to it. and to stabilize the hips and pelvic.

We found at the Ymca a similar machine torso rotation. Ambrea does 20 reps at 30% of her weight..3x a week along with the fitlynx machines.
Her back looks amazing. We also bought wii fit to work on balancing and core muscles..trying to disguise our workouts with fun.
I am not sure of the cut off age, but I have seen 8 year olds on the machines. They have to take an orientation class, and get trained before using the equipment.

We see the orthopedic on Jan 18, the xrays will tell.

Dingo

01-03-2010, 06:02 PM

Bigbluefrog

Just a thought...how about having your son sit on a chair backwards.. straddling it. Use a chair with a low profile back to it. and to stabilize the hips and pelvic.

Thanks Bigbluefrog but we've got a pretty good system in place now. The exercises we do aren't as effective as a machine but my son is only 6 and it's the best we have. I think you are right, he needs to be about 8 before he can fit into a torso strength training machine. Our goal is to stop Scott's curve from progressing or keep progression to a minimum until then. When he is big enough we'll buy him a used machine that he can use at home. At that point I'm not worried because torso rotation appears to be almost universally effective for small and medium curves.

We found at the Ymca a similar machine torso rotation. Ambrea does 20 reps at 30% of her weight..3x a week along with the fitlynx machines. Her back looks amazing.

How long have you been doing strength training? In my experience it appeared to have an impact after just a few weeks. Six months after Scott started strength training he had his recheck and his curve went from 11 to 10 degrees. To my eyes his curve had improved but at the very least it hadn't progressed. I can live with that. :)

Bigbluefrog

01-03-2010, 08:00 PM

We started her exercises as soon as we discovered she had scoliosis.
With the weight machines ~ only two weeks.

I used to be able to see the curve, now it looks straighter.
But its more ~ its the muscle definition, better posture, and excellent balance.

We joined the club for their machines and the pool. I read that it can benefit her back muscles. Plus she loves to swim...so its easy to motivate.

The wii fit is excellent on working the core muscles for balance.
She designed a program that includes yoga and strength training.
We only work out with the machines 3x a week. The study rec 2x a week.

At home and on other days she has basketball practice, plays wii fit, or yoga.

And I believe in prayers, so we are praying for a miracle here. Ask and it shall be given....seek and ye shall find..knock and the door will be open.

we are asking..we are seeking....we are knocking...for a positive outcome.:)

Dingo

01-03-2010, 09:12 PM

Bigbluefrog

BTW we got a Wii for Christmas and I agree, it is AWESOME!

When my son does the boxing game he punches left and right so much and so fast that it's practically a torso rotation workout. :)

I'm not sure if you saw the message (it's a little bit back in this thread) but Turtlelover spent a few hundred dollars to buy her daughter a Cybex torso rotator. She used it every day and at her next recheck her curve went from 11 degrees to like 5 or 6. That's consistent with all 3 published studies. If your daughter sticks with it her back should be just fine.

hdugger

01-04-2010, 12:25 AM

I have to temper that a little bit. So far, although we've seen that it has a short-term effect, we haven't seen whether it holds the effect long-term or, more importantly, during a growth spurt.

I'd certainly *like* to believe that it could, but it is far from definitive yet.

The one thing that I've seen from all of the exercise people I've read (SEAS and Schroth mainly) is that they feel that, during a growth spurt, exercise alone will not hold a curve. Both groups recommend a brace to hold the curve during growth spurts.

hope404

01-04-2010, 12:41 AM

hdugger..I agree with your point....

but is it possible, with a consistent, appropriate exercise program, that smaller curves can be taught to behave properly????? Can some of the neurological issues( that seem to drive scoliosis) be caught early..and be overcome through consistent exercise...stimulation....therapy??????

I don't know myself ....just wondering..is it possible???

It may be???

hdugger

01-04-2010, 12:55 AM

I don't think we know exactly what reverses small curves, but there is ample evidence that they do reverse. Because they so frequently reverse without doing anything, it's hard to say if it's the exercise that's reversing them or something else.

OTOH, if you have a largish curve (35 degrees or more) those *don't* reverse on their own. So, if an exercise program shows a reduction in those curves, you can pretty safely attribute it to the exercise. We've seen a few examples of this (I think I've collected 8 data points so far). So, even with larger curves, exercise *can* help - we just don't understand yet exactly what helps.

(Emphatic belief on my part always to be taken with a grain of salt - I don't believe most orthopedic surgeons would agree. Also, by reverse I mean "go backwards," not necessarily completely correct.)

Dingo

01-04-2010, 08:47 AM

hdugger

The one thing that I've seen from all of the exercise people I've read (SEAS and Schroth mainly) is that they feel that, during a growth spurt, exercise alone will not hold a curve. Both groups recommend a brace to hold the curve during growth spurts.

If a kid or parents wants to use a brace during a growth spurt I'm all for it because I believe the evidence shows that braces help.

However if you look at the 3 torso rotation studies no child with a curve under roughly 40 degrees experienced curve progression during PT. Most had curve reductions. All of these kids were growing and no doubt many were in a spurt.

I think this therapy is effective because it's not a bandaid over a problem. This PT works directly on the problem, which is muscle imbalance during growth. Time will tell if that's true but a growing pile of evidence points in that direction.

Bigbluefrog

01-04-2010, 09:01 AM

I have to agree with Dingo here...after studying the articles and just looking at her back there is an asymestric in the muscle structure.

Do you notice how many have here have right thoracic curves...and my guess is that they are right handed.

Most right handed people have a stronger right side. I was in a car accident many years ago and it effected my right side strength...The PT stated its rare for the left side to be stronger in a right-hand dominated person.

Hearing stories of how exercise helps their scoliosis...whether its Schroth, SEAS, or rotational turbo therapy...there is measurable benefit.
The patient feels better...THAT IS HUGE!
The studies listed in this forum...show improvement in some and no change in others....That is a very positive outcome in my book.:)

hdugger

01-04-2010, 10:09 AM

However if you look at the 3 torso rotation studies no child with a curve under roughly 40 degrees experienced curve progression during PT. Most had curve reductions. All of these kids were growing and no doubt many were in a spurt.

Yes, I think that's true. I would just be much more comfortable if I'd seen a longer-term study. Without that, it's more of a hypothesis.

Dingo

01-04-2010, 12:44 PM

hdugger

I assume there will never be a good, longterm study on torso rotation. The best we can hope for is probably a small study or a case study like what Martha Hawes published. However if torso rotation is effective the proof of why it works will eventually be discovered anyway.

For example scientists may determine that an asymmetric distribution of Calmodulin in the paraspinal muscles triggers Scoliosis. Scientists know that Calmodulin is significantly impacted by exercise and they may learn that strength training repairs the distribution of this protein. So even without a longterm study scientists would know that as long as child is strength training he/she would be protected from curve progression. I bring up this particular hypothesis because a scientist involved in Scoliosis research mentioned it to me.

hdugger

01-04-2010, 12:47 PM

Hi Dingo,

I'd take a single long-term case showing a significant reduction (10 degrees or over) of a significant (over 35 degree) curve in someone with AIS that is maintained for over a year. I agree that showing curve stabilization appears to be an impossible task for medical researchers.

Dingo

01-04-2010, 01:44 PM

hdugger

I'd take a single long-term case showing a significant reduction (10 degrees or over) of a significant (over 35 degree) curve in someone with AIS that is maintained for over a year.

I think a study like that is a significant nearterm possibility. Swiss researchers are wrapping up what looks like a study on torso rotation strength training. It appears to contain multiple groups of children and the project lasted 3 years. Maybe they looked at some of these kids longterm.

The effect of asymmetrical weight training on paraspinal muscle activity in scoliosis (http://www.forschungsportal.ch/unizh/p7882.htm)

I believe this is the guy in charge.

Dr. Florian Brunner (http://www.evimed.ch/mitarbeiter/fbrunner.html)

If you look at his credentials it's immediately obvious that this guy is a well educated, mainstream scientist. Somebody with this stature probably wouldn't waste his time on a marginal or fringe hypothesis. Dr. Vert Mooney and Dr. Marc Asher who worked on the previous torso rotation studies are also respected, mainstream scientists.

aterry

01-19-2010, 09:02 AM

I e-mailed Dr Brunner to ask when the research would be published. Here is his reply:

"Thank you very much for your e-mail. Our paper is accepted for publication in Journal of Sport rehabilitation. However, we have no information regarding publication date.
Best regards,
Florian Brunner"

So now I'm going to e-mail the Journal to ask for a publication date.

mamamax

01-19-2010, 06:07 PM

Dingo & Aterry -

Thanks much! This is an important one for all of us, can't wait to see the results. The documentation will likely be very important in regards to future treatment recommendations - and answer a lot of questions.

The effect of asymmetrical weight training on paraspinal muscle activity in scoliosis

Paraspinal EMG measurements on the convex side of the scoliotic curve have been demonstrated to be enhanced. At present, most scoliotic patients are trained symmetrically which possibly further enhances the muscular imbalance. The present study therefore aims to investigate whether asymmetrical training will be superior compared to symmetrical training in terms of muscle balance in the spine of scoliotic patients. The project is divided into two studies: The first study investigates the immediate changes in paraspinal EMG in scoliotic patients during symmetrical vs. asymmetrical exercises. In the second study, scoliotic patients will be randomly assigned to a symmetrical or an asymmetrical weight training for 3 months and functional outcome, pain, paraspinal EMG, trunk strength/endurance will be compared.

r. med. Florian Brunner (Project Leader)
florian.brunner@balgrist.ch
Dr. med. Thomas Boeni
thomas.boeni@balgrist.ch

http://www.forschungsportal.ch/unizh/p7882.htm

Dingo

01-19-2010, 09:22 PM

mamamax

We work my son equally on both sides because that's what Dr. Mooney and Dr. McIntire studied. The results of this study are going to be very interesting. :)

mamamax

01-19-2010, 09:28 PM

mamamax

We work my son equally on both sides because that's what Dr. Mooney and Dr. McIntire studied. The results of this study are going to be very interesting. :)

I thought of that Dingo. Your son though, is quite young - and curvature quite small ... in such a case, it may not make a difference? Now for someone my age - with some substantial curves ... it may make quite a difference. Yes, that study will be interesting.

aterry

01-20-2010, 08:23 AM

I e-mailed the editor of the journal (he's at the Univ of Kentucky) asking when the report would be published. Here is his reply:

"Ann:

It is schedule for publication but has not been assigned to an issue yet. It will likely be the fall of 2010.

Carl G. Mattacola, PhD"

Now I'm itchy, knowing it's there but inaccessible for 6months+

skevimc

01-20-2010, 12:57 PM

mamamax

We work my son equally on both sides because that's what Dr. Mooney and Dr. McIntire studied. The results of this study are going to be very interesting. :)

Sure will. :) Especially because Mooney reported that the EMG difference was eliminated after therapy. Also, we both reported symmetrical strength afterward. Will the plot thicken??? :)

Dingo

01-20-2010, 02:51 PM

Skevimc

Personally I'm betting on symmetrical training. The more equal (and strong) my son's paraspinal muscles become the straighter his back will grow.

My sense is that Scoliosis is something like a Bonsai tree (http://www.indoor-bonsai-tree.com/Bonsai.jpg). If you apply an unequal force to a growing object you will create deformity every time.

If Scoliosis was as simple as improper bone growth then why don't children with Scoliosis have crooked arms and legs? All or part of the problem has to be located in the muscles around the spine. I think your work not only sheds light on how Scoliosis can be treated but also what's causing it.

hdugger

01-20-2010, 03:16 PM

skevimc

01-20-2010, 06:13 PM

Maybe I'm missing the point here, but, in a spine where the muscles are weaker on one side than on the other, isn't symmetrical exercise actually asymmetical? That is, aren't the muscles on the weaker side working harder to achieve the same force?

Yes. It is for this reason that we progressed the patients' sides (or directions of rotation) at different speeds. For example, rotate right (convex) with 20 pounds; rotate left (concave) with 15 pounds. Concave is weaker so it starts with a smaller amount. Once concave can lift 20 pounds, increase weight symmetrically. Then we count the sets and reps. Convex does 25 pounds 3 sets of 7 reps. Concave side does 25 pounds 3 sets 4 reps. Increase once concave can do 3 sets 7 reps.

mamamax

01-20-2010, 07:44 PM

Yes. It is for this reason that we progressed the patients' sides (or directions of rotation) at different speeds. For example, rotate right (convex) with 20 pounds; rotate left (concave) with 15 pounds. Concave is weaker so it starts with a smaller amount. Once concave can lift 20 pounds, increase weight symmetrically. Then we count the sets and reps. Convex does 25 pounds 3 sets of 7 reps. Concave side does 25 pounds 3 sets 4 reps. Increase once concave can do 3 sets 7 reps.

Now that - makes perfect sense! Thank you.

Dingo

01-21-2010, 08:56 AM

Skevimc

Do you have any opinion on the following statement?

If Scoliosis was purely a function of improper bone growth why wouldn't we see a greater incidence of bone deformities in children with AIS? For instance the foot contains 26 tightly packed bones, supports hundreds of pounds of force and takes hours of punishment each day. Shouldn't these bones be deformed as well? Even if these deformities didn't hit every child shouldn't there at least be a significantly, greater incidence?

I'm not suggesting that bones don't play a part because according to Dr. Alain Moreau they probably do.
Melatonin Signaling Dysfunction in Adolescent Idiopathic Scoliosis (http://pico.sssup.it/files/allegati/2004_1469.pdf)
But I don't see how bone health/deformity could be the single, decisive factor in AIS.

This reminds me of a story I read on Sciencedaily last week (http://www.sciencedaily.com/releases/2010/01/100115182639.htm). All children with Down Syndrome have Alzheimers by the age of 30 or 40. This led one scientist to suspect that Down Syndrome and Alzheimers were essentially the same disease. New evidence proves that he was right. Alzheimers is simply late onset Down Syndrome.

Unlike the Down/Alzhemiers connection I've never seen AIS associated with any other bone disease/deformity except possibly an increase in Osteoporosis. I assume that Melatonin Signaling Dysfunction contributes to weak bones which can potentially lead to Osteoporosis.

skevimc

01-21-2010, 12:08 PM

reneemarie

01-21-2010, 03:45 PM

Hi! I just got off the phone with Roger Schwab from this article

"September-17-2008 - Video: (currently down) MedX torso machine reduces 8 year old girl's curve from 14 degrees to 8 degrees.
Roger Schwab: "We've seen it work on almost every case that we've had."
Main Line Health and Fitness Scoliosis page"

I don't know if anyone's posted this information yet so here's what I found out. I wanted to know if he's seen a decrease in curvature with adults during Torso Rotation. He told me that to this point he has not. His best success is with growing children but he also said they have only worked on 25 to 30 people. He told me that one child went from 16 degrees to zero curvature. He does not believe it is temporary. He recommended that I still try it using a Torso Rotation machine that Anchors the Pelvis (doesn't have to be MedX), a cervical extension machine and a machine that works the muscles in my lower back. They are desperately trying to get a grant to study this in broader terms. I told him to put together a template letter and let us know who he wants it sent to and send it to me so that I can post it on the board. If many of us respond, maybe we can make this study happen. Also, he told me to feel free to post his contact information if you have questions. Nice guy and very helpful.

Roger Schwab, 610-527-2200, Mainline Health and Fitness, Bryn Mawr PA

aterry

01-21-2010, 04:34 PM

I would definitely send a letter. (or dozens)

mamandcrm

01-21-2010, 04:43 PM

I don't post on this thread or the Clear-related thread, but I do read them and wanted to say thank you to all who are participating in the discussion, particularly hdugger and skevinc (?), who are newer to the forum. The information is very interesting and I appreciate the measured posts and responses. It's really helpful in terms of following the discussion when things stay so civilized. A program of exercise is not something we are doing now, or plan to do anytime in the near future, but has caught my attention as something to stay abreast of and consider for the future, whatever that may bring.

dailystrength

01-21-2010, 08:26 PM

Yes, I also appreciate this discussion greatly. I am happy to help get any further research off the ground. Thanks, all.

Dingo

01-22-2010, 08:13 AM

reneemarie

He told me that one child went from 16 degrees to zero curvature.

Assuming the 16 degree curve was in a Juvenile this child probably dodged a bullet.

In this sample of 205 Juvenile patients if a curve reached 21 degrees the chance of fusion was 75%.
Progression Risk of Idiopathic Juvenile Scoliosis During Pubertal Growth (http://journals.lww.com/spinejournal/pages/articleviewer.aspx?year=2006&issue=08010&article=00010&type=abstract)

Dingo

01-22-2010, 09:05 AM

skevimc

I would say that I'm sure there are deformations in the foot bones. But the foot is able to change shapes with relatively little functional or cosmetic deformity e.g. high arch, flat feet, pronated, supinated. Whereas, the spine has little room for error.

Not to beat a dead horse but... :)

You are right, maybe different parts of the body have a greater tolerance for error than the spine. But no part of the body has unlimited tolerance. Shouldn't somebody have noticed a greater incidence of bone problems in children with AIS? I'm not saying 100%, just reliably higher than average.

I remember when my son was diagnosed my first thought was that he had a bone problem. It wasn't until almost a year later that I got to thinking, why doesn't he have other bone problems? He has more than 200 bones in his body, why is it just his spine?

mamamax

01-23-2010, 08:47 AM

skevimc

I remember when my son was diagnosed my first thought was that he had a bone problem. It wasn't until almost a year later that I got to thinking, why doesn't he have other bone problems? He has more than 200 bones in his body, why is it just his spine?

Good question Dingo - maybe because ... it (IS) is not, initially, a bone problem ;)

An interesting article I stumbled across w/morning coffee:
http://www.merck.com/mmhe/sec06/ch076/ch076d.html

Dingo

01-23-2010, 09:19 AM

mamamax

Good question Dingo - maybe because ... it (IS) is not, initially, a bone problem

I think that's what they'll ultimately discover.

I asked my son's doctor (the best in my city) what caused AIS. He said that his friends in the research community knew it was a neurological disorder but they weren't sure how it worked or what the trigger was. I assumed that meant that his nervous system was disrupting the way his bones grew and in response his spine grew crooked. But if that's true why is every other bone growing normally?

I'm sure that scientists are right, it's a neurological disorder. And no doubt bones are a link in the chain of events that cause Scoliosis. But it seems to me that something bigger is going on.

That fact that TRS works is a big clue that muscles are either the driving force or a key player.

BTW good link on the nervous system! I'm putting that in my favorites for reference.

mamamax

01-23-2010, 09:38 AM

mamamax

I think that's what they'll ultimately discover.

I asked my son's doctor (the best in my city) what caused AIS. He said that his friends in the research community knew it was a neurological disorder but they weren't sure how it worked or what the trigger was. I assumed that meant that his nervous system was disrupting the way his bones grew and in response his spine grew crooked. But if that's true why is every other bone growing normally?

I'm sure that scientists are right, it's a neurological disorder. And no doubt bones are a link in the chain of events that cause Scoliosis. But it seems to me that something bigger is going on.

That fact that TRS works is a big clue that muscles are either the driving force or a key player.

BTW good link on the nervous system! I'm putting that in my favorites for reference.

I think there is a good case for what your doctor said. That would explain why so many things (TRS, Yoga specifically for scoliosis, Pilaties specifically for scoliosis, PT specifically for scoliosis, Schroth, Martha's work, my brace, etc, et al) provide benefit in some cases. These things are (in this context) a form of - rehabilitation.

Glad you liked that link - me too!

mamamax

01-23-2010, 09:57 AM

mamamax
I asked my son's doctor (the best in my city) what caused AIS. He said that his friends in the research community knew it was a neurological disorder but they weren't sure how it worked or what the trigger was.

I'm still trying to wrap my mind around this - the statement is huge in terms of what the research community "knows."

I assumed that meant that his nervous system was disrupting the way his bones grew and in response his spine grew crooked. But if that's true why is every other bone growing normally?

Presuming the above is true - the answer to that is complex. From the referenced link on the nervous system:

Motor (anterior) nerve root: The motor root emerges from the front of the spinal cord. Motor nerve fibers carry commands from the brain and spinal cord to other parts of the body, particularly to skeletal muscles.

Muscle activity (or lack thereof) plays a role in bone (spinal) formation/deformation?

Dingo

01-27-2010, 01:59 PM

Mamamax

Muscle activity (or lack thereof) plays a role in bone (spinal) formation/deformation?

There are two possibilities.

A) An internal force is pushing the spine out of alignment as it grows.

B) An external force is pushing the spine out of alignment as it grows.

According to Roger Schwab a few minutes of strength training per week brought a 16 degree curve down to 0.
That's strong evidence for B.

I don't see how TRS could have such a fast and significant impact if the problem was primarily located in the vertebrae. Bone is a lot tougher than muscle.

Example:
Polio can cause children's bones to become bent and deformed (see picture (http://www.immune.org.nz/site_resources/Professionals/Diseases/Polio/Polio.jpg)).
Exercise is good for almost everything. However my sense is that improvement for significant bone deformities like this would come slowly if at all.

mamamax

01-27-2010, 05:25 PM

Dingo -

Yes - agreed. My comment really wasn't that well stated. What I was trying to suggest is that - the muscles play a role in directing curvature (going back to things neurological).

Shaping is a whole other thing - and something as I understand it, that can happen quite rapidly with the immature spine, quite slowly with the mature one.

Seems almost less complex to rehabilitate the situation than to figure out how it happened.

Dingo

01-28-2010, 05:18 PM

mamamax

Seems almost less complex to rehabilitate the situation than to figure out how it happened.

Ya know in small curves you could be exactly right. I think I remember that the first 10 degrees of a curve doesn't necessarily change the shape of the vertebrae much or at all. After that they start to wedge and grow differently.

I pray my son's spine stays in the "10ish" degree range for another 2 years. Once he turns 8 I'm buying a used MedX.

Dingo

01-29-2010, 09:48 PM

This is from Health Central.

Scoliosis - Managing Scoliosis (http://www.healthcentral.com/ency/408/guides/000068_8.html)

Strengthening the Muscles That Turn the Torso. A promising approach focuses on training and strengthening the muscles that turn the torso. Studies using specific equipment (e.g., MedX Torso Rotation machine) are showing promise. In a 2003 California study, 16 of the 20 patients experienced curve reduction and no curves progressed. In an earlier study, patients increased strength from 12% to 40%. One girl with a severe lumbar curve required surgery, but there was no progression of curvature in the remaining 11 patients, and four of the patients experienced a reduction in their curvature. No braces were used. Clinical trials using this approach are underway in California, Maryland, Missouri, and Tennessee. Exercising the torso to build muscle strength is important, in any case, in conjunction with braces.

I don't know how accurate that is but who knows? I didn't realize the Swiss study on torso rotation was set for release until Sealy found it a few weeks ago. Maybe quite a few of these are in the pipeline.

I can say this with confidence. If scientists developed a pill that was half as effective as what TRS appears to be $millions would be pouring in to get it on the market.

LindaRacine

01-29-2010, 10:00 PM

I can say this with confidence. If scientists developed a pill that was half as effective as what TRS appears to be $millions would be pouring in to get it on the market.

Not even close. They'd be setting up controlled trials. IF those worked out, they'd have to do some longer-term follow up, to show that the correction actually held up over time. They'd also have to show that the treatment didn't have other negative effects.

Dingo

01-29-2010, 10:05 PM

LindaRacine

They'd be setting up controlled trials. IF those worked out, they'd have to do some longer-term follow up, to show that the correction actually held up over time. They'd also have to show that the treatment didn't have other negative effects.

Of course, and that's what the millions of dollars worth of research money would be used for.

LindaRacine

01-29-2010, 10:12 PM

The folks with the rotation machine could be spending the same millions. Ever wonder why they're not?

Dingo

01-29-2010, 10:16 PM

The folks with the rotation machine could be spending the same millions. Ever wonder why they're not?

Because they don't have millions? Plus if they turned their machine into an FDA approved medical device (which would take about a decade) wouldn't that open them up to a massive amount of liability?

LindaRacine

01-29-2010, 10:38 PM

Because they don't have millions? Plus if they turned their machine into an FDA approved medical device (which would take about a decade) wouldn't that open them up to a massive amount of liability?

Yes, the same amount (or probably even less) of liability the drug company would have.

And, yes, Cybex has plenty of money:

http://investing.businessweek.com/research/stocks/financials/financials.asp?ticker=CYBI:US

Pooka1

01-29-2010, 10:44 PM

Yes, the same amount (or probably even less) of liability the drug company would have.

And, yes, Cybex has plenty of money:

http://investing.businessweek.com/research/stocks/financials/financials.asp?ticker=CYBI:US

If there was credible evidence that this was the first effective, permanent non-surgical scoliosis reduction approach, I suspect they would be investing heavily in it. They will have cornered the market.

But in lieu of actual evidence we instead have personal trainers with less than zero research training personally vouching for it. Just when you think there could be nobody in this game with less training than chiros have, along come the personal trainers. The only thing left are the psychic healers and chanters.

hope404

01-29-2010, 11:05 PM

"psychic healers and chanters"

That is toooooo funny Pooka1!!!!

Pooka1

01-29-2010, 11:09 PM

I suspect we would have heard about psychic surgery by now also if The Amazing Randi hadn't already debunked it...

http://www.youtube.com/watch?v=sxMGxz6-oTs

Dingo

01-30-2010, 08:45 AM

Jan 13, 2006: FDA rules aim to speed drug tests and trim costs (http://www.boston.com/business/globe/articles/2006/01/13/fda_rules_aim_to_speed_drug_tests_and_trim_costs/)

If the length of clinical trials were shaved by 25 percent, drug manufacturers would save $129 million per new drug approved, according to recent research by Joseph A. DiMasi of the Tufts Center for the Study of Drug Development, which put the cost of developing a new drug at $802 million. Halving the time spent on clinical trials would lower drug development costs by 29 percent, saving drug companies $235 million per new drug approved, DiMasi found.

I'm not sure how closely this relates to a medical device but getting FDA approval is neither fast nor cheap. I should also add that the first offical pilot study on torso rotation was released by Dr. Mooney in 2003. Even if Cybex or MedX had started the approval process the very next week they wouldn't have FDA approval yet.

And, yes, Cybex has plenty of money:

CYBEX INTERNATIONAL INC (http://investing.businessweek.com/research/stocks/financials/financials.asp?ticker=CYBI:US)

What makes you think they have plenty of money? According to your link they recently lost $9.1 million on $147.9 million in revenue. I don't think an $800 million dollar, 10 year FDA approval process is in their budget right now.

From a business standpoint it's more profitable to refrain from making medical claims and let the growing number of independent studies promote their products.

mamamax

01-30-2010, 05:37 PM

I find it interesting that the MedX machine (which has had FDA approval since 1989, as a rehabilitation machine) is used at:

The Texas Back Institute (4 locations)
Kaiser Permanente Hospitals
Kieser International (over 60 locations worldwide)
Arizona Spine Institute
California Spine Institute

2008 Spine Journal Publication here: http://www.fitstrength.com/MedX%20Research.html

Based on what I've learned about all this (deepest thanks Dingo), and its current applications - I would not be surprised to see research in the future with specific applications towards scoliosis.

Some 40 years ago, I was told (by an orthopedic surgeon) that there absolutly were no exercises that could exert enough influence on paraspinal muscles to effect any change in a spine with scoliosis. I don't think the same can be said today with the development of a machine such as this. The in depth research cannot come soon enough for me - but maybe for my great-grandchildren. The future does look a bit brighter. And bty, the offered 2008 Spine Journal publication indicates that this machine is also useful for those suffering post spine surgery pain. Looks like something all could benefit from. A true pity that funding is not available for more study.

Dingo

01-30-2010, 05:52 PM

Mamamax

Right on, very interesting about the MedX.

Some 40 years ago, I was told (by an orthopedic surgeon) that there absolutly were no exercises that could exert enough influence on paraspinal muscles to effect any change in a spine with scoliosis.

That reminds me of the good old peptic ulcer (http://en.wikipedia.org/wiki/Timeline_of_peptic_ulcer_disease_and_Helicobacter_ pylori).

In 1968 Dr. John Lykoudis was fined for treating ulcers with antibiotics. At the time this was considered medical quackery.

In 2005 two Australian doctors received the Nobel prize for proving that Ulcer's were caused by bacteria and could be easily treated with antibiotics. :)

skevimc

02-01-2010, 11:17 AM

Mamamax

In 1968 Dr. John Lykoudis was fined for treating ulcers with antibiotics. At the time this was considered medical quackery.

In 2005 two Australian doctors received the Nobel prize for proving that Ulcer's were caused by bacteria and could be easily treated with antibiotics. :)

I remember this coming out. (Not the 1968 thing :)). That's a great find Dingo. Science is full of these kinds of reversals and accidents.

Dingo

02-03-2010, 09:22 AM

In case anybody was interested I'm adding an exercise to my son's workout.

We already do dumbbell press once per week but I am adding one more easy chest exercise.

Isometric Chest Squeezes (http://www.bodybuilding.com/exercises/detail/view/name/isometric-chest-squeezes)

Our version is slightly different. Instead of pushing his hands together Scott holds the handles on a pec machine together.

The machine at our house is different but this picture (http://www.pro-fitness.com/photos/pec_dec_machine.jpg) works.
Scott stands on the seat (ours is flat) and faces the machine.
I stand behind him so he doesn't fall or wobble.
I pull the pec grips together in the middle and he holds them in position like the "chest squeeze" for 30 seconds. He can do 20 pounds without problem.
Right now we do 3, 30 second sets so the whole thing only lasts a few minutes. That's all that a 6 year old will tolerate in one sitting. :)

This really works his chest and it's an isometric exercise so it's safe on the joints.

Disclaimer: I'm not a doctor or physical therapist. Always consult a doctor before you begin any exercise program.

hdugger

02-03-2010, 10:43 AM

This discussion is starting to address some of the questions Pooka and I were exploring about whether flexibility is a "good" thing for scoliosis patients. It seems like the answer is "yes, but it has to be coupled with strenghtening to help the muscles hold the spine in a better position."

So, I have an overall question. What, exactly, makes someone "more flexible?" Is it muscle weakness? Or, is it more a role of ligaments? Or ??? I just can't get a good handle on exactly what system I'm talking about when I talk about flexibility.

leahdragonfly

02-03-2010, 12:18 PM

Flexibility is mostly a function of the ligaments and other connective tissue.

Too much flexibility caused by ligament laxity is definitely not good for the spine, or any other joints.

mamamax

02-03-2010, 05:13 PM

mamamax

02-03-2010, 05:14 PM

Flexibility is mostly a function of the ligaments and other connective tissue.

Too much flexibility caused by ligament laxity is definitely not good for the spine, or any other joints.

Now that makes perfect sense - thank you!

mamamax

02-03-2010, 07:17 PM

So, I have an overall question. What, exactly, makes someone "more flexible?" Is it muscle weakness? Or, is it more a role of ligaments? Or ??? I just can't get a good handle on exactly what system I'm talking about when I talk about flexibility.

I'm not sure but I think its a combination of many things. In a normal spine that is flexible - say a gymnast ... I can see where parspinal, ligaments, and other muscles are obviously strong enough to hold the spine erect symmetrically. Those same muscles are also flexible enough to perform upon demand - so they have an elasticity combined with strength.

With scoliosis there is a loss of symmetry in muscle strength - if the spine is still flexible, maybe it is because the muscles are strong (and elastic) enough to perform and respond. That would be the best case scenario - but then, like leahdragonfly basically said .. too much flexibility could be due to an even greater lack of muscle strength (like atrophy), which could trigger progression in older adults (I'm thinking).

Great question - has me pondering much. We have a few Physical Therapists here. I hope they will respond.

Dingo

02-04-2010, 08:58 AM

Mamamax

Thanks Dingo - a few of us are scouting around for chest expansion/strengthening exercises .. looks good!

bodybuilding.com: List of exercises (http://www.bodybuilding.com/exercises/)

You might like this site. It has movies that show how to do exercises for every part of the body. I usually find an exercise on this site and then google for a 2nd opinion.

dailystrength

03-02-2010, 09:23 PM

So, I have an overall question. What, exactly, makes someone "more flexible?" Is it muscle weakness? Or, is it more a role of ligaments? Or ??? I just can't get a good handle on exactly what system I'm talking about when I talk about flexibility.

For me, I was prescribed certain PT exercises to maintain spinal flexibility. I do them every night because I do feel it eliminates tightness and I feel better. Lay on floor with knees up and rock pelvis up then down to floor, 15X, repeat. Now, sides - play with each hip bone to rock toward ceiling on each side. This is a good flexibility exercise. 15X/ repeat. It's called "bowl of jello" because you can picture trying to rotate a bowl of jello and keeping it in the bowl. Another: hands under bottom of rear for stability (I face mine towards feet, palms down), legs straight up in air. Move feet side to side 1" each side. 15X, repeat. Then Bridges. Again, all work on keeping vertebrae movable, seems to me. Works for me.

txmarinemom

03-02-2010, 11:17 PM

I'm happy to remove posts, but they have to be reported. (Click on the little triangle in the upper right hand corner of the message.)

Thank you, Linda ... will do.

I'm trying to be more gentle in my written objections (large credit to hdugger for that ;-), and I forget about the flag thing ...

Dingo

03-03-2010, 03:24 PM

Laval University, Quebec Canada, Evidence for cognitive vestibular integration impairment in idiopathic scoliosis patients (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2739533/)

Manzoni and Miele [31] and Pompeiano et al. [32] have proposed that deficit in melatonin has an inhibitory effect on the vestibulospinal activity which could lead to abnormal activities of the cervical and axial muscles. In addition, impaired vestibular information from the cerebellum to the vestibular cortical network or alteration of this cortical network could also lead to alteration of back muscle activities. Therefore, vestibulospinal [31,32] as well as corticospinal abnormal activities may be part of the mechanisms leading to the onset and progression of scoliosis.

Evidence that implicates the back muscles helps explain why 3 seperate studies found that TRS was consistently effective for small and medium curves.

hdugger

03-03-2010, 03:37 PM

Based on the surrounding conversation (also deleted) the complaint was not with the study but with the "effective for everyone" claim.

mamamax

03-03-2010, 05:56 PM

Laval University, Quebec Canada, Evidence for cognitive vestibular integration impairment in idiopathic scoliosis patients (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2739533/)

Evidence that implicates the back muscles helps explain why 3 seperate studies found that TRS was consistently effective for small and medium curves.

I see the connection Dingo ;-) Very good article, thank you for posting. The vestibular thing is also covered extensively in this one, for those interested in such things.

The present results show that cognitive vestibular processing is impaired in ISP. It is possible that severe spine deformity developed partly due to impaired vestibular information travelling from the cerebellum to the vestibular cortical network or alteration in the cortical mechanisms processing of vestibular signals. The present study, however, does not allow one to make claims as to whether deficits in cognitive processing of vestibular signals should be considered as a potential factor leading to curve progression in scoliosis patients. Further studies may determine if this deficit and the melatonin signaling dysfunction in ISP can predict curve progression in patients with small spine deformity.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2739533/

dailystrength

03-03-2010, 09:51 PM

Great question - has me pondering much. We have a few Physical Therapists here. I hope they will respond.

You all are so smart - I don't have time to do all this research; I am so encouraged by these discussions.

I wanted to add that spinal flexibility I would think would allow the spine to ease back into a better position, rather than be cramped into a curve. Just my intuition but we women gotta listen to it! :)

hdugger

03-04-2010, 12:22 AM

I think the double-edged sword is that flexibility allows the spine to move more freely, but there's no guarantee that it will decrease rather than increase the curve. Our resident researcher recommends increasing muscle strength along with increasing flexibility to nudge it in the right direction :)

dailystrength

03-04-2010, 09:43 PM

I've just ordered an Ab machine, to try it out. I will let you all know what I think!

And that is a very wise point, hdugger. Along with flexibility exercises, I must always make a point to do strength-building, also. Thanks again; excellent point.

**Udated 5/5: sent the ab machine back - it was way too big to try to put together! haha

Dingo

05-04-2010, 10:08 AM

More evidence that assymetry in the muscles of the spine play a role in Scoliosis

Spine (Phila Pa 1976). 2003 Nov 15;28(22):2535-9.
Asymmetry of premotor time in the back muscles of adolescent idiopathic scoliosis. (http://www.ncbi.nlm.nih.gov/pubmed/14624091)

STUDY DESIGN: In 38 patients with adolescent idiopathic scoliosis (AIS), the correlation between left and right differences in premotor time (D-PMT) of back muscle and clinical findings were analyzed.
OBJECTIVE: To investigate the clinical relevance of back muscle D-PMT in AIS.
SUMMARY OF BACKGROUND DATA: There have been numerous studies investigating back muscle asymmetry of AIS by EMG, but to date, no studies have measured D-PMT in back muscles.
MATERIALS AND METHODS: D-PMT in the back muscles measured in a similar manner as that in the extremity muscles was assessed in 10 nonscoliotic teenaged girls and 38 AIS patients. The correlation between back muscle D-PMT and four factors (age, Risser sign, Cobb angle, and progression of deformity) was investigated.
RESULTS: The D-PMT values of back muscle at all levels in the control group were within +/-5 ms, but those in 20 of the 38 AIS patients were more than 5 ms. D-PMT at the lower-end vertebra level was strongly correlated with progression of deformity, but not with age, Risser sign, and Cobb angle. All five patients with D-PMT of more than 10 ms at the lower-end vertebra level had progressive deformity.
CONCLUSIONS: D-PMT in back muscle at the lower end vertebra level in AIS correlated closely to the progression of scoliotic deformity, thus suggesting that this phenomenon is associated with the progression in AIS.

Premotor Reaction Time (http://www.answers.com/topic/premotor-reaction-time)

The interval from the presentation of a stimulus to the initial changes in the electrical activity of a muscle.

Dingo

05-04-2010, 05:11 PM

skevimc

05-06-2010, 12:53 PM

Skevimc

Paging Dr. McIntire! :)

I wonder if you have an opinion on this. According to the study in the post above children with AIS have back muscles that fire at different rates. Does this predict strength asymmetry in the paraspinal muscles? The fast side starts any motion without help from the slow side which suggests that it has to do more work. In addition once the slow side gets moving it has inertia to help it out. Because of the extra workload would the fast side grow stronger than the "lazy", slow side? Does that theoretically make sense?

Interestingly enough your study (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2072936/) found strength asymmetry in children with AIS. I wonder if the fast side was always the strong side.

Thanks for the link and question.

I've been thinking about this concept over the last couple of days. First, I would say that it's not a fast response on the convex as much as it is a slow response of the concave side (am I remembering that correctly?). How that would affect strength I'm not sure. My hypothesis is that the concave side is the weak side. Some other people have stated that the convex side is the weak side and is why there is increased EMG activity on the convex because it's trying to 'keep up' with the stronger concave side. I disagree because the concave side musculature has a phenotype of atrophying muscle similar to that of astronauts returning to earth... :confused:

I've read a few other studies looking at EMG ratios and they found something similar at the lower end vertebrae and linking it with progression. It's pretty interesting. I'll certainly include this type of measurement in the future.

Pooka1

05-06-2010, 01:03 PM

I've been thinking about this concept over the last couple of days. First, I would say that it's not a fast response on the convex as much as it is a slow response of the concave side (am I remembering that correctly?). How that would affect strength I'm not sure. My hypothesis is that the concave side is the weak side. Some other people have stated that the convex side is the weak side and is why there is increased EMG activity on the convex because it's trying to 'keep up' with the stronger concave side. I disagree because the concave side musculature has a phenotype of atrophying muscle similar to that of astronauts returning to earth... :confused:

I don't know if it is relevant but all horses have a convex and concave side and training them takes this into account in trying to even them out.

They have more trouble lengthening their concave side which might be consistent with a weakness on the convex side or more likely a stiffness on the convex side. In fact convex sides of the horse are referred to as the "stiff" side. My horse's right side in concave and his left side is stiff.

rohrer01

05-07-2010, 04:37 AM

The only thing I have to add to this is that my mother took me to a D.O. who was going to "get rich" finding a cure for scoliosis on me (gosh I hope he didn't charge her to use me as a guinea pig!). Anyway, he did neuromuscular electrical stimulation on the convex sides of my curves. I did improve 3*. For whatever that is worth it kept me out of the OR. They were just waiting like vultures for me to progress one more degree to hit the magical 40. That's what it was back then.

The study Dingo cited does seem to suggest that this is more a disease of the nervous system to me. Some very good things to think about.

It's late, I'm in pain and my meds are just kicking in. So if what I'm saying is irrelevant or off topic, please excuse me. I'm going to bed. :o

Dingo

05-07-2010, 09:46 AM

Rohrer01

The study Dingo cited does seem to suggest that this is more a disease of the nervous system to me. Some very good things to think about.

Scoliosis is not fully understood but it appears to be a nervous sytem disorder that for some reason alters the way muscles work. This in turn leads to a curve in the spine.

Obviously some new discovery could overturn that hypothesis but that's the direction the latest research points.

After decades of slow progress scientists are finally making rapid headway on this disease.

According to Dr. Alain Moreau...
INAUGURATION OF A WORLD-LEADING MUSCULOSKELETAL DISORDERS LABORATORY (http://www.chu-sainte-justine.org/research/nouvelle.aspx?ID_nouvelles=51533&ID_Menu=2546&ID_Page=2546)
“we are now, for the first time, in the exceptional position of being able to foresee the eradication of the disease in the very near future with the development of the first drugs within ten years' time.”

A word of caution. Even if a Scoliosis cure is developed in the next ten years it will still have to go through the FDA which will take another ten years. But it seems to me that our grandchildren will only know what Scoliosis is because they read about it in history books... assuming kids still use books in 20 years. :)

skevimc

05-07-2010, 05:20 PM

I don't know if it is relevant but all horses have a convex and concave side and training them takes this into account in trying to even them out.

They have more trouble lengthening their concave side which might be consistent with a weakness on the convex side or more likely a stiffness on the convex side. In fact convex sides of the horse are referred to as the "stiff" side. My horse's right side in concave and his left side is stiff.

I know you've mentioned horses before but this is the first I'm noticing this concept. That's pretty interesting. I looked at a few sites and it seems like most horses have this curve (also right convex which is also interesting). Could it have anything to do with the horse bending a bit to keep their back feet from hitting their front feet? I only ask that because I notice when my dogs trot/canter(??) on the beach in front of me they'll be a little crooked and I notice that it allows their back feet to perfectly straddle their front feet. :confused:

At any rate, this is the first sort of 'naturally' occurring spine curve animal model that I've ever heard of. Granted, it's not scoliosis. But horses also aren't bi-pedal. I wonder what would happen (hypothetically of course) if a horse with a stiff and hallow side were to walk around on its back legs. It kind of follows the idea that scoliosis isn't in other animals because no other mammal is solely bi-pedal. Humans have a unique biomechanical situation. We get to stand upright, but at what cost. Anyway... pretty interesting stuff.

Pooka1

05-07-2010, 06:10 PM

I know you've mentioned horses before but this is the first I'm noticing this concept. That's pretty interesting. I looked at a few sites and it seems like most horses have this curve (also right convex which is also interesting). Could it have anything to do with the horse bending a bit to keep their back feet from hitting their front feet? I only ask that because I notice when my dogs trot/canter(??) on the beach in front of me they'll be a little crooked and I notice that it allows their back feet to perfectly straddle their front feet. :confused:

That's a good hypothesis! I think you should test it. :)

Actually the back legs do not straddle the fronts. Sometimes they will interfere with the fronts and that is called forging and it is a big problem as the horse can seriously lame itself not to mention pulling the shoes off and such.

I don't know the reason for convexity/concavity but have heard it might be related to how they lay in the womb. Most horses are concave/stiff in one direction which you state it is right convex which is opposite my horse. That said, my horse had a serious orthopedic problem that although has been successfully rehabbed may have affected this. ETA: Further thought on convexity/concavity in horses is NOT due to how they lay in the womb but rather it is just a consequence of having a split brain like all mammals. So each half controls the opposite half of the horse.

The idea behind dressage training at least is to get the horse perfectly even laterally. Horses are trapezoids where the hind legs are naturally wider than the front legs. They all start out with some degree of crookedness wherein they are not placing the hinds the identical distance to the side of each front when viewed from the front. They travel crooked with haunches one way or the other or they are popping a shoulder or something. Correct training allows the rider to position the shoulders or the haunches such that they are straighter and straighter. Straight is when the inside legs are perfectly aligned. Later, as the horse strengthens, the hinds travel closer to each other so the horse travels even straighter. The inability to get the horse straight is arguably the reason why most riders never make it out of the lower levels.

Sorry if that was too much information but I think it is relevant. :eek:

At any rate, this is the first sort of 'naturally' occurring spine curve animal model that I've ever heard of. Granted, it's not scoliosis. But horses also aren't bi-pedal. I wonder what would happen (hypothetically of course) if a horse with a stiff and hollow side were to walk around on its back legs. It kind of follows the idea that scoliosis isn't in other animals because no other mammal is solely bi-pedal. Humans have a unique biomechanical situation. We get to stand upright, but at what cost. Anyway... pretty interesting stuff.

Yes it isn't really a scoliosis because it isn't genetic. :D Sorry, just kidding.

I don't think it is a curve in the spine. Rather I think it is a habitual way of moving that takes the least amount of effort. Absent strength training, all horses will throw their haunches usually to the inside of a circle and usually more one way that the other (more when the concave side is towards the inside). Once the rider learns to control the shoulders and haunches with their seat and other aids and once the horse develops sufficient strength, then straightening and straight travel where the inside legs are on the same track is possible.

skevimc

05-07-2010, 06:37 PM

That's a good hypothesis! I think you should test it. :)

Actually the back legs do not straddle the fronts. Sometimes they will interfere with the fronts and that is called forging and it is a big problem as the horse can seriously lame itself not to mention pulling the shoes off and such.

I don't know the reason for it but have heard it might be related to how they lay in the womb. Most horses are concave/stiff in one direction which you state it is right convex which is opposite my horse. That said, my horse had a serious orthopedic problem that although has been successfully rehabbed may have affected this.

The idea behind dressage training at least is to get the horse perfectly even laterally. Horses are trapezoids where the hind legs are naturally wider than the front legs. They all start out with some degree of crookedness wherein they are not placing the hinds the identical distance to the side of each front. They travel crooked with haunches one way or the other or they are popping a shoulder or something. Correct training allows the rider to position the shoulders or the haunches such that they are straighter and straighter. Straight is when the inside legs are perfectly aligned. Later, as the horse strengthens, the hinds travel closer to each other so the horse travels even straighter. The inability to get the horse straight is arguably the reason why most riders never make it out of the lower levels.

Sorry if that was too much information but I think it is relevant. :eek:

Yes it isn't really a scoliosis because it isn't genetic. :D Sorry, just kidding.

I don't think it is a curve in the spine. Rather I think it is a habitual way of moving that takes the least amount of effort. Absent strength training, all horses will throw their haunches usually to the inside of a circle and usually more one way that the other (more when the concave side is towards the inside). Once the rider learns to control the shoulders and haunches with their seat and other aids and once the horse develops sufficient strength, then straightening and straight travel where the inside legs are on the same track is possible.

Not TMI at all. Really very interesting. Especially the habitual way of moving. Kind of like when your mom says "if you keep making that face it will freeze like that". :D But seriously.. The strength training, straightening, etc... Kind of neat from a rehab point of view. Reinforces to me how awesome muscles are.

As far as testing it :), I came across several kinematic studies of horses. So I'd imagine the study has already been done to some extent. Scientists will study ANYTHING.

Pooka1

05-07-2010, 06:44 PM

Reinforces to me how awesome muscles are.

I take it as axiomatic that someone who does a PhD in muscle physiology will find muscles "awesome." ;)

Scientists will study ANYTHING.

Yes they will. At this point, I will do any study that presents itself no matter how rarefied let's say. I have a horse to support. :D

Dingo

05-24-2010, 11:14 PM

LindaRacine

05-24-2010, 11:33 PM

An 11 year old girl (now 12) began torso rotation strength training approximately 1 year ago. Late today her mother e-mailed me the before and after x-rays. I put them together into one picture. This one is worth 1,000 words. :)

Before and after x-rays (1 year) (http://img205.imageshack.us/img205/5517/trs1year.jpg)

That is just so beyond ridiculous. A year worth of exercise to make an 11 degree curve, that had a snowball's chance in hell of progressing, into nothing. Wonder what the cost per degree was.

mamamax

05-25-2010, 05:06 AM

An 11 year old girl (now 12) began torso rotation strength training approximately 1 year ago. Late today her mother e-mailed me the before and after x-rays. I put them together into one picture. This one is worth 1,000 words. :)

Before and after x-rays (1 year) (http://img412.imageshack.us/img412/5517/trs1year.jpg)

Dingo - Yes, a picture is worth a thousand words - in this case, maybe a million. No one, that I am aware of, can predict what course any curve may take. The best anyone can do is speculate - and speculation often proves faulty over the course of a lifetime.

True cause to celebrate for this young girl and her family, regardless of any monetary cost. Thank for posting!

mamamax

05-25-2010, 05:22 AM

Originally Posted by Dingo

An 11 year old girl (now 12) began torso rotation strength training approximately 1 year ago. Late today her mother e-mailed me the before and after x-rays. I put them together into one picture. This one is worth 1,000 words.

Before and after x-rays (1 year) http://img205.imageshack.us/img205/5517/trs1year.jpg

That is just so beyond ridiculous. A year worth of exercise to make an 11 degree curve, that had a snowball's chance in hell of progressing, into nothing. Wonder what the cost per degree was.

Maybe a lifetime of suffering has been avoided. How can this be defined as ridiculous? I don't recall that we had a medical evaluation which stated that this young girl's future involved a prognosis of: a snowball's chance in hell of progressing. Did I miss something?

Dingo - please extend my best wishes to this mom and her daughter - I'm sure the treatment cost paled in comparison to the results.

Pooka1

05-25-2010, 05:30 AM

That is just so beyond ridiculous. A year worth of exercise to make an 11 degree curve, that had a snowball's chance in hell of progressing, into nothing. Wonder what the cost per degree was.

Exactly. It would have been extremely against the odds had she progressed. Here's some statistics...

http://www.scoliosis.org/forum/attachment.php?attachmentid=435&d=1239026641

I believe these are from the Greek study which I can't locate at the moment.

That study showed a large fraction of kids who spontaneously resolved completely NOT doing torso rotation (to anyone's knowledge) if you can believe it.

To be wowed by this complete remission is to admit you are a folkscientist unfamiliar with the facts. Q.E.D.

Pooka1

05-25-2010, 05:34 AM

Pooka1

05-25-2010, 05:37 AM

I'm sure the treatment cost paled in comparison to the results.

The statistics suggest she wasted her time and money. Free country.

This is the type of "geniusry" we routinely see from the Clear chiros on Fix's site. It doesn't belong on a science and fact oriented group.

Nim

05-25-2010, 06:10 AM

Well, I am glad you posted this! I don't believe torso rotation can hurt in a healthy scoliosis patient without pain. So why not try it????

My daughter has a 27 degree curve...we are joining a gym with a torso rotation machine......I will keep you posted.........

Dingo

05-25-2010, 07:54 AM

Nim

Well, I am glad you posted this! I don't believe torso rotation can hurt in a healthy scoliosis patient without pain. So why not try it????

Oddly enough the girl in those x-rays had quite a bit of pain/discomfort. After several months of strength training her pain was gone.

Pooka1

05-25-2010, 08:23 AM

Nim

Oddly enough the girl in those x-rays had quite a bit of pain/discomfort. After several months of strength training her pain was gone.

Folkmedicine.

LindaRacine

05-25-2010, 10:21 AM

The price tag of treating kids with 10 degree curves would bankrupt the U.S.

Approximately 10% of the population of the world has a scoliosis curve of >10 degrees. But, only about 10% of that 10% (1%) will actually require treatment in their lifetime.

So, let's say the U.S. population is 300,000,000 people. 10% of that population is 30,000,000. Let's say that one year of torso rotation exercise is $1,000. (That's probably very conservative, especially considering that these people would probably treat their kids for longer than a single year.) My calculator doesn't even go that high.

If individuals who have kids with curves between 10-25 degrees want to pay the tab out of their own pockets, that could actually solve the current economy dilemma. So, I'd definitely encourage it. If, however, one expects their insurance company to cover it, get ready for a price tag that would change everyone's life, and not for the better.

Nim

05-25-2010, 12:30 PM

LindaRacine

05-25-2010, 01:01 PM

How do you figure so much money for torso rotation use? The gym near my house has a torso rotation machine, and to join the gym, it is $39.00 up front and then $9.99 a month, and If I sign up, I can bring a guest every time I go. So, she will go with me and use the machine.........And I get to stay in shape too......don't think that's a bad deal.....

I will not say I know a lot about the body or the science of it..........BUT, I DO know that the body is amazing....and exercise can often help with many problems our bodies may have.......Actually, my doctor once told me "Medicine is NOT an exact science..........
Hi Nim...

One would need to work with a therapist for at least the beginning of treatment. I think a typical course of PT is relatively close to $1,000. And, not everyone has a gym with a torso rotation device near their home.

And, as I said, if you're paying for it privately, I totally endorse it.

--Linda

hdugger

05-25-2010, 02:59 PM

Hi Nim...

One would need to work with a therapist for at least the beginning of treatment.

--Linda

Why would working with a physical therapist be required?

Pooka1

05-25-2010, 03:14 PM

Soucacos et al., 1998

A 5-year prospective study of 85,622 kids found 1,436 kids with scoliosis. (0.17% therefore genetic for sure! :D)

Results over an average observation of 3.2 years:

Progression - 14.7%
Spontaneous improvement of at least 5* - 27.4%
Complete spontaneous resolution - 9.5%

Therefore we have 36.9% whose curves decreased with 26% of these having a complete spontaneous resolution.

Then we have only 14.7% that progressed. That means that 85.3% either stayed the same or regressed, in some cases completely. Since 36.9% decreased and in some cases completely, then that means 48.4% stayed the same.

So the group that stayed the same was the largest accounting for almost half followed by the group that regressed, some completely which was more than a third of the total. The smallest group were the progressors and that was only 14.7%.

This is why Clear and ilk can dupe bunnies by claiming a 85+% "success" rate (100 - 14.7) when in fact that rate would be obtained had the kids done NO treatment. They exploit this.

Pooka1

05-25-2010, 03:24 PM

Here is the text...

http://www.springerlink.com/content/8q1y9nafxc3d1am7/fulltext.pdf

From the abstract:

In conclusion, the findings of the present study strongly suggest that only a small percentage of scoliotic curves will undergo progression.

skevimc

05-25-2010, 05:26 PM

I don't want to come across as biased. I've posted on several threads what I feel about RTS. I fully acknowledged and understand its weaknesses and faults. And I'll say explicitly that I think it would be wrong for a PT clinic to charge for RTS. It's certainly jumping the gun to charge insurance for something that's severely untested.

However, it seems like some of the negative comments on here are also jumping the gun a bit...

That is just so beyond ridiculous. A year worth of exercise to make an 11 degree curve, that had a snowball's chance in hell of progressing, into nothing. Wonder what the cost per degree was.

The statistics suggest she wasted her time and money. Free country.

I think the question of how much money was spent is a good one. But Dingo didn't post how this was paid for. Maybe they billed insurance and it cost $10k or maybe they did it at the local YMCA and they spent a couple of hundred bucks on a gym membership. Without knowing that information it's difficult to say what was wasted money

I'll certainly acknowledge the risk of that curve progressing was not the highest. So I understand the argument that the money was 'wasted'. However, the Soucacos et al., 1998 paper shows ~15-20% chance depending on the criteria selected (11-12 yr Female 11° R T/L). So I'm not sure if that would justify calling it wasted money. I'd further argue against that, but for reasons that could be considered non-scientific.

This is the type of "geniusry" we routinely see from the Clear chiros on Fix's site. It doesn't belong on a science and fact oriented group.

I get your point. But think you're being a tad hyper-critical. This is nowhere near the CLEAR folks. Nobody is claiming their surgery caused their colon cancer. ;) As well, none of the RTS papers suggest they can reduce major curves.

Although the commercial products might be approaching the CLEAR realm of things.

The price tag of treating kids with 10 degree curves would bankrupt the U.S.

Approximately 10% of the population of the world has a scoliosis curve of >10 degrees. But, only about 10% of that 10% (1%) will actually require treatment in their lifetime.

So, let's say the U.S. population is 300,000,000 people. 10% of that population is 30,000,000. Let's say that one year of torso rotation exercise is $1,000. (That's probably very conservative, especially considering that these people would probably treat their kids for longer than a single year.) My calculator doesn't even go that high.

If individuals who have kids with curves between 10-25 degrees want to pay the tab out of their own pockets, that could actually solve the current economy dilemma. So, I'd definitely encourage it. If, however, one expects their insurance company to cover it, get ready for a price tag that would change everyone's life, and not for the better.

I don't know that anyone is suggesting treating 10% of the population. I doubt the treatment load would change much from what it is now. So I don't think this is a fair criticism.

Overall, it's a little weird at how personal the comments were towards the family from the x-rays. I'm hopeful that this was not the intent and that it was a symptom of the ongoing argument between several members. A girl had an 11° curve. And now she doesn't. Good news! All critiques after that appear to be based on assumptions (unless I missed something).

Pooka1

05-25-2010, 05:43 PM

I get your point. But think you're being a tad hyper-critical. This is nowhere near the CLEAR folks. Nobody is claiming their surgery caused their colon cancer. ;) As well, none of the RTS papers suggest they can reduce major curves.

Although the commercial products might be approaching the CLEAR realm of things.

Okay. I'm just saying Clear makes bunny cry...

http://icanhascheezburger.com/2007/01/11/you-make-bunny-cry/

Dingo

05-25-2010, 06:41 PM

LindaRacine

That is just so beyond ridiculous. A year worth of exercise to make an 11 degree curve, that had a snowball's chance in hell of progressing, into nothing. Wonder what the cost per degree was.

Would you respond the same way if a child improved her math score by 11 points? What a vicious tone.

In the future you might want to consider limiting your exposure to children.

mamandcrm

05-25-2010, 06:59 PM

That's interesting. Very nice straight spine there on the right. The x-ray on the left looks like more than an 11* curve. My kid has an 11* curve now and her spine definitely is straighter than that on her x-ray. Maybe the mechanics of measurement are more complex than just what you see on the x-ray. Or maybe my kid's curve actually is less than 11*...

Dingo

05-25-2010, 06:59 PM

I think the question of how much money was spent is a good one. But Dingo didn't post how this was paid for. Maybe they billed insurance and it cost $10k or maybe they did it at the local YMCA and they spent a couple of hundred bucks on a gym membership. Without knowing that information it's difficult to say what was wasted money

The mother of the 12 year old purchased a used Cybex rotation machine off the internet for a few hundred bucks. When her daughter has finished growing she can sell it back for a few hundred bucks.

I'll leave it to the accountants on this forum to determine whether that will bankrupt the United States.

hdugger

05-25-2010, 07:01 PM

Overall, it's a little weird at how personal the comments were towards the family from the x-rays. I'm hopeful that this was not the intent and that it was a symptom of the ongoing argument between several members. A girl had an 11° curve. And now she doesn't. Good news! All critiques after that appear to be based on assumptions (unless I missed something).

It's the non-scientific side of the "it's all about science" argument :) yes, one would think that "good news" would be a more appropriate response.

Dingo got an interesting question about this study over at the scoliosis support forum. One of the participants wondered if the torso rotation would have any effect on the wedging seen in Scheuermann's kyphosis.

Pooka1

05-25-2010, 07:04 PM

Dingo got an interesting question about this study over at the scoliosis support forum. One of the participants wondered if the torso rotation would have any effect on the wedging seen in Scheuermann's kyphosis.

And just how the heck is Dingo supposed to address it may I ask?

And this isn't a study.

Dingo

05-25-2010, 07:09 PM

hdugger

yes, one would think that "good news" would be a more appropriate response.

LindaRacine may not have given an appropriate response to news that a child had a complete resolution of her Scoliosis, but she did give an honest response.

That is just so beyond ridiculous. A year worth of exercise to make an 11 degree curve, that had a snowball's chance in hell of progressing, into nothing. Wonder what the cost per degree was.

Truth be told I think she was holding back.

hdugger

05-25-2010, 07:17 PM

And just how the heck is Dingo supposed to address it may I ask?

Actually, the question was for Kevin, but I'd imagine anyone else could approach the question the way we usually do with such matters - look at the research and try to muddle through. Our collective lack of real training in the field has never held us back before!

Pooka1

05-25-2010, 07:23 PM

Actually, the question was for Kevin, but I'd imagine anyone else could approach the question the way we usually do with such matters - look at the research and try to muddle through. Our collective lack of real training in the field has never held us back before!

Well, you have my vote for most elliptical, if not obscurantist, answer lately. :)

The question was posed to Dingo. Can I just ask if it gives you pause to see lay folks asking other lay folks questions that require specific expertise and training that the lay folks don't have? Are you completely sanguine about that? If cut do you not bleed??? :D

Well, at least your response wouldn't make bunny cry but it might drive a hamster to drink (which doesn't take much).

hdugger

05-25-2010, 07:39 PM

The question was posed to Dingo. Can I just ask if it gives you pause to see lay folks asking other lay folks questions that require specific expertise and training that the lay folks don't have? Are you completely sanguine about that? If cut do you not bleed??? :D

Oh, you mean the question over at Scoliosis support - not my question. Yes, that was for Dingo.

We get questions like that here all the time, and we're always happy to answer. "Should I get surgery for my 27 degree curve?," "Is it normal to tilt to the side after surgery?" and so on and so on. It's the nature of a non-technical support forum that we untrained end up answering all manner of questions for which we haven't a lick of professional qualification.

If that's *always* an issue, then we need to shut down the forum, because, frankly, the blind-leading-the-blind accounts for about 80% of all exchanges here. OTOH, if that is *only* an issue when the question is addressed to Dingo . . . well, it would certainly seem like something other then pure "it's all for science" is going on.

hdugger

05-25-2010, 07:43 PM

BTW, before I thought of asking Kevin, I was going to field the question over at Scoliosis Support myself, with absolutely *no* research to back me up whatsoever :)

Willfully uninformed, highly opinionated, and loving it!

Pooka1

05-25-2010, 07:46 PM

Oh, you mean the question over at Scoliosis support - not my question. Yes, that was for Dingo.

We get questions like that here all the time, and we're always happy to answer. "Should I get surgery for my 27 degree curve?," "Is it normal to tilt to the side after surgery?" and so on and so on. It's the nature of a non-technical support forum that we untrained end up answering all manner of questions for which we haven't a lick of professional qualification.

If that's *always* an issue, then we need to shut down the forum, because, frankly, the blind-leading-the-blind accounts for about 80% of all exchanges here. OTOH, if that is *only* an issue when the question is addressed to Dingo . . . well, it would certainly seem like something other then pure "it's all for science" is going on.

The issue is lay, untrained people coming on here claiming x, y, and z as AGAINST the evidence in hand and accusing actual researchers (like Ogilvie) of doing "silly" science on no rational basis whatsoever.

Ninety-nine point nine nine nine nine nine percent of the players here ADMIT they don't know, make it abundantly clear when they are speculating/guessing, and don't pretend to know more than researchers in the field.

One player does NOT do that.

Do you disagree? Can you?

Pooka1

05-25-2010, 07:59 PM

Here is my suggestion for an intellectually honest post on this subject that conveys known facts and limitations of TRS and has little to no chance of misleading the bunnies...

An 11 year old girl (now 12) began torso rotation strength training approximately 1 year ago. Late today her mother e-mailed me the before and after x-rays. I put them together into one picture. This one is worth 1,000 words.

Before and after x-rays (1 year)

Although she did TRS, many small curves like this regress spontaneously and completely on their own. While TRS may have contributed in whole or in part to this great result, it is impossible to say one way or the other at this point. It's good news for the family and hopefully they will not be making any unsupported claims to others based on their results.

Had something like that been posted rather than what was, there would have been zero pushback. ZERO.

hdugger

05-25-2010, 08:12 PM

One player does NOT do that.

Do you disagree? Can you?

I'm positive that sustained exercise can decrease/hold curves, and am only searching for the correct combination that will work in a larger percentage of cases. I know that belief lies in opposition to some research, but I'm (pretty openly) dismissive of much of that research.

I've spent a fair amount of time online, so I know how to hem and haw, but that doesn't change the fact that I have no professional background in the field and hold a fairly strong opinion.

Likewise, I imagine that the strong feelings you have against bracing (even though the research is inconclusive) has swayed some people away from using braces, even against their doctor's advice.

The internet is full of strong opinions, and all of them have consequence. Reader beware, I suppose.

Pooka1

05-25-2010, 08:21 PM

Likewise, I imagine that the strong feelings you have against bracing (even though the research is inconclusive)

I'm not the one who had to wear the brace. I'm required to seek out the evidence, if it exists, for my kids. Bracing is no benign treatment.

And it would be more accurate to say the evidence is inconclusive AFTER ALL THESES YEARS. A bit of a different lilt that matters.

As for the remaining, I think in your attempt to play devils advocate you have overstepped. Your skepticism in re PT is about a LACK of evidence which you suspect really exists out there. In stark contrast, others here are skeptical about KNOWN FACTS. That's a world of difference and I think you realize it.

Dingo

05-25-2010, 08:32 PM

Many of you know that I talk to scientists who conduct research on Scoliosis. Some work in the USA and others work in various locations around the world.

I sent the before & after x-rays with some supporting information to a spine surgeon who also does R&D. To my surprise he replied with a page and a half response and a "thank you" for getting it to him.

The difference between that response from a top scientist and the seething anger that routinely flows from some members of this group including the Mod is striking.

mamamax

05-25-2010, 08:56 PM

Yes - many of us do know that about you Dingo :-)

I'm glad you posted this. The difference in responses - obviously, based on education and professionalism.

I can find no excuse for the seething anger, and mockery displayed by a moderator and her assistant, other than ignorance. I would hope they take the time to better educate themselves and invest in a few courses to better polish their communication skills.

While the literature supports that approximately 10% of cases will resolve on their own - we have no way of knowing which child will fall into that category. When a child, such as the case you shared with us, overcomes this insidious condition, it is true cause for celebration. And not a time to rip her victory to shreds.

Nim

05-25-2010, 09:22 PM

Wow! Scoliosis treatment can be such a crap shoot! This might help, then again, it may not.....This helped her, but it didn't help her.....this curve progressed, this one didn't.....and this one got better!

With that in mind......I would say, go for the torso rotation training......if ballet dancers can get great leg extension and hip turn out from working the muscles and training, beyond what you would ever think the human body is capable of, I've gotta believe consistent working of the back and core muscles just might be able to de-rotate the turning vertebrae...........At least to me, an ex-cheerleader and dancer, it makes sense, and it can't seem to hurt any, so we're going to give it a try ........

Also.....I'll share something with you I stumbled upon while researching scoliosis. I found a site set up by a woman that collected old medical journals and books as a hobby. She said she found an entry in an old medical book titled: " Scoliosis Cures and Causes, Unknown or Just Forgotten."...........She said that until doctors started to operate on scoliosis patients, medical journals listed causes and cures for scoliosis.......once they started to do operations, they did not list the causes or cures.......Makes you think, doesn't it.............

skevimc

05-25-2010, 10:47 PM

Also.....I'll share something with you I stumbled upon while researching scoliosis. I found a site set up by a woman that collected old medical journals and books as a hobby. She said she found an entry in an old medical book titled: " Scoliosis Cures and Causes, Unknown or Just Forgotten."...........She said that until doctors started to operate on scoliosis patients, medical journals listed causes and cures for scoliosis.......once they started to do operations, they did not list the causes or cures.......Makes you think, doesn't it.............

That's an interesting finding. Definitely something to think about. However, I'd suggest that reason they stopped talking about the 'cure' and 'cause' of scoliosis is the realization that nothing they were doing or will do will actually 'cure' the scoliosis. It was actually fairly common for some surgeons to talk about their surgeries as "curing scoliosis". The community at large began to shift that thinking. It's the difference between a treating scoliosis and managing scoliosis.

Also the realization that, after polio, they had no idea what caused scoliosis. But this definitely feeds in to the idea that doctors want to operate on everything as a solution. And that is certainly worth thinking about.