What do we think? I don't want to shadow this information too much with my own thoughts other than to say - I think it would be wonderful to find this available in our Physical Therapy departments - and covered by insurance. Other thoughts?
Scoliosis Intensive Rehabilitation
Rehabilitation employs an individualized exercise program combining corrective behavioural patterns with physiotherapeutic methods, following principles described by Lehnert-Schroth (2000) and Weiss (Weiss 2007a, Weiss and Maier-Hennes 2008). The three-dimensional scoliosis treatment is based on sensomotor and kinesthetic principles and its goals are like the goals of out-patient treatment:
1. to facilitate correction of the asymmetric posture, and
2. to teach the patient to maintain the corrected posture in daily activities (Weiss and Maier-Hennes 2008)
The treatment program consists of correction of the scoliotic posture with the help of proprioceptive and exteroceptive stimulation. Central to the individual and group exercise programs is therapist assistance (Figure 1), who supervise all exercises and provide exteroceptive stimulation needed to obtain the desired corrections. Depending on individual curve patterns, the patients are assigned to special exercise subgroups making the program for the individualised to suit the patient's needs (Figure 2). Development and maintenance of the corrected posture is facilitated using asymmetric standing exercises designed to employ targeted traction to restore torso balance and mobility.
The "Best Practice" rehabilitation program uses a certain methodology in order to address all clinical aspects of the patient's deformity:
* physio-logic® exercises (correcting the sagittal profile, Weiss and Klein 2006)
* 3D made easy® exercises (3D program easy to acquire for small curves, Weiss, Hollaender and Klein 2006)
* Pattern specific activities of daily living (specific ADL, Weiss and Hennes 2008) and
* Schroth exercises (Lehnert Schroth 2000)
The bigger the curve, the more the Schroth exercises are performed because this method of treatment is most effective in curvatures of more than 30° (Weiss et al. 1997). On the other hand curvatures between 15 and 25° do not necessarily need the Schroth program, which is rather complex and not very easy to learn, when there are other specific approaches available, which are easier to learn and already have been tested in the environment of an in-patient rehabilitation centre (Weiss and Klein 2006, Weiss, Hollaender and Klein 2006).
The primary goal of specific rehabilitation is for patients to be able to assume their personal corrected postural stereotype, independent of the therapist and without mirror control, and to maintain this position in their daily activities. Recommended at-home follow-up treatment includes three to four exercises for 30 minutes daily in order to maintain the improved postural balance. Therapists throughout Germany, Spain, Austria, Switzerland, United States, Turkey and Israel have received training in the Schroth approaches so that local out-patient resources are available. In cases of reported pain, curvature progression, or pulmonary symptom development repeat intensive rehabilitation treatment is available by referral from primary care physicians, paediatricians and orthopaedic specialists (Weiss et al. 2003, 2003, Weiss 2003).
Full Text Article (Weiss, Goodal, 2010) available in English, Spanish & French: