Scoliogold?

[Pooka1]

1: Disabil Rehabil. 2008;30(10):799-807. Links
Adolescent idiopathic scoliosis (AIS) - an indication for surgery? A systematic review of the literature.Weiss HR.
Asklepios Katharina Schroth, Spinal Deformities Rehabilitation Centre, Bad Sobernheim, Germany. hr.weiss@asklepios.com

PURPOSE: Historically, the treatment options for AIS, the most common form of scoliosis are: Exercises, in-patient rehabilitation, braces and surgery. While there is evidence in the form of prospective controlled studies that Scoliosis Intensive Rehabilitation (SIR) and braces can alter the natural history of the condition, there is no review on prospective controlled trials for surgical treatment. The aim of this review was to perform a systematic search of the Pub Med literature to reveal the evidence on scoliosis surgery. METHODS: A systematic review has been performed using the Pub Med database. Literature has been searched for the outcome parameter; 'rate of progression' and only prospective controlled studies that have considered the treatment versus the natural history have been included. RESULTS: No controlled study, not in the short, mid or long term, searched within the review, has been found to reveal evidence to support the hypothesis that the effects of surgery as a treatment option for AIS is superior to natural history. CONCLUSIONS: No evidence has been found in terms of prospective controlled studies to support surgical intervention from the medical point of view. In the light of the unknown long-term effects of surgery and in concluding on the lack of evidence already found that surgery might change the signs and symptoms of scoliosis, a randomized controlled trial (RCT) is long overdue. Until such a time that such evidence exists, there can be no medical indication for surgery. The indications for surgery are limited for cosmetic reasons in severe cases and only if the patient and the family agree with this.

PMID: 18432438 [PubMed - indexed for MEDLINE]

Related ArticlesThe treatment of adolescent idiopathic scoliosis (AIS) according to present evidence. A systematic review. [Eur J Phys Rehabil Med.

In other articles written by this author HR Weiss- some of their patients still need surgery despite their best efforts. I believe Schroth can be helpful but still fails and is confined to mostly adolescents. Bracing and PT are used.

I also wonder if this has been correctly translated from German.:confused:

I've offered some explanations for this article (non-peer-reviewed, nefarious editing, grey literature, Scroth-controlled publication, etc. etc.)

The main issue is I would not expect that a study would be publishable demonstrating the efficacy of surgical correction of ever-progressing curves. It's like there is probably no publication showing the efficacy of setting broken arm bones. It's so obvious that it isn't publishable nor is it necessary to publish. The thing speaks for itself.... there is no other demonstrated way to stop certain curves from killing the person besides surgery.

The article above does not say that surgery is ineffective. It only states that there are no pubs on the issue. Big difference.

[txmarinemom]

I also wonder if this has been correctly translated from German.:confused[/B]:

Good LORD ... one can only hope NOT.

Pardon me, but "cosmetic" my a**. That's the second most ignorant thing I've read today.

Thanks for posting that to bring everyone up to speed, Karen.

[joan]

I am trying to find out about Scoliogold, has anyone ever heard of it? According to the Scoliosis SOS clinic in the UK, it's the only nonsurgical treatment that is scientifically proven to help correct scoliosis (that's what it says on the letter they sent my friend).

I can't find any scientific studies, or medical documents, or anything to back up this claim. No-one seems to have heard of it anywhere. I would like to know who invented this treatment method, because it can't be anyone at the Scoliosis SOS clinic - the only medically trained person they have is one doctor who got her basic medical degree in 2004 according to the General Medical Council (though the clinic claim she is a "world renowned spinal expert"), and all the physiotherapists there are relatively newly qualified too. The Maude family, who run the clinic, have no medical qualifications at all.

The clinic used to say they teach the Schroth Method and they got a lot of publicity because it was supposed to be the first Schroth Clinic in the English speaking world (though the American clinics were open already and the German clinics all speak English) but for some reason it has changed to Scoliogold now - I am wondering if this is because they didn't offer bracing, which is an integral part of Schroth therapy? I know Dr Weiss seemed very unhappy with the clinic.

It really doesn't sound good to me, I can't find any info at all and the clinic isn't even registered with the Healthcare Commission so there doesn't appear to be any regulatory body overseeing what they are claiming to do.

Hello my daughter visited the sos uk clinic in dec 07(then aged 12)and has been following the exercise regime since. She only has a mild curve, spotted in June 07 and x rayed/and confirmed by NHS consultant Sep 07. Our NHS consultant said the most likely outcome was progression but it was possible but unlikely the curve may not change. Unfortunately it was obvious things were progressing at quite a rate by the time we visited the clinic the rotation and curve had visibly changed. By coincidence the week after we returned an x ray was due it showed a reduced curve. As this was only a reduction of 5 degrees it can really only be confirmed that things had not progressed, given the margin of error of x rays. The most recent x ray Oct 08 a further reduction in the curve was evident again 5 degrees. I have copies of the first two xr and I am waiting for the last copy. But dont know how to open them to put on email. Any advise they are on cd.
I am positive the exercise regime controlled the progression.
I found the clinic staff a dedicated lot, very confident in their abilities and who could blame them, in four weeks the group my daughter had trained with had improved their posture regardless of age or progression of curvature.
I hope this info helps

[Qikdraw]

Exactly!

I mean we don't need no steenkin' publications to know that plenty of folks who be in serious trouble, if not dead, without surgery.

And yet we see these pubs from Scroth types pointing out the lack of pubs supporting the efficacy of surgery in some scoliosis cases as a "Look at the Wookie" ploy to draw attention away from the fact that they are NOT publishing any positive evidence for Scroth (or rather only THREE pubs by affiliated people in 90 years).[/QUOTE]

Wait... There's a wookie? Is it an original Star Wars wookie? Is it still in its original plastic? Cause its worth more if it is.

[Pooka1]

And yet we see these pubs from Scroth types pointing out the lack of pubs supporting the efficacy of surgery in some scoliosis cases as a "Look at the Wookie" ploy to draw attention away from the fact that they are NOT publishing any positive evidence for Scroth (or rather only THREE pubs by affiliated people in 90 years).

Wait... There's a wookie? Is it an original Star Wars wookie? Is it still in its original plastic? Cause its worth more if it is.

Very good.

[Writer]

Here (three posts above this one) is an interesting personal testimony from joan, which shows that Schroth or closely related physiotherapy can stop progression and even reverse it -- in a few weeks' time. And that the SOS clinic in Suffolk is effective. Has anybody else recognized this as a positive report?

Joan -- There are a couple ways to upload photos to share. First copy them from the CD to an appropriate directory on your hard drive (you don't want to have only one copy of them!).

1) You could upload a batch of them to a photo-sharing site like Google's Picasa.

http://picasa.google.com/

2) Or you can post them singly at a site like www.glowfoto.com . Just click the Browse button and find the file on your CD drive or on your hard disk, then click Upload. In a few seconds when it's uploaded you will see a List of LINKS. Click and select the address at DIRECT and copy that into your post. Same with other photos. Then readers of your post can click the link and see the picture(s).

[Pooka1]

Is the basis of Schroth to build up muscle to hold the curve in place?

Is that physiologically possible?

Are the exercises required for life? Can you do them when you're 70 or 80?

What happens if you get sick or become pregnant (that's a question for adults!) and can't continue the exercises?

How long until the muscles weaken and allow the curve to go where it will?

And a question for Joan... did the same person measure all three Cobb angles and use the same upper and lower vertebra?

Thanks.

[joan]

Hello
I don't know what the basis of the exercises are but it seems logical if you can support your curve with bracing from the outside, you should be able to support with your own muscles from the inside. The training has to be specific to each person because of the enormous variation in types of curve.
I met a lady who was 83 at the clinic it was only her first week of training but she said she was feeling the benefit and intended to carry on with the exercises.
If you are not well or pregnant the clinic give advice on how to modify what your doing.
Not sure how fast curves return if you stop exercising
No the same person did not measure curve at was actually three different consultants but they did use the same vertebra.
Our consultant back in sept 07 described the possible outcomes and treatments and timing of such treatments. Bracing in Jan 07 and surgery after growth had slowed possibly 2009.
The exercises he said would do no harm so we gave it a shot.
With a two month waiting list just for a diagnosis and possibly a two year waiting list for surgery, any effort by those who can be helped by exercise to get out of the way of others who have no choice, I think is a good thing.
Best wishes. Joan

[LindaRacine]

Hello
I don't know what the basis of the exercises are but it seems logical if you can support your curve with bracing from the outside, you should be able to support with your own muscles from the inside.

Hi Joan...

Scoliosis braces reduce curves while the patient is in the brace, but when the brace is removed, the vast majority of curves return to their original degrees. A few retain some improvement, and many get worse.

With that said, I think it is possible to reduce one's curves somewhat by very diligent exercise. But, as previously speculated, one's curves will return to their original degrees when the exercise program is discontinued. I suspect a small percentage of people have enough control to stick with a program for the rest of their lives.

And, I think there can be great value to any good physical therapy program in terms of helping with pain.

One just needs to be realistic about the limitations of any treatment (including surgery). There are plenty of studies that have been published in peer-reviewed journals in terms of the effectiveness of bracing (in children) and surgery. I'd like to see the Schroth folks do a long-term outcome study.

Regards,
Linda

[txmarinemom]

I'd like to see the Schroth folks do a long-term outcome study.

One would think the 90 years of success claimed by Schroth would provide enough data to produce ONE (at *least*).

[Pooka1]

One would think the 90 years of success claimed by Schroth would provide enough data to produce ONE (at *least*).

Although not absolute, the fact that we have:

1. no large scale, controlled studies showing the efficacy of Schroth in 90 years, and

2. Weiss, a major proponent of Schroth, publishing NOT about the success of Schroth but on a literature study on NON-Schroth issues,

then we can at least tentatively conclude they have no data. They might get data but it doesn't seem like they have it now. Ninety years.

Even assuming there are no pubs supporting the (penetrating glimpse into the obvious) efficacy of surgery to correct a curve, and even assuming there is no evidence at all that surgery works, pointing that out in no way adds one iota of support for other modalities. It could be they are all wrong. In this case, they are not all wrong... surgery works... but the point stands.

This is the identical error in thinking that creationists make, supposing that if they can shoot down evolution then the only other option is creationism. Evolution (change over time) is a fact but the theory (mechanisms) of evolution continues to be investigated. If the theory is shown to be incorrect then it will be replaced by another scientific theory, NOT religion.

It has to be that the muscles are built up to better hold the curve. But if you don't or can't do the exercises then there is nothing to hold the curve. I don't think it's even empirical... it is muscle tone holding the curve IF it holds the curve. But it's still paranormal because there should be much more evidence by now.

[joan]

Hello Linda
Braces may improve curve whilst being worn but if the brace is supporting the back the muscles may weaken and counter any benefit given.
The benefit to teenagers maybe to slow progression until they have stopped growing and can decide if they would go for surgery or carry on exercising.
I am not sure why there has not been an extensive controlled study, but from a personal point of view I would not sign up for such a study and would feel very mean signing a child up. My daughter worked incredibly hard in her months training and to find out later you were part of the control group I think would be soul destroying.
Regards Joan

[LindaRacine]

I am not sure why there has not been an extensive controlled study, but from a personal point of view I would not sign up for such a study and would feel very mean signing a child up. My daughter worked incredibly hard in her months training and to find out later you were part of the control group I think would be soul destroying.
Regards Joan

I think most would agree that it is probably unethical to withhold treatment for scoliosis just to provide a control group. So, how about an uncontrolled, but long-term follow up? Or, how about a long-term follow up comparison of brace treatment to Schroth treatment?

--Linda

[Writer]

Linda is correct about the probably unethical nature of a true controlled study on such a topic, as it would deny treatment to the control group and the benefits of Schroth treatment are already known. Hans-Rudolf Weiss has already mentioned this consideration in at least one of his publications.

Pooka and tx are incorrect about paucity of data and publications on Schroth. Have they done a careful search? No, they have not. Even a quick search in PubMed on "Weiss HR scoliosis" yields three pages of citations.

There is a great deal of data and there are dozens of publications on various aspects of the method and its results, starting in 1924. In other posts I've only cited a few that are in English and easily available, and I never suggested they were the only ones.

I'm preparing a new post that will list many of these and refer to lists elsewhere of others, and I will put a link to it in this thread when it's finished. This preliminary rejoinder today is simply to counter any accusation or misconception that the Schroth method lacks requisite scientific underpinning and reporting.

[Writer]

Incidentally, the impartial reader who wishes to hear more first-hand reports of treatment at the Scoliosis SOS clinic in England as well as the German one in Bad Sobernheim might log onto the English scoliosis forum at http://www.scoliosis-support.org/