Torso Rotation Strength Training for Scoliosis

[Dingo]

Wii

Bigbluefrog

BTW we got a Wii for Christmas and I agree, it is AWESOME!

When my son does the boxing game he punches left and right so much and so fast that it's practically a torso rotation workout.

I'm not sure if you saw the message (it's a little bit back in this thread) but Turtlelover spent a few hundred dollars to buy her daughter a Cybex torso rotator. She used it every day and at her next recheck her curve went from 11 degrees to like 5 or 6. That's consistent with all 3 published studies. If your daughter sticks with it her back should be just fine.

[hdugger]

I have to temper that a little bit. So far, although we've seen that it has a short-term effect, we haven't seen whether it holds the effect long-term or, more importantly, during a growth spurt.

I'd certainly *like* to believe that it could, but it is far from definitive yet.

The one thing that I've seen from all of the exercise people I've read (SEAS and Schroth mainly) is that they feel that, during a growth spurt, exercise alone will not hold a curve. Both groups recommend a brace to hold the curve during growth spurts.

[hope404]

agreed.

hdugger..I agree with your point....

but is it possible, with a consistent, appropriate exercise program, that smaller curves can be taught to behave properly????? Can some of the neurological issues( that seem to drive scoliosis) be caught early..and be overcome through consistent exercise...stimulation....therapy??????

I don't know myself ....just wondering..is it possible???

It may be???

[hdugger]

I don't think we know exactly what reverses small curves, but there is ample evidence that they do reverse. Because they so frequently reverse without doing anything, it's hard to say if it's the exercise that's reversing them or something else.

OTOH, if you have a largish curve (35 degrees or more) those *don't* reverse on their own. So, if an exercise program shows a reduction in those curves, you can pretty safely attribute it to the exercise. We've seen a few examples of this (I think I've collected 8 data points so far). So, even with larger curves, exercise *can* help - we just don't understand yet exactly what helps.

(Emphatic belief on my part always to be taken with a grain of salt - I don't believe most orthopedic surgeons would agree. Also, by reverse I mean "go backwards," not necessarily completely correct.)

[Dingo]

Torso Rotation

hdugger

The one thing that I've seen from all of the exercise people I've read (SEAS and Schroth mainly) is that they feel that, during a growth spurt, exercise alone will not hold a curve. Both groups recommend a brace to hold the curve during growth spurts.

If a kid or parents wants to use a brace during a growth spurt I'm all for it because I believe the evidence shows that braces help.

However if you look at the 3 torso rotation studies no child with a curve under roughly 40 degrees experienced curve progression during PT. Most had curve reductions. All of these kids were growing and no doubt many were in a spurt.

I think this therapy is effective because it's not a bandaid over a problem. This PT works directly on the problem, which is muscle imbalance during growth. Time will tell if that's true but a growing pile of evidence points in that direction.

[Bigbluefrog]

I have to agree with Dingo here...after studying the articles and just looking at her back there is an asymestric in the muscle structure.

Do you notice how many have here have right thoracic curves...and my guess is that they are right handed.

Most right handed people have a stronger right side. I was in a car accident many years ago and it effected my right side strength...The PT stated its rare for the left side to be stronger in a right-hand dominated person.


Hearing stories of how exercise helps their scoliosis...whether its Schroth, SEAS, or rotational turbo therapy...there is measurable benefit.
The patient feels better...THAT IS HUGE!
The studies listed in this forum...show improvement in some and no change in others....That is a very positive outcome in my book.

[hdugger]

However if you look at the 3 torso rotation studies no child with a curve under roughly 40 degrees experienced curve progression during PT. Most had curve reductions. All of these kids were growing and no doubt many were in a spurt.

Yes, I think that's true. I would just be much more comfortable if I'd seen a longer-term study. Without that, it's more of a hypothesis.

[Dingo]

long term study

hdugger

I assume there will never be a good, longterm study on torso rotation. The best we can hope for is probably a small study or a case study like what Martha Hawes published. However if torso rotation is effective the proof of why it works will eventually be discovered anyway.

For example scientists may determine that an asymmetric distribution of Calmodulin in the paraspinal muscles triggers Scoliosis. Scientists know that Calmodulin is significantly impacted by exercise and they may learn that strength training repairs the distribution of this protein. So even without a longterm study scientists would know that as long as child is strength training he/she would be protected from curve progression. I bring up this particular hypothesis because a scientist involved in Scoliosis research mentioned it to me.

[hdugger]

Hi Dingo,

I'd take a single long-term case showing a significant reduction (10 degrees or over) of a significant (over 35 degree) curve in someone with AIS that is maintained for over a year. I agree that showing curve stabilization appears to be an impossible task for medical researchers.

[Dingo]

35 degree - 1 year study

hdugger

I'd take a single long-term case showing a significant reduction (10 degrees or over) of a significant (over 35 degree) curve in someone with AIS that is maintained for over a year.

I think a study like that is a significant nearterm possibility. Swiss researchers are wrapping up what looks like a study on torso rotation strength training. It appears to contain multiple groups of children and the project lasted 3 years. Maybe they looked at some of these kids longterm.

The effect of asymmetrical weight training on paraspinal muscle activity in scoliosis

I believe this is the guy in charge.

Dr. Florian Brunner

If you look at his credentials it's immediately obvious that this guy is a well educated, mainstream scientist. Somebody with this stature probably wouldn't waste his time on a marginal or fringe hypothesis. Dr. Vert Mooney and Dr. Marc Asher who worked on the previous torso rotation studies are also respected, mainstream scientists.

[aterry]

I e-mailed Dr Brunner to ask when the research would be published. Here is his reply:

"Thank you very much for your e-mail. Our paper is accepted for publication in Journal of Sport rehabilitation. However, we have no information regarding publication date.
Best regards,
Florian Brunner"

So now I'm going to e-mail the Journal to ask for a publication date.

[mamamax]

Asymetrical training superior to Symmetrical training?

Dingo & Aterry -

Thanks much! This is an important one for all of us, can't wait to see the results. The documentation will likely be very important in regards to future treatment recommendations - and answer a lot of questions.

The effect of asymmetrical weight training on paraspinal muscle activity in scoliosis

Paraspinal EMG measurements on the convex side of the scoliotic curve have been demonstrated to be enhanced. At present, most scoliotic patients are trained symmetrically which possibly further enhances the muscular imbalance. The present study therefore aims to investigate whether asymmetrical training will be superior compared to symmetrical training in terms of muscle balance in the spine of scoliotic patients. The project is divided into two studies: The first study investigates the immediate changes in paraspinal EMG in scoliotic patients during symmetrical vs. asymmetrical exercises. In the second study, scoliotic patients will be randomly assigned to a symmetrical or an asymmetrical weight training for 3 months and functional outcome, pain, paraspinal EMG, trunk strength/endurance will be compared.

r. med. Florian Brunner (Project Leader)
florian.brunner@balgrist.ch
Dr. med. Thomas Boeni
thomas.boeni@balgrist.ch

http://www.forschungsportal.ch/unizh/p7882.htm

[Dingo]

which works best

mamamax

We work my son equally on both sides because that's what Dr. Mooney and Dr. McIntire studied. The results of this study are going to be very interesting.

[mamamax]

mamamax

We work my son equally on both sides because that's what Dr. Mooney and Dr. McIntire studied. The results of this study are going to be very interesting.

I thought of that Dingo. Your son though, is quite young - and curvature quite small ... in such a case, it may not make a difference? Now for someone my age - with some substantial curves ... it may make quite a difference. Yes, that study will be interesting.

[aterry]

I e-mailed the editor of the journal (he's at the Univ of Kentucky) asking when the report would be published. Here is his reply:

"Ann:

It is schedule for publication but has not been assigned to an issue yet. It will likely be the fall of 2010.

Carl G. Mattacola, PhD"

Now I'm itchy, knowing it's there but inaccessible for 6months+