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Thread: SOSORT paper with discussion of Dolan's metanalysis

  1. #31
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    Finally had a chance to look at one of the bracing studies that did not make Dolans metanalysis (because they included excercise therapy with bracing).

    I looked at the Japan study (Maruyama, their Table 1 is attached. They had a 6% surgical rate (indication for surgery was 50*). Much better than the results of the metanalysis would suggest (23*). Both Dolans Table is attached as well as Table 1 from Japan (Which is Dolan's number 11 on her chart).

  2. #32
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    bracing plus exercise

    Are you saying that the Maruyama sample was children treated with bracing plus exercise?

    My doctor instantaneously slammed the idea of exercise to slow or stop curve progression. I googled for a while and came to the conclusion that he was correct.

    Maybe not.

  3. #33
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    Quote Originally Posted by Dingo View Post
    Are you saying that the Maruyama sample was children treated with bracing plus exercise?
    That is what I am saying.

    I am not attributing the difference in results to the excercise, simply saying that this sample was excluded from the metanalysis solely because of the excercise.

    Quote Originally Posted by Dingo View Post
    My doctor instantaneously slammed the idea of exercise to slow or stop curve progression. I googled for a while and came to the conclusion that he was correct.

    Maybe not.
    All depends what you google. Most US doctors would agree with your doctors opinion. Many (most?) European doctors may disagree with him.

    Which sort of has me thinking about Sharons comment in the closed (or vanished?) thread about why are americans susceptable to woo woo treatments. Hmmmm, maybe our stubborn insistence against excercise is the woo woo part. Maybe we shouldnt be totally closed minded about the europeans approach. I dunno. But looking at results like this 6% surgery rate makes you think a bit anyway.

  4. #34
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    got me thinking

    But looking at results like this 6% surgery rate makes you think a bit anyway.

    All 4 of these studies found that torso rotation exercises stopped and even reversed curve progression at least temporarily. The studies weren't longterm and some period of time after exercise stopped curve progression resumed. One thing I found interesting was that children with Scoliosis have a strong side and a weak side. Exercise eliminated that symptom.

    April 2000 - A preliminary report on the effect of measured strength training in adolescent idiopathic scoliosis.

    2003 - The Role of Measured Resistance Exercises in Adolescent Scoliosis

    2006 - Trunk rotational strength training for the management of adolescent idiopathic scoliosis (AIS).

    July 2008 - Treatment of adolescent idiopathic scoliosis with quantified trunk rotational strength training: a pilot study.
    Last edited by Dingo; 05-01-2009 at 02:48 PM.

  5. #35
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    I cant wait to hear what the rest of the villagers think about those papers.

  6. #36
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    In re the Japanese study... is that the rate at which folks actually got the surgery or the rate at which they hit or exceeded 50*?
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

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  7. #37
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    Quote Originally Posted by concerned dad View Post
    I cant wait to hear what the rest of the villagers think about those papers.
    How this villager feels about those papers

    Love,
    a villager
    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."

  8. #38
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    Quote Originally Posted by Pooka1 View Post
    In re the Japanese study... is that the rate at which folks actually got the surgery or the rate at which they hit or exceeded 50*?
    That is the surgical rate. They said they wait till 50 degrees for surgery. They also mentioned that others used 45 degrees as an indication for surgery which might explain a bit of their low rate.

    I didnt read it carefully enough to see if any people refused surgery once they passed 50 degrees. But looking at the non-surgery column in their table, the after bracing number plu one standard deviation was still below 50 degrees so it couldnt have been many (if any) I suppose.

  9. #39
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    Quote Originally Posted by concerned dad View Post

    All depends what you google. Most US doctors would agree with your doctors opinion. Many (most?) European doctors may disagree with him.

    I've been talking to a German guy who runs a scoliosis forum. Apparently, Schroth and other exercises for scoliosis are still seen as very much a "fringe" treatment in Germany and other European countries, rather than being the norm. I thought that was quite interesting to note.

  10. #40
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    Quote Originally Posted by tonibunny View Post
    I've been talking to a German guy who runs a scoliosis forum. Apparently, Schroth and other exercises for scoliosis are still seen as very much a "fringe" treatment in Germany and other European countries, rather than being the norm. I thought that was quite interesting to note.
    That is entirely to be expected. Europe isn't a backwater. They are out ahead of the US on a lot of things.

    If Schroth et al. was efficacious, the world would know it by now.

    Yet the world is still waiting.
    Last edited by Pooka1; 05-01-2009 at 08:28 PM.
    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."

  11. #41
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    Quote Originally Posted by Dingo View Post
    Here is my not entirely scientific 2 cents on bracing

    1) There are studies that indicate bracing works, marginally works or doesn't work at all.
    Analysis: Bracing just barely comes out ahead on this one.

    2) Bracing lowers Calmodulin levels which are the prime mover in curve progression.
    Analysis: Clear evidence that bracing could work.

    3) I've read at least 100 posts that give me anecdotal evidence that bracing works.
    Analysis: Not scientifically strong but still believable evidence that bracing works for some kids.

    Add it all up and I say bracing works.
    You left out #4; There are many times more than 100 posters (not posts) in the adult surgical area who were braced kids.

    It's my belief when someone claims a brace worked it's PURELY anecdoctal: There's no way to gauge what a curve would have done on its own. The stories of brace failure told by those who have worn braces, and gone on to have surgery as a juvenile, adolescent, or many years down the road as an adult, however, are as far from anecdoctal as it gets. We did it ... and it didn't work.

    You certainly can't claim a child who was braced, thought to be stabilized, yet later requires surgery as an adult, a "bracing success".

    I think the only correct leap of logic you've made is bracing *may* be effective in kids who are susceptible to bracing. And I'll stop there ... there's already a huge thread devoted to this debate.

    Pam
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  12. #42
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    Quote Originally Posted by concerned dad View Post
    Dr Dolan mentioned in her paper that her confidence in the braced surgical rate was high. These SOSORT guys seem to disagree.
    It stands to reason Dolan can state she has more faith in the braced surgical rate. Kids don't typically show up for an initial consult with an SRS doc with a 60 curve: They generally show up early, and unless there are mitigating circumstances (curve too large, bone age too mature, patient/parent refuses to brace), they are usually braced as a first measure. There's a lot of documentation on kids who go on to need surgery after first being braced.

    From what I've read here over the years, it's my perception a higher number of patients who elect to go the alt route (and futz around with a non-surgical SOSORT types) are no more or less likely to end up having surgery. They do, however, seem to present with a higher degree of curvature when they finally see a *real* doctor, are usually unclear how severe their curve even IS, and later feel they wasted a lot of valuable time trying to exercise their curves away.

    In no way am I saying exercise hurts - even I had prescribed exercises (in brace and out) back in 1978. I still don't understand precisely why Dolan excluded that group, and what exactly is her definition of exercise that warrants exclusion?
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op 53, Post-op < 20
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
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