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  • torso rotation exercises

    Some interest has been expressed in this forum with regards to dr Mooney's torsorotation exercises. I recently wrote to him asking for kind of an update on whether he was still using this method. Enclosed his replies (in blue)

    shame that he doesn't seem to be pushing it a lot apparantly. hopefully dr asher is able in due course to either confirm or refute his findings.

    To me it remains an approach with is kind of logical and one of the few exercise based approaches with has some evidence of effectiveness behind it



    Dear Dr Mooney



    You might remember that i wrote to you in 2004, and you kindly gave me some advice regarding the use of torsorotation exercises in the treatment of scoliosis.



    To update you, we have tried to replicate your approach using a cybec torsotwist machine, and have used this regularly, twice weekly since september 2005. We have seen no progression of the curve (which at worse was measured at 29 degrees) Ofcourse this could also be due to the use of initially a hardplastic TLSO and later a spinecorbrace. We have seen a considerable equalisation of rotation strength between convex and concave side (initially twisting to the concave side was weaker).



    Some questions

    You mentioned a plateau after 6 months after which little improvement occured. Did your clients stopped the torsorotation at that stage, or have they kept going until the end of the growth spurt? If so, did they continue twice weekly? Some kept going, some stopped before ended growth spurt.



    Similarly to what i asked a year ago, are you still following your initial study group and has stabilisation been maintained.? I have followed some and stabilization has been maintained.


    Since nov 2004, are you still taking on new clients and have results been comparable? Yes, the results remain the same.



    For the benefit of other scoliosis patients who do not live within traveling distance from where you work; are you aware of any other centres were a similar treatment is available? Any places which has a torso rotation strengthening machine should be ok.

    Are you aware of any other published research on the subject since your original article, or is any further publication being planned? So little response resulted from the original reports. I’ve stopped a formal study, and don’t plan to publish further. It awaits the interest of a recognized scoliosis specialist. Dr Mark Asher in Kansas City has started some studies.

  • #2
    Hi Gerbo...

    I find it a little odd that he doesn't intend to do a followup study. I'm guessing that the small amount of initial reaction was due to a lack of followup.

    Regards,
    Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

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    • #3
      one factor could be that he is well in his sixties (i believe) semiretired and maybe just cannot be bothered.

      Still, he mentions that Mark Asher is doing follow up studies, so we might hear more in the future

      gerbo

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      • #4
        He looks more like he passed his sixties long time ago...

        Comment


        • #5
          Thanks for doing this Gerbo ! It's definitely something which shows promise and I would have Deirdre in this program if not for the fact that she's only 5 years old

          Canadian eh
          Daughter, Deirdre born Oct 2000. Diagnosed with 60 degree curve at the age of 19 months. Serial casting by Dr. Hedden at Sick Kid's Hospital. Currently being treated by Dr. Rivard and Dr. Coillard in Montreal with the Spinecor brace and curve is holding at "2" degrees. Next appointment 2008

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          • #6
            if symmetric exercises "hold" the curve, one wonders what would happen if you only would train towards the concave side and ignore the convex side altogether..........

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            • #7
              Didn't the symmetric exercises "correct" and not just "hold" ? I looked up Dr. Mark Asher and he is a past president of the SRS.
              Last edited by Celia; 05-26-2006, 09:03 AM.

              Canadian eh
              Daughter, Deirdre born Oct 2000. Diagnosed with 60 degree curve at the age of 19 months. Serial casting by Dr. Hedden at Sick Kid's Hospital. Currently being treated by Dr. Rivard and Dr. Coillard in Montreal with the Spinecor brace and curve is holding at "2" degrees. Next appointment 2008

              Comment


              • #8
                torso rotation at home?

                I emailed Dr. Mooney a while back also to see if there is anyone here in Texas that uses this program, he was not aware of any. I was also thinking along the same lines as Gerbo, what if you only train the weak side (concave?) and stretch the other side. I would have also assumed the concave side requires strengthening but have seen some conflicting reports.
                http://www.sportsinjuryclinic.net/cy...engthening.php

                http://www.erikamaude.com/introduction.html

                The first link definitely says outside of curve requires strengthening.

                The 2nd link is a download for the Schroth method. Refer to page 813 of that article. The diagram indicates the outer curve is overstretched.

                If anyone has time to look at these, please let me know how you would interpret them.

                Also, does anyone know if you can achieve this type of exercise at home, with or without equipment? I would be very interested in trying this method out for my daughter.

                Sherie

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                • #9
                  Sherie, i noticed that as well. When it says outside the curve, does it mean to the right of the S-curve(rib hump), or to the left(when seen from the back). By the way, there is no page 813 in the article as you mention, it only goes to page 12.

                  All exercises that has been prescribed by my chiropractor is the opposite of what the first link's studies states. I've always been trained to strengthen the weak side and stretch out the muscles being compressed by the rib hump.
                  Last edited by Jinseeker; 05-29-2006, 05:52 AM.

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                  • #10
                    Jin, that is page 4 of the schroth article (printed out is page 813).

                    My daughter is also under chiropractic care along with the Spinecor brace. Her curves are t34/l45. She is getting electric stim in 2 places. One is on the concave side of the lumbar curve to help strengthen those muscles (thus, confirms the notion that those muscles should be strengthened) the other location is on the convex side of lumbar curve but way down on the side to help derotate the spine. She is also doing flexion/distraction, adjustment, stair stepper with traction and recently started vibration therapy. He is going to eventually integrate more into this routine.

                    I would be interested to find out about the treatments you are receiving and what are the results so far, Sheena's only been on this program for 7 weeks.

                    Thanks for your input,
                    Sherie

                    Comment


                    • #11
                      I'm not in any intensive program right now with a chiropractor. I only visit my chiro once a month, and all he does is adjust the soft tissues around my spine and neck to re-establish posture and proper alignment by helping the muscles out. My chiropractor doesn't believe that intensive exercise therapy can do anything to reverse a structural-scoliosis curvature of my degree, but my previous one has. I for myself, only feel i need to undergo such intensive therapy if i am in constant pain, but i am intersted otherwise with the philosophy of these techniques because i want to strengthen muscles of my body the right way by going to the gym.

                      I still do want to know which side of the back is outside of the curve, though.
                      Last edited by Jinseeker; 05-31-2006, 04:20 AM.

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                      • #12
                        Here's a study which supports the role of exercise in idiopathic scoliosis. Of interest is the following:


                        "It has been reported that RVAs is an expression of the resultant muscle forces, which act on each rib. It was also suggested that RVA asymmetries by weakening the spinal rotation-defending system are aetiological for idiopathic scoliosis, (Burwell et al 1992). This study shows that scoliotic children with small curves have underdeveloped thoracic cage compared to nonscoliotic counterparts. The differences are more apparent in the scoliotic children with thoracic curves. It is suggested that the differences of the RVAs between right and left side in this group are an expression of asymmetric muscle forces acting on the thoracic cage. It is concluded that asymmetric muscle forces participate in the pathogenesis of idiopathic scoliosis on the thoracic cage, which deforms early"





                        1: Stud Health Technol Inform. 2002;91:20-4. Related Articles, Links


                        Study of the rib cage deformity in children with 10 degrees-20 degrees of Cobb angle late onset idiopathic scoliosis, using rib-vertebra angles--aetiologic implications.

                        Grivas TB, Samelis P, Chadziargiropoulos T, Polyzois B.

                        Scoliosis Clinic, Orthopaedic Department, "Thriasio" General Hospital G. Genimata Avenue, Magula, 19600 Greece. grivas@dias.itel.gr

                        The aim of the study is to compare the rib-vertebra angles (RVAs) between children with 10 degrees - 20 degrees of Cobb angle late onset idiopathic scoliosis (LOIS) and non-scoliotic children. MATERIALS AND METHOD: The RVAs of 47 children, with mean age 12.4 years, who presented LOIS with a Cobb angle 10 degrees - 20 degrees, were studied. The children were classified into three groups according to the site of the scoliotic curve: 17 children had thoracic (T), 14 children had thoracolumbar (TL) and 16 children had lumbar (L) curves. The RVAs of the scoliotic children were compared to the RVAs of 60 non-scoliotic children of a similar age group, who were studied in the past. RESULTS: The comparison of the right and left RVAs within each group showed that the children who had: T curves differ at the level T4, T5, T6, T7 and T8, TL curves differ at the level T3, and L curves differ at the level T7 and T12. The comparison of the ipsilateral RVA's between the scoliotic groups showed that between: T and TL curves there are no differences at any thoracic level, between T and L curves the RVAs differ at the T7 level on the right side, whereas there are no differences between the RVAs on the left side, between TL and L curves the RVAs differ at the level T5, T6, and T7 on the right and at the level T5 on the left side. Comparing the RVAs between the scoliotic and nonscoliotic children, it was apparent that the scoliotic children rib cage had lower RVAs (p<0.01) at almost all thoracic levels. DISCUSSION: It has been reported that RVAs is an expression of the resultant muscle forces, which act on each rib. It was also suggested that RVA asymmetries by weakening the spinal rotation-defending system are aetiological for idiopathic scoliosis, (Burwell et al 1992). This study shows that scoliotic children with small curves have underdeveloped thoracic cage compared to nonscoliotic counterparts. The differences are more apparent in the scoliotic children with thoracic curves. It is suggested that the differences of the RVAs between right and left side in this group are an expression of asymmetric muscle forces acting on the thoracic cage. It is concluded that asymmetric muscle forces participate in the pathogenesis of idiopathic scoliosis on the thoracic cage, which deforms early.

                        Canadian eh
                        Daughter, Deirdre born Oct 2000. Diagnosed with 60 degree curve at the age of 19 months. Serial casting by Dr. Hedden at Sick Kid's Hospital. Currently being treated by Dr. Rivard and Dr. Coillard in Montreal with the Spinecor brace and curve is holding at "2" degrees. Next appointment 2008

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                        • #13
                          Originally posted by Celia Vogel
                          Didn't the symmetric exercises "correct" and not just "hold" ? I looked up Dr. Mark Asher and he is a past president of the SRS.
                          slight correction at the most, so you might as well call it holding

                          mark asher is a serious spinal surgeon, so if he is interested, there must be something in it

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                          • #14
                            I would have also assumed the concave side requires strengthening but have seen some conflicting reports.
                            to me it is quite clear that it is rotation towards the concave side, which usus paraspinal muscles on concave side, which is weaker. Mooneys result clearly confirm that in my opinion


                            Also, does anyone know if you can achieve this type of exercise at home, with or without equipment? I would be very interested in trying this method out for my daughter.
                            if you cannot find the specific medx equipment close to wear you live, try to find a gym with a torsotwist or torsorotation machine of any make, that better then nothing i think. Homeexercises are a nonstarter in my opinion as they are unlikely to target the right type of muscles as precise as the equipment does.

                            Feel free to ask me again once you found a machine as i can advice you on some of the pitfalls we encountered

                            Comment


                            • #15
                              Here's a study which supports the role of exercise in idiopathic scoliosis
                              interesting

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