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Active Correction by Sideshift Exercises as described by Min Mehta

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  • Active Correction by Sideshift Exercises as described by Min Mehta

    It appears that the information that used to be found on the internet about the side-shift exercises as described by Min Mehta for scoliosis patients has disappeared, or has become too difficult to find. Therefore, I am going to place some excerpts with the basics here, so this exercise won't become lost to the American scoliosis world. (I say American because I think side-shift exercises are a major part of European methods such as SEAS).

    Side-shift can be used during the wait and watch period, during treatment (during time out of the brace), and to stop adult progression also.


    ACTIVE CORRECTION BY SIDE-SHIFT: AN ALTERNATIVE TREATMENT FOR EARLY IDIOPATHIC SCOLIOSIS
    MH Mehta, MD

    The realization that the frequent repetition of this maneuver by itself can stabilize and even correct an early idiopathic scoliosis came about by chance when, with the intention of improving her appearance, I recommended the side-shift to a girl of 15 with a 28* thoracolumbar curve and Risser grade 4. She returned six months later with a curve of 23* and has maintained that improvement over a four year follow-up period.
    (Two girls mentioned in the study had 15* and 20* curves demanded early treatment and due to diligence with the technique managed to correct and overcorrect (to zero and -3 degrees) their curves within six months time, the over-corrected girl was told to stop the exercises).

    The side-shift is taught in the clinic and is easily learned. Most children become adept in a matter of seconds with the aid of visual feeback provided by a full-length mirror, and gentle fingertip pressure applied laterally to the convex side of the rib cage and the contralateral hip. The child is taught to shift the trunk away from the curve convexity as far as the spine will allow, to hold this position for about ten seconds and then relax into the rest position. The mirror enables the child to see that in returning to the habitual posture her body slumps passively into the position of deformity....she is required to perform the shift repeatedly through the day, standing or sitting, and to acquire the habit of "thinking shift". Children with a marked lumbar lordosis are instructed first to obliterate the lordosis by reverse pelvic tilt and then to shift sideways. Most children find the best times for concentrated periods of active side-shift are while watching television, doing homework, or sitting at school....the requirement to shift frequently through the day, every day.

    Since there are no absolute criteria for discriminating at an early stage between progressive and nonprogressive scoliosis, the decision to start treatment is deferred until a curve has been seen to increase to an arbitrary limit. Experience has shown that, in general, a curve is contained at the level at which treatment is started and that any correction obtained during treatment is lost after it is discontinued. Michel therefore recommends that "to obtain a reliable stable curve of less than 30 degrees in adulthood it is necessary to undertake treatment of a curve of less than 30 degrees.

    The size of the curve, the curve pattern, and the degree of compliance with treatment all contribute to the outcome of treatment by the side-shift or any other method. Thoracolumbar and low thoracic curves respond best to the side-shift, lumbar curves less so. For the right thoracic/left lumbar pattern the side-shift away from the thoracic curve convexity is used. Although in theory this should aggravate the lumbar curve, in practice both curves are equally contained.

    Correction and even overcorrection can be obtained when all three conditions are favorable.

    The side-shift has the advantage over other methods that it can be used as maintenance therapy to prevent progression in adult life. Five girls who are now skeletally mature (Risser 5) are maintaining their curves constant by a brief period of 15-30 minutes of side-shift daily.

  • #2
    This is also an article on side-shift.



    http://www.ncbi.nlm.nih.gov/pubmed/10552325

    Treatment of idiopathic scoliosis with side-shift therapy: an initial comparison with a brace treatment historical cohort.
    Abstract

    A group of 44 patients with idiopathic scoliosis (mean age 13.6 years) with an initial Cobb angle between 20 degrees and 32 degrees received side-shift therapy (mean treatment duration 2.2 years). A group of 120 brace patients (mean age 13.6 years) with an initial Cobb angle in the same range (mean brace treatment 3.0 years) was the historical reference group. Failure was defined as an increase of Cobb angle greater than 5 degrees within 4 months or a Cobb angle greater than 35 degrees or a total increase of Cobb angle greater than 10 degrees. The chance of success was not significantly different between the side-shift and the brace groups, whether tested for efficiency (66% vs 68%) or efficacy (85% vs 90%). The difference in the mean progression of the Cobb angle for the respective groups is small (for efficiency: 3 degrees vs -2 degrees, for efficacy: 2 degrees vs -1 degrees ). Side-shift therapy appears to be a promising additional treatment for idiopathic scoliosis in adolescents with an initial Cobb angle between 20 degrees and 32 degrees.
    The article isn't freely available but it does have a very nice discussion explaining the proposed mechanism. For a relatively small study, it is very well done.

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    • #3
      I also have a picture of the exercise from one of the articles posted here

      http://www.flickr.com/photos/45701845@N05/5211070882/

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      • #4
        Active Correction by Side Shift: An Alternative Treatment For Early IS

        I have 14 detailed pages from this chapter (with pictures and xrays) which come from a book written by Min Mehta. They are scanned copies and the file size is too large to upload here.

        These pages were gifted to me by a fellow forum member who received them from Martha Hawes. Happy to share with anyone who would like them - just send me a PM and I'll get them to you.

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