Page 1 of 2 12 LastLast
Results 1 to 15 of 233

Thread: Rehabilitation of adolescent patients with scoliosis—what do we know?

Hybrid View

Previous Post Previous Post   Next Post Next Post
  1. #1
    Join Date
    Apr 2009
    Posts
    1,251

    Rehabilitation of adolescent patients with scoliosis—what do we know?

    In 2003 Dr. Hans Weiss wrote the above article with the editorial assistance of Martha Hawes. It was published in Pediatric Rehabilitation, 2003, VOL. 6, NO. 3–4, 183–194.

    The file is too large to upload to the NSF forum, and yet it is an article which contains information that those of us interested in non surgical rehabilitation would find most interesting.

    For those not familiar with his work, for decades he oversaw the operations of the Schroth Clinic in Germany, which is the gold standard of non surgical treatment in Europe. In the last decade, a reported 3,000 patients (approximate) have been treated there on a yearly basis, with varying degrees of success - many with most impressive results. This makes Dr. Weiss (MD (surgeon) and German School Chiropractor), someone who has seen and treated more scoliosis patients than anyone else in the world. Making him someone I pay attention to, with no exception.

    There are answers to many questions in this paper. Of note also, Dr. Martha Hawes (who reduced her adult curvatures through non surgical methods, on a level matching reported surgical outcomes in cases like her own), provided him with editorial assistance in this paper. Martha did not use the Schroth method, which leaves me questioning, what were/are the elements of her own therapy which may share some commonality with Schroth? Improvement of chest wall, with exercise specific to curvature pattern, comes immediately to my mind.

    For others who may wish to read this article, it can be accessed in another forum, found here in posting #10: http://www.fixscoliosis.com/threads/...-Cor-Pulmonale

    Access is limited to members I believe - but membership is open to all at no charge, and posting is optional :-)

    Since NSF does not allow uploads of files this large - I'm just passing the info along to those who are interested.

  2. #2
    Join Date
    Apr 2009
    Posts
    1,251

    An equestrian thing ...

    As some know, Dr. Weiss is an equestrian in his spare time. I was watching a few of his videos on his Youtube channel this evening and stumbled across one he had listed as a favorite of his.

    Reminded me of my youngest sister who passed many years ago - she could ride like Stacey Westfall, having a special bond with a quarter horse named Sugarfoot. No bridle, no saddle .. only love. Enjoy!

    http://www.youtube.com/watch?v=a-7v8Ck1crg
    Last edited by mamamax; 07-06-2010 at 07:18 PM.

  3. #3
    Join Date
    Apr 2009
    Posts
    1,251

    Rehabilitation - AIS - Schroth Update 2010

    Full Text Article (Weiss, Goodal, 2010) available in English, Spanish & French:


    The change from the classical 'teacher / pupil' setting to modern concepts of learning seem to allow a reduction of total training time of in-patient scoliosis rehabilitation to 14 days or even less, without reducing the effectiveness of treatment (Weiss et al. 2006a). The role of the physical therapist changes from being that of a teacher to a supervisor, who acts as a catalyser to empower the active role of the patients and to foster the ability of the patients to develop their individual treatment protocol by themselves via experiential learning.

    This new concept called 'Integrated Scoliosis Rehabilitation (ISR)' is currently applied (Weiss 2007a) at the first few centres. 'Integrated' is used to describe the teamwork of all professionals 'acting as one'. The physician, physical therapist and (where available) psychologist are integrated in each others' work and are acting together in synchronicity in the diagnosis and treatment.

    The limitation of this concept is that it is restricted to patients where scoliosis is the major problem. Patients with neuromuscular scoliosis and patients with a significant reduction of learning capability cannot be included in this treatment. The majority of the scoliotic population however, patients with idiopathic scoliosis (80 – 90% of all scoliosis) can easily be treated using the ISR - approach.

    As has been shown, Scoliosis Intensive Rehabilitation (SIR), in its original form can no more be regarded as being effective when rehabilitation times have been reduced to 3-4 weeks, only (Weiss and Goodall 2009). The incidence of surgery for the patients receiving this in-patient program (Weiss, Weiss and Schaar 2003) is comparable to out-patient approaches (Maruyama et al. 2003, Rigo, Reiter and Weiss 2003), although the different studies have patient samples which are not necessarily comparable. The development of such research means that more intensive out-patient approaches seem more appropriate when one considers; time efficiency and new teaching approaches including experiential learning (ISR), as described within the book on "Best Practice" treatment (Weiss 2007a). Therefore an in-patient program, such as SIR is today regarded as outdated. Actually three day intensive programs based on the "experiential learning" approach of ISR are provided in the US, UK and in Germany at the first authors centre.

  4. #4
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,297
    Quote Originally Posted by mamamax View Post
    Actually three day intensive programs based on the "experiential learning" approach of ISR are provided in the US, UK and in Germany at the first authors centre.
    I predict the Schroth centers in the US will be slow to adopt this if it is much less lucrative than in-patient treatment as is likely the case. In fact I doubt any of them will do this.
    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."

  5. #5
    Join Date
    Apr 2009
    Posts
    1,251
    I can appreciate the above comment, and am even grateful for it - thank you, sincerely.

    What will such mean into the future? A good question. From the above article: The majority of the scoliotic population however, patients with idiopathic scoliosis (80 – 90% of all scoliosis) can easily be treated using the ISR - approach.

    If ISR were widely implemented outside of large centers, this means large centers can only capture about 20% (and maybe far less) of the patient population, making large centers perhaps not so profitable. If the new Schroth is implemented on a large scale throughout the country, say in hospital affiliated PT departments, will large centers be able to remain open? If a patient is in the typical scoliotic population, they could benefit from a new Schroth implemented in hospital affiliated physical therapy departments - if one is not in the majority population, it is possible that treatment could become more difficult to obtain. A conundrum - with many unknowns.

    It would seem the answer would be - to do both. Implement ISR in the large centers and also in hospital affiliated PT departments. Now the question becomes, will this be lucrative enough for the hospital affiliated therapy departments? The answer to that would seem at first, driven by geographics and patient population. Florida looks like a good start .. you know, home of the newly wed and the nearly dead ;-)

    ISR covers a lot of territory. Application can be found as a non-surgical choice or post surgical choice when pain remains an issue. It will be interesting to see how its future unfolds. In the end if there were only one center in every major city in the country ... there would still be more than enough work to go around ... I think. And finances would have to become creative (like mine).

    Bty ... excellent equestrian history above.

  6. #6
    Join Date
    Apr 2009
    Posts
    1,251

    Just a little horsin' around :-)


  7. #7
    Join Date
    Apr 2009
    Posts
    1,251

    What Happened Here?

    I was reviewing this thread this evening ... trying to figure out what happened that would cause such an uproar in responses, verging too closely upon what could be viewed as character assassination of one of recent history's most important people in the world of scoliosis rehabilitation.

    After posting links to some videos on a Youtube channel created by Dr. Weiss, and commenting scary ... what next? The what next turned out to be an onslaught of Flying Monkeys. You know, the evil witch's minions from the Wizard of Oz. No matter that my use of the word scary was slang, for a big wow - look at this! I think I shall use less slang in the future. I tried to recover with a light hearted film festival review - and failed horribly ... the monkeys kept flying. My first and last film festival review, will leave that to the professionals in the future. Why would so much come into question, on a personal level which included even his equestrian abilities - without any talk of the literature? Good question. I have no answer.

    The Internet providing a fairly transparent world, Dr. Weiss got wind of our conversation and posted a response to us on Youtube. The verbiage found Here!. We were introduced to, and invited - to do mirror work. This may be a first in NSF forum history - though I can't say it is one to be necessarily proud of.

    Reminded me of a similar time when the president of the National Scoliosis Foundation was attacked in forum and he responded with Setting The Record Straight. There are other moments it reminded me of also, but they are too numerous to mention here.

    Forum member (and Schroth-mom) Susanna, stepped in to give us a Reality Check. It didn't seem to matter. The monkeys still flew.

    The NSF forum postings turn up over and again in Google searches. Ever wonder how all this looks to those outside our inner circle - to the eyes watching around the world? At best I fear we look ignorant - at worst, like the people for whom the term Ugly American was coined. Ignorant bty, does not mean stupid, but rather implies a "not knowing."

    Where do we go from here? I cannot speak collectively for the Flying Monkeys - but if I could, I would say ....

    Please forgive us - we did not know what we were doing - and we did not understand from where the video Scoliosis Girls came, or how it was used. In truth we know little about Schroth. We were having a psychotic moment.

    Our forum is un-moderated for the most part - and this is what will happen sometimes when there is no moderation among a large group of people. On one hand we enjoy a great deal of freedom - on the other, maybe sometimes such as this, such freedom is wasted in ignorance. We are not bad people - but we do sometimes behave badly.

    What did we learn? I hope, a lot. Time will tell in the future threads to come.

    Sincere apologies extended to Dr. Weiss, his patients, and his family.



    Last edited by mamamax; 07-29-2010 at 08:31 PM.

  8. #8
    Join Date
    May 2009
    Posts
    3,729
    just who are you calling a "flying monkey"???

    no apology to Dr Weiss is needed...and certainly not wanted by many MANY folks on forum who find his videos anywhere from offensive to repulsive...

    so don't apologize for me...i stick by what i say...and i DON'T have "psychotic moments"!!!

    as far as "looking ignorant"...or "not knowing"...i am a licensed clinical social worker...i know inappropriate when i see it....seen it many times...and that video IS INAPPROPRIATE!!!

    jess
    Last edited by jrnyc; 07-31-2010 at 10:47 AM.

  9. #9
    Join Date
    Nov 2005
    Posts
    399
    Mamamax, I believe Hans Weiss didn't fully appreciate the cultural differences between Germany and the US/UK. They are a lot freer about their bodies in Continental Europe and in several countries can start sexual relationships very early on (if with someone of around the same age).

    Braces are typically worn here by very young girls until they are deemed to have stopped growing, which is usually around two years after the onset of menses. For most girls this would be by the age of 16. It therefore appears to us that Hans Weiss, a guy in his 30s (in those videos), is singing about how young girls of 15 and below should feel sexy. In the US and UK, that's really not acceptable. I don't know about the US, but in the UK the "Age of Consent" is 16 and we view adults who consider younger girls to be sexy in a very dim light.

    He even shows himself biting the leg of one young girl, and it is really very difficult for someone in the US or UK to understand why he would do that. It's a very sexual image, but again, he's in his 30s and the girl is very young. Naturally to US or UK eyes, that appears "creepy". Maybe in Germany adult men go around biting the legs of young girls all the time though? It is difficult for me to get my head around, and I am at a loss. I don't think that image is acceptable at all and to my English eyes it makes him look like a sexual predator because it appears that he finds such young girls in braces sexy.

    I'm sure that he made the videos with good intentions, but I think that Hans Weiss made a great error of judgement in making them available to the entire world, and that the reaction he got was natural and completely unsurprising, especially given that a lot of people here are the parents of young girls.

  10. #10
    Join Date
    Apr 2009
    Posts
    1,251

    False Accusation

    jrnyc - If I have to point out the Flying Monkeys ... then my message is lost.



    tonibuny - Maybe Hans did not appreciate the cultural differences. If so, then something has been learned. Seems we are all constantly learning new things. If we are not learning, then maybe we are not living. Errors in judgment can be the best teachers - I don't know anyone who has never made an error, especially when trying new things.

    Speaking of cultural differences, I correspond with a woman in Germany who is in her 20's and bracing under the guidance of someone taught by Dr. Weiss. So maybe bracing in Germany is not always halted at skeletal maturity. Her results have been amazing. It is possible we have much to learn from Dr. Weiss, that would be to our benefit.

    The movie was done more as a spoof - than as some serious cultural message. The Schroth-mom upthread - no doubt her comments have been echoed around the world. So in context of the Clinic, and its setting ... it was no more than a upbeat motivational tool. This video does not a Roman Polanski make. I think it is a pity that it has been largely misunderstood and completely blown out of proportion. Truth is, one can see it from many perspectives - the choice is individual.

    I agree with you, I am sure the videos were made with good intentions. I would go further and say they are innocent in the context from where they came.

    I've been thinking about Dr. Weiss .... what a high energy man this must be. Looking at the publishing of books etc., that he has done - the clinical hours and research - private practice - a family to take care of .... and .... artistic talent which borders on the high end of amateur, oh - and yes, the equestrian thing. Pretty amazing. How does he find time for all this? Well, I guess, he makes the time - just another admirable attribute.

    False accusation - is an evil thing. The evidence here his highly circumstantial. Let us not falsely accuse this man .... he, and his family - have given more to this world in the area of scoliosis rehabilitation than any in the history prior to the last three generations. The contributions serve both those seeking to improve the quality of their lives, as well as those for whom surgery has failed (in certain circumstances where pain remains an issue).

    A few nights ago, I cleared my head of all this chatter ... and watched Scoliosis Girls from the perspective of a patient in the Clinic. I would have come to this clinic looking for a way to become more normal. At age 11 when I was diagnosed, by age 12 I had accepted that there was something wrong with me, I was different (in my mind), and not as good as my peers. From this perspective, the video made me smile, and even laugh - and for a moment, my deformity meant nothing, and carried no sadness. That is the message of this video - for those watching with a clear head.

    In the end - all the false accusation has been - Much to do about: nothing. Judgment of wrong doing has been made in haste, and the judgment is faulty. And when a man (or woman) has been falsely accused - apology is due, as it is in this case - to both the man, his patients, and his family.

  11. #11
    Join Date
    May 2009
    Posts
    3,729
    your message is lost because of how wrong and misguided it is...i know quite well who your flying monkeys are SUPPOSED to be...but i ain't a flying monkey, and neither are the others who find your doctor's videos disgustingly wrong!

    i think thee dost protest too much!! and at such length! on..and on....and on...and on...and on...and on...if anyone wanted to look up your dr weiss, they could do it without your misguided help.

    jess

  12. #12
    Join Date
    Nov 2005
    Posts
    399
    Serious errors of judgement are not something I want to see my doctor making though, especially not in public

    I found the videos amusing and also shocking; I couldn't believe he'd shot himself in the foot so massively. He certainly has a talent for writing a catchy hook, but music, horseriding and other activities like that don't make him a better medical doctor. Do I think he's any kind of pervert? Absolutely not. Do I think he's given the impression that he's quite dodgy because he's an adult who sings about young girls in braces being sexy and bites the leg of one of them? Yes, obviously he has. It's understandable that people here are quite outraged by that, and that some will think he's a pervert.

    He's been a bit dim, but I'm sure he'll have learnt from this. I've dealt with him before and he comes across as a decent, committed individual - whatever I think of his methods.

  13. #13
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    7,187
    Quote Originally Posted by mamamax View Post

    Access is limited to members I believe - but membership is open to all at no charge, and posting is optional :-)

    No, not all.

  14. #14
    Join Date
    Aug 2009
    Posts
    1,136
    Well, this is going to have the odd effect of me responding, spookily, to nothing at all, but, here goes.

    The link was interesting, but it's still science working out the details *based on a received moral code.* So, it's using scientific methods to test an already-established worldview, which has no (and can have no) scientific basis.

    For example, in the second study, babies show that they can tell "good from evil" by rewarding "good" behavior like "helping those in distress." But I see nothing which indicates exactly how they decided that "helping those in distress" *is* good behavior. It's just a received moral code, no different from religion. There's no way, within science, to decide what *is* good and evil. That judgement has to come from the encompassing worldview.

  15. #15
    Join Date
    Aug 2009
    Posts
    1,136
    hmm, that didn't seem to go through.

    But . . . then you can claim that anything is an axiom, "self-evident" and not requiring of investigation.

    Why not take as self-evident any piece of cultural consensus, like the once-belief that women are not being capable of handing heavy intellectual lifting, and just use science to show why that is so? In what way is that "good science" - it's just providing the details to back up an un-investigated worldview.

    Right? Aren't your "self-evident axioms" a "way of knowing."

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •