vestibular testing

[pamela salmon]

Spinecor

I first saw Dr. Deutchman in May of 2006 and my ten-year-old in August. We both had Vestibular testing and I have a Spinecor brace. We did our exercises and used the WVB platform by Soloflex. At our last visit in December of 2006, both of our curves were within normal range and I was pain fee. Before going to Dr. Deutchman, I went to Garden State Spine and Pain. Both Chiropractors there treated me for three years, telling me they were making me better. I had great pain which they relieved for a day or two. They charged me more than my co-pay and had GHI pay their MD. I had great pain for years before going to them. Finally I went to Dr. Deutchman and they refused to ever see me again!

[structural75]

Hi Dave,

but I am sure you understand why you have a large bullseye on your head in this forum

Thanks for the post Dave. I do indeed understand why I have a bullseye on my head... but what really confuses me is the following.

There have been many a folks on this forum reporting and advocating their use of pt, yoga, pilates and such as an adjunct complimentary treatment for scoliosis. I thought I was just adding SI to the list as another applicable and effective form of treatment (and less commonly known) . I don't recall making any claims about a 'cure' or promising anyone that this was the 'answer' to their situation. None of these other methods have been 'proven' to help scoliosis in studies either. So why the scutiny against SI? SI has been around for 50+ years, and it has shown in studies to have a positive impact on the structural organization and efficiency of the human body, among other things. No ther haven't been studies done specifically in regards to scoliosis yet, but the same is true for those other methods. Also, SI has been shown to remain unparalleled and unequaled in its ability to dramatically alter posture and structure. Now that has predominately been in populations of people without scoliosis, but its relevance and applicability to scoliosis is extremely direct, and has been used as an adjunct to treat scoliosis since its inception. It differs in many ways from other therapies, one being that it works primarily with the fascial network which is responsible in part for the shape and positioning of our structure. Now I'm not saying this to suggest superiority over other methods, but to point out that its primary intention and affect is on the structural orientation of the body and its functional capacities. I think both of those fit very beautifully into the needs of scoliotic individuals, especially ideopathic. Furthermore, there are senior instructors teaching SI courses specifically for addressing scoliosis... Why would they be doing such a thing if it was only 'theoretical' (and possibly 'incorrect')?

I'm not sure how the anatomical/biomechanical info I put forth in previous posts became 'theoretical'. It was a description of positional relationships of the soft tissue in a scoliotic spine... that info is just simple logic and fact. I wasn't suggesting I knew the 'cause' of ideo. scoliosis, just relating how to use that said anatomical reality of the tissue to develop a treatment strategy, manually or otherwise. In fact, that same knowledge is what is informing the good Drs in Montreal and elsewhere as to how to fit the brace on each individual. Essentially working to reverse the scoliotic pattern. The main difference between what they are doing and what SI practioners are doing is that the Drs. use plastic/nylon/elastic braces to attempt to 'force' or move the curve back, and we are using our hands to do it by changing the specific regions of tissue that would enable the same thing to occur. For instance, I have people laying on a specific side in a counter-rotation to the scoliotic one, while I treat the specific tissue that is responsible for the rotation. Does this sound 'theoretical' or 'incorrect'? Results will always vary, and just like bracing, you really don't know how each individual is going to respond to treatment until it actually begins. And if someone were to use any number of complimentary treatments and they functioned better as a result but the curve didn't reduce or stop progressing, does it mean that it is the fault of the treatment or a testament to the tenacity of their case? This happens quite frequently with bracing but people continue their use.... ? Just some thoughts to consider regarding equality in scrutiny.

There's obviously more to it than that, but hopefully that gets the idea across. I think using the brace in combination with a highly specific approach like that could and is in fact very beneficial. I'm not twisting anyones arm to go and do it... that is for others to decide on their own based on further inquiry and desire.

After all, I feel that in order to develop an 'effective' treatment strategy, you have to first understand what is actually going on in the body. That was really my intent in the discussion with Gerbo... I failed to see the reality of biomechanic sense in the theory he proposed because it doesn't jive with what is actually taking place. I'm happy that he's getting results and find some aspects of his treatment strategy important, but I just can't agree with how he's reaching the conclusions.

Long one again, I know....

Kind Regards,
structural

ps- As for the 'proof' of my own case... I have presented folks with things they've asked for in the past and they only return to demand something else... it's never satisfying enough for them. I was even told to ask the Drs. in Montrel themselves... so I did and posted his reply. Even that didn't suffice in the end. Why would I now want to pay to expose myself to more radiation to get a cd, to then upload for everyone to see? I can see the reply already... "How do we know that's your spine?"... I'm not jumping through anymore hoops for anyone, especially this one. I'm happy to answer question if folks have them, or give a reference and such, but otherwise if people aren't willing to do the leg work themselves to find out more,(with all due respect) then maybe they should just walk away from this discussion or topic and leave things at that.

[structural75]

Hi Gerbo,

Thought you might find this of general interest.

This quote comes from an article in the journal Spine, "Intraoperative Long-Latency Reflex Activity in Idiopathic Scoliosis Demonstrates Abnormal Central Processing, a possible cause of idiopathic scoliosis" by Maguire and others, Spine vol. 18 #12, 1993, pp 1621-26.

"The clinical manifestations of idiopathic scoliosis are well known, yet its causes remain unclear. Several factors have been proposed, including abnormal structural elements of the spine, dysfunctional spinal musculature, genetic factors, alterations of collagen metabolism, and abnormalities of the central nervous system. The most promising investigations appear to implicate the central nervous system, especially those areas involved with postural equilibrium. Spinal cord reflexes play an integral role in the maintenance of posture. These complex polysynaptic segmental reflexes are regulated by a variety of descending suprasegmental systems, by peripheral afferent impulses and within the spinal cord by a network of interneurons and propriospinal neurons."

The article goes on to say that the abovementioned reflex activity can be measured electrically by recording EMG. They studied 37 cases of idiopathic scoliosis and 8 cases of neuromuscular scoliosis (three CP, three muscular dystrophy, and two other neuromuscular disorders) by recording late reflex activity during spinal surgery for correction of scoliosis. What they found was that "long-latency complex polysynaptic activity" was present in all 37 patients with idiopathic scoliosis, and absent in all 8 patients with nonidiopathic scoliosis. (These late reflexes are also unknown in normal subjects).

In other words, when you stimulate a nerve in the leg, you can record electrical responses from a muscle in the leg. You get an early response, say 5 milliseconds, by direct stimulation, and around 35 ms you get some later responses called H-reflexes and F-waves, which involve an impulse first going to the spinal cord and then bouncing back down the same nerve, or being relayed through a reflex arc in the spinal cord. In these idiopathic scoliosis patients ONLY, there are late responses ranging from 20 -243 ms in latency and lasting up to 4 seconds. It sounds to me like a ringing effect, a failure of damping. It's like a car with bad shocks, bouncing up and down long after you hit the bump, when the bouncing should have damped out quickly.

Possibly showing that many of the 'exercise' methods being used (torsorotations, pilates, yoga, pt, swimming, etc.) are actually achieving their affect through re-coordination/synchronization of proprioceptive capacities of the nervous system via movement, more-so than through "strengthening" of muscles... which would be an inevitable by-product of these activities anyway in any individual. Just another thought to ponder... . It could be quite likely that we're overlooking the primary affect of these exercises and only seeing their secondary effect... which is sometimes the case in 'studies' because in order to do a study we have to first create a hypothesis... ask ourselves a question about a specific variable and leave the rest in the shadows.

Regards,
structural

[Bish]

Hi again

Hi Structural,

You stated you haven't made any claims about SI's success with scoliosis but didn't you say you eliminated your own scoliosis? And for your info, I am as scheptical about other treatment programs as well. If I were not I would be running all over the country spending money and time chasing pipe dreams. I have to ask for proof of some kind! I have heard lots of people on this forum saying swimming or yoga or whatever worked for pain relief for them............. prior to their operation. So I can only guess it did not affect the curve proggression.

You also mentioned some SI practitioners specifically working with scoliosis patients, but in my eyes this does not validate its success.Evidence would validate its success. I am sure you would agree that a surgeon who is a scoliosis "specialist" is not even headed in the right direction as far as a "cure".

Also as far as the many "facts" you have presented in regards to biomechanics etc., There application to scoliosis remains theoretical until we can prove otherwise.

In regards to your not wanting further Xrays, my hope would be that you would reconsider. If you can validate it you would confirm you are a walking medical miracle. Honestly,I hope it is true. One Xray could give scientific validity to SI's application in scoliosis. Not only that you wouldn't have to argue with everyone! You could be doing the world a service and increase your business. I spoke to a radiologist in my area that has been doing it for 20 plus years. He said he has never seen an adult seek treatment and end up with a reduced curvature. This does not mean it didn't happen of course, but I thought it was interesting.
Anyways all the best, Dave

P.S If I wanted to give it a shot (SI) who or what would I look for in a practitioner.

[structural75]

Hey Dave,

Thanks again Dave... I do appreciate your comments and I understand where you're coming from. And just so you know, I really don't want, nor am I looking for, more business from being on here. I initially came here to share my experiences both professionally and personally. No agendas.

I don't recall making any claims about a 'cure' or promising anyone that this was the 'answer' to their situation.

To clarify, this was what I had said regarding 'claims'. I simply stated that it has been shown to be clinically effective(whether effective meant slowing the progression, stopping it, or reducing it to some degree). Which I feel warrants inquiry or exploration for others, depending on the aetiology of their specific case. If others dom't feel that is warranting enough, that's OK by me... it's your decision ... I'm just here sharing experience, which is also valid whether I post pictures or not. Surely many would reply, as they have before, that 'one' case is not suffice... they want studies... so why bother, really? Also, I didn't claim it would reduce an adults scoliosis... that would more likely apply to younger folks.

The bottom line is that I don't have visual documentation to show you, as I don't go around collecting photographs or x-rays from clients around the world, nor do I take pctures of my clients personally because then I would be placing the emphasis on how they looked rather than how they felt/functioned.. I leave that to the Drs and proper x-rays. I admit, this is a major obstacle in the path of those trying to spread the word about the work. In the meanwhile, I'll keep working with my clients, and folks here can keep searching... .

My understanding of the non-surgical threads here is that it is a place for therapies that assist in the treatment of scoliosis, I didn't realize that there was a gauntlet one must pass before sharing useful information on the matter. And if there was, I think I've presented enough sound clinical reasoning to pass.

Also as far as the many "facts" you have presented in regards to biomechanics etc., There application to scoliosis remains theoretical until we can prove otherwise.

Dave, come on now... Unless someone here can prove that those 'facts' on biomechanics are incorrect, then I think they sit on solid ground. Again, they are objective observations on the positional relationships of muscles/tissue in a scoliotic spine... and those relationships must and do in fact change for a curve to reduce as in both sugery and bracing alike. Those two methods force the change, other approaches work more gently and dynamically to invite and encourage the change (communicate with the nervous system). That biomechanic premise is currently being used in the spinecor brace... The Drs. assess the same thing that I was describing and then fit the brace in a manner to counter those forces arising from the tissues. The main differences are 1)duration of treatment (the brace is worn for many, many hours/days/weeks/months vs. manual treatment lasting for short intervals of time) and 2) the tool applied to the body (plastic/elastic/nylon vs. human hand) and 3) specificity (bracing is generalized and non-receptive, as the vector of forces applied can potentially deviate, as is the case when the 'phantom' secondary curves arise out of nowhere - manual approach is highly specific in its intention and location of work performed, also receptive to the tissue). They are both doing the exact same thing, although the manual approach also works extensively with tissue strain patterns within the legs, up into the pelvis and so forth. I think they make for an intelligent and effective combination... but that's just my experiences... no studies for you at this point.

I have at least put forth sound logic and fact (biomechanical) to support the method I was suggesting, and even others as well. It was my intent to not make claims about somethings usefulness (in whatever sense of the word) without a solid bases of factual, anatomical, clinical reasoning. I think that's deserving of some degree of respect or credibility. Bracing works on a similar premise, it's just an approach that maintains constant force in opposition to the curve with hopes that the soft tissue will yield enough to produce desirable and effective results.

I guess I got carried away with the 'anatomy lesson' and so forth because my concern is that people will hear that "strengthening" the concave side is beneficial and turn around and go to pilates class, lay on their side over the barral and start doing side body 'crunches' to try and "strengthen" the concavity. This would be an incredibly detrimental and unfortunate misunderstanding of the 'studies' findings and will certainly make things worse.

There's probably not much more to say on this matter... thanks for the dialogue.

best regards,
structural
ps- If I presented pictures/evidence then I would be emphasising a false pretense that SI will reduce all ideopathic curvatures in children and adolescents. That is not my stance, intention or desire...

Evidence would validate its success

Wasn't the article I referenced evident of its potential and reality of claims? I don't understand???

[structural75]

Hi Dave,
If you were to give it a shot you'd want to look for a Structural Integration or Rolfing Practitioner ('Rolfing' is simply a nickname that developed as a short reference to Dr. Ida Rolf's work - structural integration). Skill, reputation and experience with scoliosis are all prerequisites for choosing someone. The right practitioner will make all of the difference. I'd also look for someone who, in addition to being a qualified SI practitioner, is also educated in visceral manipulation. This is a vital key in any scoliotic case, as visceral restrictions will make any effort a futile and tenacious one.

I do know of some talented practitioners in B.C. if that would prove helpful.

Best of luck with whatever path you choose.

Kindly,
Structural

[Bish]

Hello again

Thanx for your response. If you had the name of someone in my area that would be awesome. The least I could do is have a chat with him/her and see what they had to say. Thanx, Dave