Treatment: PT using MedX per Mooney & later, McIntire research

[Pooka1]

There's a lot of nice pronunciations in biology.... ;-)

I suppose. :-)

In this case, "toeses" is just the plural of "toes." I had five pigs at that time and "toes" didn't cut the mustard when we had to do the nail clipping. I think "toesi," similar to "focus-foci," is acceptable also. :-)

[Kevin_Mc]

Not a rodent aficionado. (At least not in any way you'd be interested in.) I am, however, a full blown cuteness-factor and tummy-index junkie. With two daughters at home, I am well versed in toeseses (pronounced toes-is-is, i.e. with a triple plural), feetseses, legseses, pantseses and hipseses. For example, how might one put their pants on when getting ready for day care or school that day? Response: I put my pantseses on my feetseses and then I pullses them ups to my hipseses.

Sorry for the hijack AMom.

[Pooka1]

Triple plural! That is pure genius! Your brain is functioning at a very high level.

I genuflect in your general direction. :-)

[AMom]

[QUOTE=AMom;134910]

…but, I was surprised. We didn’t expect such an abrupt change; she dropped from being able to do 20x at 42lbs to 20x at 28 – 36lbs depending on whether the seat was higher or lower than normal (estimated the 28-36 weight because I sprained my ankle & don’t want to walk across the house to get her chart). A 6-14lb change seems to be a wide range considering the weight she is currently moving.

It took 17 weeks for my daughter to be able to move 44lbs on the raised seat cushion (this is the same weight she moves when seated on her regular seat cushion.) Based on her breathing, focus, and facial expression, she appeared to be working harder to achieve the 20x at the lower weights. And, the fact it took over 4 months to even her strength at both seat heights tells me:
1. Her muscles are stronger than when she first began her workouts because the starting weight at the
new seat height was higher than the starting weight in Feb 2011;
2. She progressed at this seat height faster than she progressed initially; and
3. It implies the workout may not be distributing the strength equally.

IF slight variations in seat height distribute strength more evenly, could this help her to better respond to growth spurts?

We will add the third (lower) seat height next Monday. At that point, she will alternate as follows:
Monday: lower seat height
Wednesday: regular seat height
Saturday: higher seat height

I spoke w/ a gym on the East Coast (that has lots of MedX equipment) today and was told they regularly see the girls’ ability to lift a set amount of weight drop when they lower the seat height to accommodate growth. He stated, “…it must be easier to work up higher.” He added they have to reduce both the repetitions & the weight for the girls to continue their workout. He was in the middle of a big project when I called so I didn’t want to keep him long, I may call back in a week and ask a few more questions.

They are using the MedX Lumbar Extension & MedX Medical Core Torso Rotation units 1x per week. By way of comparison, I’m using the VARC & MedX Core Torso Rotation units 3x per week.

Still looking, have any of you CTR users noticed a difference in your ability to lift weight when you were at a slightly higher seat height?

[rohrer01]

I suppose. :-)

In this case, "toeses" is just the plural of "toes." I had five pigs at that time and "toes" didn't cut the mustard when we had to do the nail clipping. I think "toesi," similar to "focus-foci," is acceptable also. :-)

If it's a plurality of an already plural word, such as toes, I would say toesies just because I think it's cute! LOL...

[AMom]

[QUOTE=AMom;134911]

I spoke w/ a gym on the East Coast (that has lots of MedX equipment) today and was told they regularly see the girls’ ability to lift a set amount of weight drop when they lower the seat height to accommodate growth. He stated, “…it must be easier to work up higher.” He added they have to reduce both the repetitions & the weight for the girls to continue their workout. He was in the middle of a big project when I called so I didn’t want to keep him long, I may call back in a week and ask a few more questions.

They are using the MedX Lumbar Extension & MedX Medical Core Torso Rotation units 1x per week. By way of comparison, I’m using the VARC & MedX Core Torso Rotation units 3x per week.

Still looking, have any of you CTR users noticed a difference in your ability to lift weight when you were at a slightly higher seat height?

Found another place using CTR, MedX Core Torso Rotation (not the medical version) & Lumbar Extension, who also noticed strength difference when adjusting seat cushion to address growth. They hadn’t checked to see if there would also be a difference if the seat was raised slightly OR considered the difference may imply the strength is not being evenly distributed.

FYI: They are starting out 2x a week and then reducing it to 1x per week.

Interesting note: I haven’t found anyone else using the Variable Angle Roman Chair as part of their program.

Maybe I should change my goals entirely. I am starting to think I should begin logging how different groups are addressing compliance issues AND THEN take a look at the equipment used as well as the frequency, intensity, & duration of each groups’ workout.

This made me review the time we have invested on the core routine over a period of eleven months. The intervals add up to less than a 2 entire days. Maybe the reason professionals aren't bothering to R/O CTR is because they realize the majority of people are unlikely to follow through.

A Mom

[AMom]

[QUOTE=AMom;135015]

Found another place using CTR, MedX Core Torso Rotation (not the medical version) & Lumbar Extension, who also noticed strength difference when adjusting seat cushion to address growth. They hadn’t checked to see if there would also be a difference if the seat was raised slightly OR considered the difference may imply the strength is not being evenly distributed.

FYI: They are starting out 2x a week and then reducing it to 1x per week.

Interesting note: I haven’t found anyone else using the Variable Angle Roman Chair as part of their program.

A Mom

I came across a local gym using CTR & random additional activities (including a roman chair) to address the needs of both teens & adults with scoliosis. Fewer than 10 scoliosis clients, not using MedX equipment, no particular protocol, and workout is 1x a week. They do not allow clients to use any seat pads or foot rests so they had no experience regarding clients’ changing ability due to positioning. They stated, "…keeping the core strong is why their clients never needed surgery." Shocked, I questioned their assertion and they conceded their clients results could be due to natural progression/ genetics. When further questioned they confirmed they had no research to support their claim.

[Pooka1]

When further questioned they confirmed they had no research to support their claim.

I genuflect in your general direction.

You're good.

Reminds me of what our orthotist said when I asked how many kids he braced and how many had brace failures and then surgery. He said 2 needed fusion out of about 300. LOL.

Some folks will say anything if they don't think people will question them.

[Kevin_Mc]

They stated, "…keeping the core strong is why their clients never needed surgery."

This makes my skin crawl a bit. I just don't think people/clinicians/trainers realize how they are supposed to talk about research or their own results. It seems to be somewhat generated by the idea that only protocols with a perfect track record will be desirable, e.g. why should I go with your protocol that you say 'might' work, when 'they' claim their protocol always works? I think part of this is the clinician's fault and part is the public-at-large's fault. Neither are prepared to accept the limitations/reality of their protocol/disease. Not that this is an easy thing to accept. But I think we miss this sometimes.

[djjane]

We live in southern california. I am wondering where I can get these machines?

Treatment: PT using MedX per Mooney & later, McIntire research

CURRENT QUESTIONS
i) Is anyone else trying the core torso rotation? I would like to compare notes (positive & negative) and exchange research articles on related subjects.

ii) Will altering the seat height ½" to ¾" above or below current seat height distribute the intensity of the workout? (3 workouts per week = a possibility of up to 3 seat heights) I ask this question because her strength is not equal at the above referenced seat height variations. TRYING THIS NOW.

iii) Will the use of a WBV (whole body vibration) platform during the stretches and exercises positively impact bone density? (Amplitude range of 2-3 and Hz range of 20-35) I ask this question because of possible future concerns regarding bone density.

EQUIPMENT
WE used the MedX Core Torso machine and VARC per Mooney's initial research. We purchased both units, but then had to wait several years for our daughter to "grow into" the MedX at age eleven. The MedX unit will fit up to a 7'11" man--it isn't really made for pre-teen girls. We had the back, hip, & seat pads remade thicker and spacers added on the foot rests so the normal lumbar curve remained correct (MedX was really nice and even added a counter balance to it so she could start her workout w/out adding any weight –not adding weight does NOT equal 0lbs.) However, the length of her femur, or lack thereof, is what kept her from using the equipment sooner. We were unable to use the leg restraint system until her legs grew longer without causing injury to her knees.

I don't know anything about the other versions of rotation units being discussed, but from what I’ve read, it is important to isolate the targeted muscle groups. Doing the MedX motion without neutralizing the muscles from your hips down will end up working the muscles from the hips down rather than the ones you want to strengthen in your back. However, this is just my understanding from what I’ve read so you would definitely want to check this with someone more knowledgeable than me. (The workout is supposed to be "to fatigue," so it should not be painful.)

PT
Note: Most research states the test subjects completed the exercises 2x per week until reaching a plateau and then reduced the workout to 1x per week. Initial research suggests these PT benefits may wear off in 8-12 months if the workout is stopped altogether.

My daughter works out 3x per week as follows:
A) 10-15 minute walk to warm up
B) 20 reps on the VARC (see #1 DETAILS below to see how she progresses)
C) 20 reps Left & Right on the MedX (see #2 DETAILS below to see how she progresses)
CC) Added 2nd seat height (higher), alternating between the two every other workout
CCC) Added 10 eccentric reps Left & Right on MedX
CCCC) Added final seat height (lower), alternating between the three every workout
D) stretches (to meet her particular needs)
E) exercises (to meet her particular needs)
F) Spirometer reading (best of 3 readings is recorded)
G) Large ice pack for back 15 minutes (still no back pain, but will reduce to 2x per week if it occurs)

CURVE & PLAN
Based on what little research I can find on the subject, we do not expect the PT to reduce her curvature; rather, we are hoping it will "hold" her curve. She has a right thoracolumbar curve that has made some frightening leaps--the last one BEFORE she was able to fit into the machine was an increase of 12 degrees (thoracic) & 17 degrees (lumbar) between x-rays. Her ortho said the PT could not do any good, but agreed that at least she would be in better health for the surgery he was anticipating. We began PT in February 2011. It is much too soon to say if it will hold the curve for 5 years, (until her 3rd x-ray, we can’t even consider we may be seeing a trend) but her initial readings show she is holding steady during a substantial growth spurt.
33T & 27L on 02-10-11
32T & 23L on 06-16-11
34T & 20L on 10-10-11
__T & __L on 04-16-12

She has grown SO MUCH (gained 20lbs and several inches) in the last year!

The ortho removed the prescription for a brace (she never wore one) and the last visit was the first time he didn't bring up surgery within "the near future." Her forward head thrust is gone, her spirometer readings are now above normal, she is less tired, and because her core strength is improved her posture is better & she is more comfortable while sitting, standing, & walking.

Our plan is to continue her PT until she is 16ish/ bone maturation occurs. (When the time gets closer, I'll ask the ortho to let me know when she reaches a Risser level of 5.) Then, we will drop to 2x per week for another year—if the x-ray doesn’t show any deterioration, then we will drop to 1x per week until she goes to college. I don't know what will happen in the long run, but she likes that we made our plan together and that we can make changes based on what we see on the x-rays. In the meantime, her quality of life is great.

DETAILS
(This is NOT a suggestion that anyone else should try this workout, I am just telling you what she is doing. Many workouts can be dangerous if a child has anything else going on, so I always check with her ortho to R/O the possibilities of injuries before starting any new exercises!)

PROGRESSION OVER 11 MONTHS
BackStrong VARC (Variable Angle Roman Chair)
1) One set of 15-25 to fatigue on BackStrong (20 in a perfect world)
---Turn feet "in" (difficult to maintain)
---Back arch up, NOT flat back up (she loves to swim & calls it a mermaid dip)
---We started at 75 degrees, hands behind back & continued this position until able to do 20
---We stayed at 75°, hands cross sternum & continued this position until able to do 20
---We stayed at 75°, genie arm cross & continued this position until able to do 20
---We stayed at 75°, hands behind head & continued this position until able to do 20
Then, we moved to 60° and repeated the process
Then, we moved to 45° and are currently at hands cross sternum
30°—15°—0° to go!

MedX (Core Torso Rotation)--The BOTTOM vs. the overhead unit has updated restraints that are easier to use & will also fit a smaller child—otherwise, they are the same unit. Even modified, she remains too small to fit into the older, overhead unit. (unit fits 4’10” to 7’11” male, she is 4’7”)
2) One set of 15-25 each direction (we alternate the order Left-Right/ Right-Left each workout) to fatigue (20 in a perfect world)
Starting weight: 1/3 of body weight OR lift maximum weight and use 50 percent of that amount
ROM (range of motion) setting dependent on ability (currently at #3)
Doctor suggested she increase weight in increments of 5% of current weight

When she gets to 20 reps per side, then we are supposed to increase weight--not repetitions
She is currently at 46lbs.

Studies discuss exercising 2x per week (research suggests that for this group of muscles 2x - 3x per week provides maximum benefit)

Ongoing workout through puberty (No long term study, but there are some suggestions to be found in various articles that PT needs to be continued until a Risser level of 5 is reached/ bone maturation.

There are also quite a few comments by individuals with AIS whose curve continued to progress (usually at a slower rate than seen during adolescence) after maturation occurred, so even if PT holds the curve, the “hold” may be temporary even after maturation is achieved. I am hopeful there will not be a harsh rebound at that point.

When she plateaus we are considering the following for the MedX:
• It has been suggested by several folks to start changing the routine a lot;
• Reduce the weight to 30-50% max and increase the reps dramatically, so instead of 10 reps, do 30 reps/set;
• Go until exhaustion, keeping the weight around 20-30% of 1RM;
• She may add a 2-4 second count hold during full extension;
• Can add an additional set of 20x per side;
• Can change the ROM setting;
• Add minor seat height changes;
• Increase the weight and change angle of arms to 90°;
• Reduce the frequency of the workout to 2x per week; and/ or
• Consider asymmetric eccentric workout.

The only idea we have for the VARC when she plateaus is to add a 2 second hold during full extension.

The workout she is doing is similar, but not the same, as the Mooney study. (20x BackStrong & 20x MedX portions are the same) Why did I choose one protocol over the other? The answer is simple; I was able to access some of the professionals who worked on the Mooney study.

The McIntire protocol is different. They began their Warm up with a specified walk & workout on the MedX, move to Preparation/ Training on MedX, and end with a Burn-out on MedX.
I don't know if this is written clearly. I am sure you see I do not have a background in biology or science. If you are trying something similar, please consider sharing your workout and results. I would love to be able to compare notes and exchange research articles on related subjects.

Thanks!

A Mom

[AMom]

We live in southern california. I am wondering where I can get these machines?

Dear djjane,

First, I am not suggesting anyone else should do what we are doing—it could cause injuries. (I requested a prescription for PT prior to starting my daughter’s workout from her orthopedic surgeon, a respected specialist in the scoliosis field.) I was just hoping to share related research articles, successes & failures, and results with other families who are ALREADY USING core torso rotation.

Second, there is no current evidence this workout will prevent or reduce and hold the progression of anyone’s curve. It is something we are trying during the “watch & wait” period.

Third, the two articles I referenced contained small trial sizes, both genders, multiple curves types, sizes, & directions, children at different stages of development, and ran for very short periods of time. (I understand why this was so, but it remains a problem to be addressed by future studies.) The second trial demonstrated that whatever benefit may have been achieved was lost when the exercises were discontinued.

Fourth, there has been some anecdotal discussion regarding workouts continuing for a longer period of time, but nothing has been published so we don’t know what constitutes “success.” What were their curves, how long did they continue the workout, how likely was their curve to continue progressing, how much did it progress, etc.? Lots of questions, no answers....

Fifth, even my daughter’s results only represent eight months of stability. While we expected her curve to continue progressing, that short period of time (8 months) is conceivably within a normal pause between periods of curve progression.

Sixth, I am not a doctor, nurse, PT, body builder, trainer, or any type of person who could be considered to have specialized knowledge with regard to physical fitness. I am simply a parent. Yes, I did a lot of reading and have asked a lot of questions over several years, but I MADE UP THE ROUTINE we are using.

Seventh, yes I chose the equipment because it is used by PTs to treat people with back pain and /or following surgery and they have been tested showing they target the intended muscle groups, but I can’t say that all other pieces of equipment are not effective. (If you read the research, you will see that some have been proven to do little for the intended muscle groups.)

Eighth, due to the nature of this web site, I don’t think I am supposed to mention specifically where I purchased our equipment. (I am not related to any manufacturer, sales person, or treatment facility.) But, I think I can tell you that shortly after I purchased the MedX, the FL company appeared to be in fiscal trouble and may have gone under or been sold. As long as you clearly understand that I am NOT RECOMMENDING the WORKOUTS or EQUIPMENT, I think it is okay to tell you there are gyms (Gold’s Gym often has MedX), PT sites, & chiropractic offices that have the equipment in the general SF, Visalia, LA, and SD areas that have the equipment. The MedX equipment can be found “used” on the internet (the prices have gone down since I made our purchase) and the BackStrong/ VARC is only made and sold by one company.

Ninth, if after all of this, you are still considering trying core torso rotation, please speak with your orthopedic surgeon (w/ a scoliosis specialty!) first to make sure it will not cause any injuries.

Tenth, DO NOT DO ANYTHING JUST BECAUSE I AM DOING IT! I am just A Mom

[AMom]

Hey Folks,

Correction regarding my comment about PT and 40 degrees.

I forgot about a case in Mooney’s study, it was a female, 50°, whose curve reduced to 32°. The study doesn’t mention if the kid was/ wasn't in a growth spurt or her long term results. The case I was thinking about was the female with a 60° curve that continued to increase and went on to have surgery.

A Mom

[AMom]

Treatment: PT using MedX per Mooney & later, McIntire research

CURRENT QUESTIONS

ii) Will altering the seat height ½" to ¾" above or below current seat height distribute the intensity of the workout? (3 workouts per week = a possibility of up to 3 seat heights) I ask this question because her strength is not equal at the above referenced seat height variations. TRYING THIS NOW.

CCCC) Added final seat height (lower), alternating between the three heights every week

Her strength is changing quickly now. She is already able to lift 42lbs at the lowest seat height. It looks as though she will be increasing the second two workouts to 48lbs soon.

Monday = 42lbs (lowest seat)
Wednesday = 46lbs (regular seat)
Saturday = 46lbs (highest seat)

[djjane]

I am curious about the torso rotation to each side, if the curve is on one side, what should we do? Still exercise equally on both sides?

I read from another thread, saying "when you twist your body clockwise, you strengthen the right back muscles, and counterclockwise(that is twisting to the left), you strenghten the left back muscles." Does this sound right?

[TAMZTOM]

I am curious about the torso rotation to each side, if the curve is on one side, what should we do? Still exercise equally on both sides?

I read from another thread, saying "when you twist your body clockwise, you strengthen the right back muscles, and counterclockwise(that is twisting to the left), you strenghten the left back muscles." Does this sound right?

Hi
On another TR thread, I asked the same question a few months back. One knowledgeable poster replied that musculature on both sides is strengthened when doing each side. That answer, to me, seemed to beg the question: which muscles work, which ligaments, muscles and tendons are realigned/stretched. There is unresolved debate--i.e., speculation reigns--about asymmetric vs. symmetric exercise. My impression of TR is that's it's a "scatter-gun" approach, that may, however, provide much needed strength and endurance thereby improving posture and enabling the body, to some degree, to brace itself.
Other methods (e.g., Schroth), would proscribe "feeding the curve" by rotating into it: e.g., right thoracic curve, don't do clockwise rotation. We do Schroth with our 10 yr old daughter and have until this last week refrained from TR on any regular basis. This last week or so, we've done some very limited torso rotational exercise (not the formal Moooney or McIntire protocols, or anything anywhere near as remarkable as AMOM--qualified or not, AMOM probably knows more about TR than any 'professional' out there). We've focused on working her range of movement in an anti-clockwise direction; we've tried clockwise a few times, but nothing organised or regular as yet. In both directions, my daughter has very limited range of movement (I'm quite harsh--she might actually have quite normal ROM...as you can tell, I am not a physio, PT, etc., just a dad training his kid).

I would like to read AMON's thoughts on your questions.

Regards
Tom