spinecor

[jgd1991]

Do your own research

I think the chiropractors charge more *coughs* because they do some phoney baloney eye exercise testing to "correct" the scoliosis.

I would be careful to discredit someones work without giving good back up research to support your opinion.
There seems to be a number of research articles connecting scoliosis to a vestibular problem.
I think that the additional cost to evaluate the vestibular system is worth doing, based on my readings.

For example i found this paper

ARE ASYMMETRIC OTOLITH VESTIBULO-OCULAR REPONSES A
PREDICTIVE FACTOR FOR IDIOPATHIC SCOLIOSIS IN CHILDREN?

Sylvette R. Wiener-Vacher, and Dominique Antolini., Nn. 1

In idiopathic scoliosis spinal deformities start to develop at the time of the initial rapid growth at the
onset of puberty. A suggested cause of IS is a disequilibrium in the otolith vestibular control of the trunk
muscles. Supporting this hypothesis our previous results (2) showed that 67% of children with IS, but no
other inner ear or neurological abnormalities, had an asymmetry of their otolith vestibulo-ocular reponses
to the Off Vertical Axis Rotation test. These were significatively greater than in a control age-matched
group of normal children. We suggested that this asymmetry was a central otolith vestibular system
disorder and could lead to a vestibulospinal system imbalance, which would then provoke IS.
The goal of this study was to determine if this asymmetry exists prior to the appearance of the spinal
deformities.
Our preliminary results show that the vestibulo-ocular asymmetry appears before the spine starts to show
any significant clinical and radiological deformity.
In patients at risk for IS (e.g. a family with IS history) screening for otolith functional asymmetry could
be used as predictive factor of scoliosis and help for earlier prescription of IS preventative treatment.

1
Thanks to the Cotrel Foundation (Fondation de France) for supporting this research.
2 S.R. Wiener-Vacher, K. Mazda. Asymmetric otolith vestibulo-ocular responses in children with
idiopathic scoliosis. J. Pediatr 1998 ;132:1028-1032.

[Celia]

The goal of this study was to determine if this asymmetry exists prior to the appearance of the spinal deformities.
Our preliminary results show that the vestibulo-ocular asymmetry appears before the spine starts to show any significant clinical and radiological deformity. In patients at risk for IS (e.g. a family with IS history) screening for otolith functional asymmetry could
be used as predictive factor of scoliosis and help for earlier prescription of IS preventative treatment.

I don't see the point of expensive *tests* by chiropractors if the children that go there *already* have scoliosis and as the above study points out "vestibulo-ocular asymmetry appears before the spine starts to show any significant or radiological deformity". What exactly are the chiropractors planning to do with their results ????? Brain surgery ?????

[jgd1991]

Vestibular Rehabilitation

The vestibular Systems controls the muscle tone of the back muscles surounding the spine . If that system is not working symetrically, the scoliosis is being supported in negative way. Vestibular exercises have been well established and in the research. I rather have this system working with me then against me.
These are two more research papers conecting the vestibular system to scoliosis. I think they are on to something very important. I'm certainly not going to dismiss efforts being put in a direction that may help.Abstract from Scoliosis Research Society (SRS) 2003 Meeting

Matthew T. Provencher M.D., Derin Wester, Ph.D., Bruce Gillingham M.D.; Naval Medical Center- San Diego, CA. Orthopedic Research and Education Foundation- Resident Research Grant
Conclusion: A central vestibular deficit is present in scoliosis patients. Central vestibular function is worse with larger curves, and the dysfunction is opposite to the curve. Curves with location in the mid-thoracic region demonstrated less central deficit than low-thoracic and lumbar scoliosis curves. The data supports a central vestibular dysfunction in patients with scoliosis.



A study of labyrinthine function in patients with adolescent idiopathic scoliosis. I. An electro-nystagmographic study.

Spontaneous nystagmus (SN) and positional nystagmus (PN) were found in 24 out of the 47 patients with single curvatures and in only one subject in the control group (P less than 0.001).

Significant differences were observed in the caloric response between right and left scoliotic patients (P less than 0.05). The right convex patients had a sensitivity dominance in the right labyrinth and the left convex patients in the left labyrinth (Acta Orthop Scand 1979 Dec;50(6 Pt 2):759-69 Sahlstrand T, Petruson B.)

[Celia]

Vestibular exercises have been well established and in the research.

You mean eye exercises ? Where is it well established ?

[cherylplinder]

This may be a factor in scoliosis, but it is one theory of possible causes. It may deserve further study, and probably does. But should the patient pay huge sums to be the recipient of such research? I highly question, not the study, but the profit from the study. That, I think, is where Celia is coming from...

A true researcher is not going to charge astronomical sums. A true researcher rather is looking for a participant willing to take the risk to be a part of his study.
The vestibular component of scoliosis and treatment of that component of scoliosis are still under research.

I think this practice is a racket motivated by profit. It cannot cost 3000 dollars a patient to run these tests and teach the exercises. There is no documentation that these exercises do anything to help the scoliosis. Therefore, they are still experimental. I think it is highly suspect to charge such astronomical sums and prey upon the fears of the parents and patients.

When and if this is ever a well documented treatment for scoliosis, it would be ethical to charge a reasonable fee.

[christine2]

Well said Cherylplinder !!!

Dr. Rivard's Office visit was only $100. and he spent approx. 3 hours on my daughters case.

Christine

[Celia]

Dr. Rivard's Office visit was only $100. and he spent approx. 3 hours on my daughters case.

Christine

The man is a Saint! I have to agree with Christine that Cheryl made some EXCELLENT points


jgd1991,


Nowhere in the studies that you have referred to, does it elaborate on how to *correct* this asymmetry. You are trying to legitimize these bogus eye exercises which are totally unproven by referencing studies conducted by *true* researchers such as the Cotrel Foundation.

[cherylplinder]

Yes, Dr. Rivard is a Saint. He asks so little for his time, I am tempted to make a donation!

[jgd1991]

Vestibular testing

I have two neices in the Spinecor Brace. They both had vestibular imbalances that are being addressed with home exercises. The reason we brought them to NewYork City for Spinecor was that this was the only office that seemed to address other aspects conected to scoliosis. We also found that most of the other spinecor offices did not offer even the exercise program from spinecor. They offered testing that made sense to us. The Vestibular system controls balance and spinal muscle tone. The fees for the testing ranged from 800-1200 for my neices. This test is a well established medical test and these fees were normal for this test. I' m sure Spinecor also had this type of atitude from patients when they first came out. People were being charged for the spinecor brace and wondering why it should cost the same as a hard brace. Over time people are becoming very happy with results and are glad they found it at almost any price.
In addition, when I was in the new York office for a quartly visit recently with my neices. There was a young child that had been in for 3 months earlier for an examination and had come back for a followup. I was told that the child had a 9 degree curve and was given only vestibular exercises. The parents were expecting that she may have progressed and need a brace only to find out that her curve reduced to less than 1 degree. I was very excited for them and was real happy that we didn't try to cut corners and miss out on any possible benefits from there program.
Everybody has to do what they feel is the right thing to do. I only came on the forum with my coments because I thought people were being guided improperly.

[Celia]

Oh...you're actually a patient ??? You sounded like a chiropractor. These tests are medically established and necessary? According to who ? Do you have studies that show that these eye exercises are nothing but pure fiction ?

[jgd1991]

Vestibular testing and eye exercises

I'm at work but I found a study for you.

Role of vestibular adaptation in vestibular rehabilitation.


Herdman SJ. Department of Orthopaedics and Rehabilitation, University of Miami, Coral Gables, Florida 33146, USA.

Recovery of gaze and postural stability in human beings with vestibular deficits is well documented. The mechanisms that contribute to this recovery form the basis for the exercises used in the rehabilitation of these patients. These mechanisms include the central preprogramming of eye movements and of postural responses, the potentiation of the cervico-ocular reflex, modification of saccadic eye movements, and the substitution of visual and somatosensory cues for the lost vestibular cues. . .

I really think that this is going to be the next Ah ha. of course we should have been doing these exercises.

[Karen Ocker]

for jgd1991

I see that one of the studies was published in 1979 from Scandinavia; are there any more than 3 such studies?
Unless other studies ---with other populations by other researchers replicate those results there is not enough evidence suggesting validity as a basis for a treatment modality. Also, were there any flaws in the conduction of those studies? There were not very many subjects.

What about this problem in blind people; do they get scoliosis? How would they be treated by these vestibular exercises?

I have actually heard about that theory before.

I also read a promising study in Poland(found on PubMed) about "syndrome of contractures" in children.
By diagnosing these contractures early and instituting early PT in these children scoliosis was avoided. The other children in the study, with these contractures, were watched and later developed scoliosis. In the 3rd part of the study PT was instituted later on and scoliosis still developed.

Sounds interesting because, during a hysterectomy last Spring, my surgeon noticed my abdominus rectus on the right was poorly developed; on the left it was normal.
This may explain why early bracing/PT works in minor curves.

Maybe the vestibular problem develops afterward???...if it really exists.


I've always had excellent balance with and without the severe scoliosis.
Chicken before the egg or vice versa???

[Celia]

I really think that this is going to be the next Ah ha. of course we should have been doing these exercises.

I think we may be on to something BIG So, if I have scoliosis and I train my eyes to move in a certain direction this will straighten my spine ?

[gerbo]

such a cynic, you are.....

[Sherie]

"syndrome of contractures" in children.

What is this Karen? I never heard of it, but I believe all these bits and pieces may someday come together to form a picture of what we can look for in children genetically disposed to developing scoliosis. My daughter who's 14, is already questioning wether she should have children for fear of passing it on. It made me sad to hear her say it, but what if they found some commonalities that children could be watched for and treated from a very early stage, then perhaps this wouldn't be a concern.

I am not sure that any of these therapies are beneficial, but I don't agree that all chiropractors who try them are out to get your last dime. I think most of them probably have a real interest in helping their patients. The chiropracors I've seen so far have been compassionate and have a real desire to help. Believe me, if the medical community had something better to offer, I would jump at it, but my daughter seems to be beyond bracing, so what are the alternatives? We could do nothing and hope it doesn't get worse or she can have surgery and be fused in her lower back the rest of her life. Hmmm....I think we'll try the alternatives first.