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Thread: Rehabilitation of adolescent patients with scoliosis—what do we know?

  1. #31
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    oh yes, i am sure American doctors will take him seriously if they see his videos! just what every doctor in this country wants to look at!
    all it does is make him look like a buffoon!

    jess

  2. #32
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    Were surgeons visiting him or other types of doctors like PhDs in muscle physiology, and non-medical folks like chiros and PT types?

    The latter makes some sense. I am skeptical surgeons would visit him for any reason given he doesn't seem to do surgery any more and he publishes on a bunch of stuff EXCEPT he efficacy of Schroth and bracing. I have heard one surgeon refer to Weiss as a rehab doctor so it might not be clear Weiss is even a surgeon himself.

    The fact that he has many pubs is not a point in his favor when you point out NONE show what patients want from PT and bracing... a permanent solution.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  3. #33
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    Well, seems we all are watching ... is anybody reading?

    Physiotherapy / Rehabilitation

    Case report studies have demonstrated that measurable positive changes in the signs and symptoms of IS are correlated with physiotherapy treatment (Weiss 1991, Weiss 1993). Among over 800 patients, nearly every case revealed a small but significant improvement in chest expansion and a 14-19% improvement in VC after rehabilitation treatment (Weiss 1991). Among 794 adult patients with severe scoliosis, 55% exhibited at least one sign of right ventricular strain at admission and by the end of the study only 12% exhibited signs of impairment. Vital Capacity improved by 250 ml in the same adult population (Weiss 2003).

    Among 107 patients mean Cobb angle decreased from 43 to 39 degrees, with improvements of up to 20 degrees in individual patients after in-patient rehabilitation (Weiss 2003).

    Studies also have demonstrated significant improvements in pain (Weiss 1993, Weiss et al. 1999, Weiss 2003) and psychological distress (Weiss and Cherdron 1994, Weiss et al. 2006d, Freidel et al. 2008) in response to rehabilitation.

    Results of a preliminary study were consistent with the possibility that incidence of progression among 181 patients treated with physiotherapy during the late 1980's was significantly less than the incidence that would be expected based on natural history surveys (Weiss 2003).

    Another study to test the hypothesis that physiotherapy-based intervention can reduce incidence of progression in children with IS was performed 2003 with materials from 1989-1991 and an untreated control group (Weiss et al. 2003). A follow-up of the outcome of two prospective studies used the outcome parameter, incidence of progression (≥5°), in treated and untreated patient groups matched by age, sex, and degree of curvature at diagnosis, were included factors. A six-week scoliosis in-patient rehabilitation program offering patient-specific physiotherapy including intensive therapist-assisted exercise in diagnosis-matched groups was the method of treatment. The Incidence of progression in groups of untreated patients ranged from 1.5-fold (71.2% vs 46.7%) to 2.9-fold (55.8% vs 19.2%) higher than in groups of patients treated with rehabilitation, even when rehabilitation-treated groups included patients with more severe curvatures. The differences recorded were highly significant. The results of this study indicate that a supervised program of exercise-based therapy can reduce the incidence of progression in children with IS.

    The results of this study however, have not been reproduced with patient samples undergoing in-patient rehabilitation with treatment times reduced to 3-4 weeks (Weiss and Goodall 2009).

    At last a RCT on physiotherapy from China provides the physical medicine and rehabilitation approach to scoliosis with level Ib evidence and a level A recommendation (Negrini et al. 2008). Interestingly the approach used in this study seems not specific, however due to possible translation problems this issue should be investigated more closely in the near future.

    Full Text Article (Weiss, Goodal, 2010) available in English, Spanish & French:

    Idiopathic, from the Latin meaning: we're idiots 'cause we can't figure out what's causing it (TV Dr. House, MD)

    I'm not weird ... I'm simply - multifactorial

  4. #34
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    Well Susanna, you sound a little defensive there! No one said anything at all about his methods or results. We were commenting on his profound and disturbing lack of professionalism, and his poor judgement. (and you too, mamamax).

    I am wondering, would you be proud to show those videos to your daughter's grandparents or your friends, and would you tell them proudly that this is the professional who you have chosen to treat your daughter's scoliosis?

    I am glad to hear he has never touched your daughter inappropriately--that is a relief. But I would sure be disgusted to wonder if my child's doctor was having inappropriate/sexual thoughts about my daughter's body. THAT is what people are concerned about.

    By the way, I have a great sense of humor. And there is nothing funny about those videos.
    Gayle, age 47
    Boston brace as a teen for AIS
    Oct 2010 fusion T8-sacrum w/ pelvic fixation, TLIF at L4/5.
    Feb 2012 major A/P revision for broken rods


    mom of Leah, 12 y/o, diagnosed Jan '08 with 26* thoracic JIS (age 6)
    4/08 26 degrees, brace 16 hrs/day
    9/08 17 deg. OOB - brace discontinued
    9/09 30 deg, resuming brace
    5/10 VBS Dr Luhmann Shriners St Louis
    5/14 stable 4 yrs post-op, 14* T

    also mom of Torrey, 9 y/o son, 12* T, decreasing spontaneously (from 19*)

  5. #35
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    i agree with both Sharon and Gayle..and all the other forum folks who find the videos...beyond disturbing!!

    charming that he refers to the brace and "no better lover"..just charming!
    all the lyrics are so inappropriate!

    jess

  6. #36
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    Quote Originally Posted by leahdragonfly View Post
    Well Susanna, you sound a little defensive there! No one said anything at all about his methods or results. We were commenting on his profound and disturbing lack of professionalism, and his poor judgement. (and you too, mamamax).
    I don't think Susanna sounds all that defensive - and I would like to know more about her experience with the method.

    Regarding the video and the attempt to judge it right or wrong ... that is going to be a matter of personal opinion, which we all are entitled to.

    I am more disturbed by many other media forms used to program the masses than this video used to help youngsters adjust to all that is involved with bracing. Is it new and innovative? Yep. Profoundly disturbing? Not when compared to the larger world around it - and, were the video alone used to condemn a person ... I would say the evidence would then be - highly circumstantial, in my opinion.
    Idiopathic, from the Latin meaning: we're idiots 'cause we can't figure out what's causing it (TV Dr. House, MD)

    I'm not weird ... I'm simply - multifactorial

  7. #37
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    Quote Originally Posted by mamamax View Post

    Regarding the video and the attempt to judge it right or wrong ... that is going to be a matter of personal opinion, which we all are entitled to.

    I am more disturbed by many other media forms used to program the masses than this video used to help youngsters adjust to all that is involved with bracing. Is it new and innovative? Yep. Profoundly disturbing? Not when compared to the larger world around it -


    mamamax,

    Wag the dog.

    Jumping off this thread now.
    Gayle, age 47
    Boston brace as a teen for AIS
    Oct 2010 fusion T8-sacrum w/ pelvic fixation, TLIF at L4/5.
    Feb 2012 major A/P revision for broken rods


    mom of Leah, 12 y/o, diagnosed Jan '08 with 26* thoracic JIS (age 6)
    4/08 26 degrees, brace 16 hrs/day
    9/08 17 deg. OOB - brace discontinued
    9/09 30 deg, resuming brace
    5/10 VBS Dr Luhmann Shriners St Louis
    5/14 stable 4 yrs post-op, 14* T

    also mom of Torrey, 9 y/o son, 12* T, decreasing spontaneously (from 19*)

  8. #38
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    Quote Originally Posted by leahdragonfly View Post
    mamamax,

    Wag the dog.

    Jumping off this thread now.
    Code for: I missed my calling as a campaign manager?

    Idiopathic, from the Latin meaning: we're idiots 'cause we can't figure out what's causing it (TV Dr. House, MD)

    I'm not weird ... I'm simply - multifactorial

  9. #39
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    Calling Dr. Skevimc

    Quote Originally Posted by skevimc View Post

    I have also seen the pictures of him riding when I was visiting him. Doesn't mean he's 'accomplished' (like I'd know what that means anyway). But I seem to remember him talking about his horses/stable one night. It can at least be said that he's been on a horse at least once.
    Skevimc ... you have no idea how many times I have thought of your quote from, Ascher was it? I would like to know more about your experience at the Clinic. What were your goals in going - and what were your parting conclusions? Any humor in between would also be interesting.
    Idiopathic, from the Latin meaning: we're idiots 'cause we can't figure out what's causing it (TV Dr. House, MD)

    I'm not weird ... I'm simply - multifactorial

  10. #40
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    Weiss/Schroth References & future ponderings ...

    Quote Originally Posted by hdugger View Post
    So, given my experience, I'm inclined to think that the Schroth method holds promise. But, I am somewhat puzzled why Weiss is not publishing papers showing the effectiveness of his methods. Without those papers, it is very expensive for Americans to seek out this treatment (because its effectiveness has to be proven before our insurance will pay for it).
    Yes. He has been a prolific publisher. I wonder if being associated with the German Clinic was somewhat limiting to him for corporate reasons not fully understood. Now that he is in private practice with a modified, or new method (which is built upon the old), we may see what we have been looking for. Seems this has begun with his most recent 2010 publication: http://cirrie.buffalo.edu/encycloped...uage=e#article

    I look forward to the day when the new - or - Power Schroth will be available to us through physical therapy departments, and covered by insurance. Beyond that I would hope that one day, there will be free clinics reaching those with even more limited financial resources. While we are closer to this than years ago - I fear we still have very far to go.

    If one wanted to read all things Weiss - well, this would be quite a project - and an even larger one considering the German writings which have yet to be translated. For example (in English only, as the first author):


    • Weiss HR, Goodall D. 2009. Is Scoliosis In-patient rehabilitation clinically effective? A systematic Pub Med review. Paper presented at the 6th annual meeting of the SOSORT, May 20th-23rd, Lyon 2009
    • Weiss HR, Werkmann M. 2009a. Unspecific chronic low back pain - a simple functional classification tested in a case series of patients with spinal deformities. Scoliosis 4:4.
    • Weiss HR, Werkmann M. 2009b. Treatment of chronic low back pain in patients with spinal deformities using a sagittal re-alignment brace. Scoliosis. 4:7.
    • Weiss HR. 2008a. Adolescent Idiopathic Scoliosis (AIS) - an indication for surgery? A systematic review of the literature. Disability and Rehabilitation 30(10):799-807.
    • Weiss HR. 2008b. Conservative treatment in patients with severe congenital scoliosis – presentation of three cases. Proceedings of the 5th international conference on conservative management of spinal deformities, Athens, April 2-5.
    • Weiss HR, Goodall D. 2008. The treatment of adolescent idiopathic scoliosis (AIS) according to present evidence. A systematic review. European Journal of Physical and Rehabilitation Medicine 44(2):177-93.
    • Weiss HR, Bohr S. 2008. Conservative Treatment in patients with scoliosis due to Prader-Willi Syndrome. Proceedings of the 5th. international conference on conservative management of spinal deformities, Athens, April 2-5.
    • Weiss HR, Rigo M. 2008. The chêneau concept of bracing - actual standards. Studies in Health Technology and Informatics 135:291-302.
    • Weiss HR, Maier-Hennes A. 2008. Specific exercises in the treatment of scoliosis - differential indication. Studies in Health Technology and Informatics 135:173-90.
    • Weiss HR. 2007a. Best Practice in Conservative Scoliosis Care. Pflaum Munich, 2nd ed.
    • Weiss HR. 2007b. Adolescent Idiopathic Scoliosis - case report of a patient with clinical deterioration after surgery. Patient Safety in Surgery. Dec 19;1:7. Available from:
    • http://www.pssjournal.com/content/1/1/7
    • Weiss HR. 2007c. Is there a body of evidence for the treatment of patients with Adolescent Idiopathic Scoliosis (AIS)? Scoliosis Dec 31;2:19. Available from:
    • http://www.scoliosisjournal.com/content/2/1/19
    • Weiss HR, Werkmann M, Stephan C. 2007a. Brace related stress in scoliosis patients - Comparison of different concepts of bracing. Scoliosis Aug 20;2:10. Available from:
    • http://www.scoliosisjournal.com/content/2/1/10
    • Weiss HR, Werkmann M, Stephan C. 2007b. Correction effects of the ScoliOlogiC "Chêneau light" brace in patients with scoliosis. Scoliosis Jan 26;2:2. Available from:
    • http://www.scoliosisjournal.com/content/2/1/2
    • Weiss HR, Dallmayer R. 2006a. Brace treatment of spinal claudication in an adolescent with a grade IV spondylosisthesis--a case report. Studies in Health Technology and Informatics 123:590-3.
    • Weiss HR, Dallmayer R. 2006b. Brace treatment of spinal claudication in an adult with lumbar scoliosis--a case report. Studies in Health Technology and Informatics 123:586-9.
    • Weiss HR, Klein R. 2006. Improving excellence in scoliosis rehabilitation: a controlled study of matched pairs. Pediatric Rehabilitation 9(3):190-200.
    • Weiss HR, Hollaender M, Klein R. 2006a. ADL based scoliosis rehabilitation--the key to an improvement of time-efficiency? Studies in Health Technology and Informatics 123:594-8.
    • Weiss HR, Dallmayer R, Stephan C. 2006b. First results of pain treatment in scoliosis patients using a sagittal realignment brace. Studies in Health Technology and Informatics 123:582-5.
    • Weiss HR, Negrini S, Rigo M, Kotwicki T, Hawes MC, Grivas TB, Maruyama T, Landauer F. 2006c. Indications for conservative management of scoliosis (guidelines). Scoliosis 1:5.
    • Weiss HR, Reichel D, Schanz J, Zimmermann-Gudd S. 2006d. Deformity related stress in adolescents with AIS. Studies in Health Technology and Informatics 123:347-51.
    • Weiss HR. 2005. Das "Sagittal Realignment Brace" (physio-logic ® brace) in der Behandlung von erwachsenen Skoliosepatienten mit chronifiziertem Rückenschmerz. MOT 125: 45-54.
    • Weiss HR. 2003. Rehabilitation of adolescent patients with scoliosis--what do we know? A review of the literature. Pediatric Rehabilitation 6(3-4):183-94.
    • Weiss HR, Weiss G, Schaar HJ. 2003. Incidence of surgery in conservatively treated patients with scoliosis. Pediatric Rehabilitation 6:111-8.
    • Weiss HR, Weiss G, Petermann F. 2003. Incidence of curvature progression in idiopathic scoliosis patients treated with scoliosis in-patient rehabilitation (SIR): an age- and sex-matched controlled study. Pediatric Rehabilitation 6:23-30.
    • Weiss HR. 2002. Rehabilitation of scoliosis patients with pain after surgery. Studies in Health Technology and Informatics 88:250-3.
    • Weiss HR, Verres Ch, Steffan K, Heckel I. 1999. Scoliosis and Pain – is there any Relationship? In: IAF Stokes (editor) Research into Spinal Deformities 2, IOS Press.
    • Weiss HR, Lohschmidt K, el-Obeidi N, Verres C. 1997. Preliminary results and worst-case analysis of in patient scoliosis rehabilitation. Pediatric Rehabilitation 1(1):35-40.
    • Weiss HR. 1995. Standard der Orthesenversorgung in der Skoliosebehandlung. Med Orth Tech, 115:323-330.
    • Weiss HR, Cherdron J. 1994. [Effects of Schroth's rehabilitation program on the self concept of scoliosis patients]. Rehabilitation (Stuttg). 33(1):31-4.
    • Weiss HR. 1993. Scoliosis-Related Pain in Adults – Treatment Influences. European Journal of Physical Medicine and Rehabilitation 3:91-94.
    • Weiss HR. 1991. The effect of an exercise program on vital capacity and rib mobility in patients with idiopathic scoliosis. Spine 16(1):88-93.
    Idiopathic, from the Latin meaning: we're idiots 'cause we can't figure out what's causing it (TV Dr. House, MD)

    I'm not weird ... I'm simply - multifactorial

  11. #41
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    Waging the Dog

    Quote Originally Posted by mamamax View Post
    Code for: I missed my calling as a campaign manager?

    Of course, a really good campaign manager would have told Dr. Weiss that to proclaim innocence without being accused of guilt ... does not look good.

    Therefore, adding references (or the source of accusation) to the disclaimer would be better than to have no reference at all.

    Now I'm joining Jess and taking an all too brief vacation from all this. Will be on the Gulf of Mexico beaches ... that part yet untainted by the oil.
    Idiopathic, from the Latin meaning: we're idiots 'cause we can't figure out what's causing it (TV Dr. House, MD)

    I'm not weird ... I'm simply - multifactorial

  12. #42
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    Weiss, HR - Complete Listing of Publications


    + About another 200 for which I cannot find a listing :-)
    Last edited by mamamax; 07-29-2010 at 06:27 PM.
    Idiopathic, from the Latin meaning: we're idiots 'cause we can't figure out what's causing it (TV Dr. House, MD)

    I'm not weird ... I'm simply - multifactorial

  13. #43
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    Video Update

    Idiopathic, from the Latin meaning: we're idiots 'cause we can't figure out what's causing it (TV Dr. House, MD)

    I'm not weird ... I'm simply - multifactorial

  14. #44
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    What Happened Here?

    I was reviewing this thread this evening ... trying to figure out what happened that would cause such an uproar in responses, verging too closely upon what could be viewed as character assassination of one of recent history's most important people in the world of scoliosis rehabilitation.

    After posting links to some videos on a Youtube channel created by Dr. Weiss, and commenting scary ... what next? The what next turned out to be an onslaught of Flying Monkeys. You know, the evil witch's minions from the Wizard of Oz. No matter that my use of the word scary was slang, for a big wow - look at this! I think I shall use less slang in the future. I tried to recover with a light hearted film festival review - and failed horribly ... the monkeys kept flying. My first and last film festival review, will leave that to the professionals in the future. Why would so much come into question, on a personal level which included even his equestrian abilities - without any talk of the literature? Good question. I have no answer.

    The Internet providing a fairly transparent world, Dr. Weiss got wind of our conversation and posted a response to us on Youtube. The verbiage found Here!. We were introduced to, and invited - to do mirror work. This may be a first in NSF forum history - though I can't say it is one to be necessarily proud of.

    Reminded me of a similar time when the president of the National Scoliosis Foundation was attacked in forum and he responded with Setting The Record Straight. There are other moments it reminded me of also, but they are too numerous to mention here.

    Forum member (and Schroth-mom) Susanna, stepped in to give us a Reality Check. It didn't seem to matter. The monkeys still flew.

    The NSF forum postings turn up over and again in Google searches. Ever wonder how all this looks to those outside our inner circle - to the eyes watching around the world? At best I fear we look ignorant - at worst, like the people for whom the term Ugly American was coined. Ignorant bty, does not mean stupid, but rather implies a "not knowing."

    Where do we go from here? I cannot speak collectively for the Flying Monkeys - but if I could, I would say ....

    Please forgive us - we did not know what we were doing - and we did not understand from where the video Scoliosis Girls came, or how it was used. In truth we know little about Schroth. We were having a psychotic moment.

    Our forum is un-moderated for the most part - and this is what will happen sometimes when there is no moderation among a large group of people. On one hand we enjoy a great deal of freedom - on the other, maybe sometimes such as this, such freedom is wasted in ignorance. We are not bad people - but we do sometimes behave badly.

    What did we learn? I hope, a lot. Time will tell in the future threads to come.

    Sincere apologies extended to Dr. Weiss, his patients, and his family.



    Last edited by mamamax; 07-29-2010 at 08:31 PM.
    Idiopathic, from the Latin meaning: we're idiots 'cause we can't figure out what's causing it (TV Dr. House, MD)

    I'm not weird ... I'm simply - multifactorial

  15. #45
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    just who are you calling a "flying monkey"???

    no apology to Dr Weiss is needed...and certainly not wanted by many MANY folks on forum who find his videos anywhere from offensive to repulsive...

    so don't apologize for me...i stick by what i say...and i DON'T have "psychotic moments"!!!

    as far as "looking ignorant"...or "not knowing"...i am a licensed clinical social worker...i know inappropriate when i see it....seen it many times...and that video IS INAPPROPRIATE!!!

    jess
    Last edited by jrnyc; 07-31-2010 at 10:47 AM.

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