Torso Rotation Strength Training for Scoliosis

[Pooka1]

Dingo, how do you know that regression occurred at the same time as PT began? Were they following her from zero to 11*? If not, you really can't say that. It could have been worse at some point prior and they didn't find it until it started to get better and was already improved to 11*. My son had a curve about that size spontaneously disappear.

Good point. The other thing is that we know PT can temporarily reduce curves. Having the PT coincident with the resolution is not necessarily a good thing. The fact that she resolved after a year of PT might trigger the question if she will progress if she stops. I certainly hope not after doing all that PT! Maybe McIntire can weigh in.

I wonder if she will ever stop even after her growth spurt? She may be afraid to do so. She may get anxious if she is sick and can't exercise. Again, I hope McIntire will weigh in.

Reason #5,908,664 why research on PT and scoliosis is so difficult.

[rohrer01]

If she was diagnosed at 11, with an 11* curve, then no one really knows "when" improvement began. Unless it was followed from zero to 11* it can't be stated authoritatively that improvement began when PT started. Although, circumstantially it looks that way.

[rohrer01]

Good point. The other thing is that we know PT can temporarily reduce curves. Having the PT coincident with the resolution is not necessarily a good thing. The fact that she resolved after a year of PT might trigger the question if she will progress if she stops. I certainly hope not after doing all that PT! Maybe McIntire can weigh in.

I wonder if she will ever stop even after her growth spurt? She may be afraid to do so. She may get anxious if she is sick and can't exercise. Again, I hope McIntire will weigh in.

Reason #5,908,664 why research on PT and scoliosis is so difficult.

I know if I were in her shoes, I certainly would be afraid to stop for any length of time.

[Pooka1]

I know if I were in her shoes, I certainly would be afraid to stop for any length of time.

Me too. Life is so unfair.

[Pooka1]

If she was diagnosed at 11, with an 11* curve, then no one really knows "when" improvement began. Unless it was followed from zero to 11* it can't be stated authoritatively that improvement began when PT started. Although, circumstantially it looks that way.

Yes.
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[aterry]

Dingo, THANK YOU for your posts and please keep up the good work. I find a number of people on this forum supportive of each other and I look forward to their posts: flerc, mamamax, skevimc, concerneddad (who I miss, a lot), fireflymd. And many others--I made a list but it was soooo long. I wish the site was moderated, but it's not. So perhaps we should just IGNORE, by not answering or posting back, the two people who insist on being cruel. I don't understand the impulse to wish that positive developments should not occur; that all patients should get worse curves and suffer until they are forced into expensive and dangerous surgery--especially our children. But we know who they are so just skip over their posts. Don't even read them, or block them.

[hdugger]

I know if I were in her shoes, I certainly would be afraid to stop for any length of time.

Why?

If the curve is actually easily reversed with exercise, then it can be easily reversed again if it progresses. And, if it's not easily reversed with exercise, then it doesn't matter if she stops or not.

[Pooka1]

Why?

If the curve is actually easily reversed with exercise, then it can be easily reversed again if it progresses. And, if it's not easily reversed with exercise, then it doesn't matter if she stops or not.

She exercised a year. So we can't say it was "easily" reduced even if it was the PT.

We further can't say it would be as easily reduced again especially if it got bigger at any point say during the growth spurt to come or if it got stiffer just with age.

I don't follow the last point.

[skevimc]

Good point. The other thing is that we know PT can temporarily reduce curves. Having the PT coincident with the resolution is not necessarily a good thing. The fact that she resolved after a year of PT might trigger the question if she will progress if she stops. I certainly hope not after doing all that PT! Maybe McIntire can weigh in.

I wonder if she will ever stop even after her growth spurt? She may be afraid to do so. She may get anxious if she is sick and can't exercise. Again, I hope McIntire will weigh in.

Reason #5,908,664 why research on PT and scoliosis is so difficult.

We began to think that T/L curves responded the best to TRS. There were 3 that reduced (2 completely) and held for ~2-3 years at last follow-up with no further training.

Then there was another T/L curve in a boy that trained and reduced. Stopped training and progressed. Started training again and reduced. I'm reasonably convinced that the fluctuation was because of the training. But since he was off the protocol by that time we weren't officially following him and testing him. We probably could have, but I was graduating and moving at the time so the study was basically shut down.

Then there was another T/L curve whose compensatory curve progressed after 5 months.

Anecdotally, it would seem the T/L curves do respond better, and biomechanically it makes sense. But I'm not sure if that would hold up with a larger n.

I'd just be guessing completely to say whether it would progress or not if she stopped working out. And I learned that what you think will happen is wrong half the time, i.e. you'd get just as good of an answer by flipping a coin. I think I read that the family bought a used Cybex machine for a couple of hundred dollars. If she has it at home, I'd keep my kid doing it. The worst thing that could happen is that she gets strong abs.

[rohrer01]

Why?

If the curve is actually easily reversed with exercise, then it can be easily reversed again if it progresses. And, if it's not easily reversed with exercise, then it doesn't matter if she stops or not.

Well, for one, if she progressed without knowing it and progressed farther than 11*, it might not be so easily reversed. Also, she is a child and children's spines are more flexible. If she develops a curve as an adult, she might not be able to reverse it then either. If she continues and keeps her core muscles and back muscles strong, I would think that it would reduce her chances of progressing again. I'm not an expert, it's just my thought.

If I found an exercise that cured my scoliosis, which I do have, I just wouldn't quit. I have pain associated with it.

[Dingo]

case history

Rohrer01

Dingo, how do you know that regression occurred at the same time as PT began? Were they following her from zero to 11*? If not, you really can't say that. It could have been worse at some point prior and they didn't find it until it started to get better and was already improved to 11*. My son had a curve about that size spontaneously dissappear.

This is the history of this case as I remember it. She was diagnosed with a 9 degree curve. Although pain isn't usually associated with Scoliosis in kids this girl had some pain. If I remember correctly the mom thought that the curve was continuing to progress. Three months later she went in again and her curve had progressed to 11 degrees. At that point the mom came across the thread on Torso Rotation Therapy (the old one that used to be in the research section I believe). She purchased a used Cybex machine and had it shipped to her home. After a short period of time her mom noticed that her daughter's back was improving. One year later at her recheck the curve was gone.

I hope I have my facts straight. In the future I'm going to try and get an exact timeline of events and post it here for other parents. As a side note the girl's father is an M.D.

[Dingo]

chance of progression

hdugger

Dingo, you probably know the statistics for juvenile scoliosis better then I do. What's the risk of progressing, given a very small curve at diagnosis?

For small curves I'm not exactly sure. However Scoliosis among Juveniles is much more dangerous than it is among adolescents. In this study of 205 Juveniles with Scoliosis (source) 99 or 48.3% were ultimately fused.

At onset of puberty...
Curves less than 20 degrees progressed to fusion 15.6% of the time.
Curves between 21 and 30 degrees progressed to fusion 75% of the time.
Curves over 30 degrees at puberty progressed to fusion 100% of the time.

Among adolescents Scoliosis is much more dangerous if you are a girl. However among Juveniles the rate of progression is about the same for boys and girls.

[Dingo]

thanks

aterry

Dingo, THANK YOU for your posts and please keep up the good work. I find a number of people on this forum supportive of each other and I look forward to their posts: flerc, mamamax, skevimc, concerneddad (who I miss, a lot), fireflymd. And many others--I made a list but it was soooo long. I wish the site was moderated, but it's not. So perhaps we should just IGNORE, by not answering or posting back, the two people who insist on being cruel. I don't understand the impulse to wish that positive developments should not occur; that all patients should get worse curves and suffer until they are forced into expensive and dangerous surgery--especially our children. But we know who they are so just skip over their posts. Don't even read them, or block them.

Thanks, I'm glad you liked the x-rays. I miss concerneddad too!

BTW I used to make an attempt to argue down every ridiculous thing I read on this forum. Then I discovered the ignore feature. I think my blood pressure dropped 10 points since then.

[Dingo]

What scientists think about TRS

I sent the 12 year old girl's x-rays with a small amount of support information about TRS to scientists around the globe. The x-rays went to researchers in the USA, Greece, The Netherlands, Poland, Spain, Australia, Germany, Canada, Turkey, etc. etc. You name it and they probably went there.

Many scientists were kind enough to write back and so I thought people on this forum might be interested to know what top researchers thought about TRS.

Long story short they don't because outside of 2 notable exceptions my sense was that nobody had heard of it. This includes one researcher who knew Dr. Vert Mooney and told me that he'd never heard of TRS.

As for their reactions...
2 researchers seemed dismissive, 1 was very interested so I sent him the TRS video and study links and the other few fell somewhere in the middle.

In one response I got an indication that the x-rays had been forwarded to at least one other scientist whose name I could not possibly pronounce.

[mamamax]

More Info on Spontaneous Resolution

Well referenced posting/sharing from another forum (with author permission) regarding the topic:

I've studied the topic of spontaneous resolution quite thoroughly. In one of the earliest papers I wrote, one of the criticisms laid forth was that most cases of scoliosis resolve spontaneously, without the need for treatment. I have not seen this clinically, and there are many, many research papers which provide evidence against it. If the reader of this post is familiar with Martha Hawes, PhD, you may recall her discussion, Progression and Natural History, in Chapter 1, under Subheading G, in her book Scoliosis and the Human Spine: "Virtually all cases of juvenile IS are progressive (Robinson and McMaster 1996)." I must give due credit to Dr. Hawes, for many of the references below come from this landmark publication; everyone who is interested in the topic of scoliosis should own at least one copy of this text. I personally owe a deep debt of gratitude to her & this book for inspiring my own research journey into the field of scoliosis.

The age of a patient has been shown to significantly affect the chance of regression. Numerous studies confirm that a significant percentage of infantile scoliosis cases do, in fact, resolve spontaneously (Drummond 1985, McMaster 1985, Wynne-Davis 1978). In a review of clinical surveys of infantile scoliosis, the rate of spontaneous regression averaged at 53.7% and the rate of progression averaged 38.9%, out of over six-hundred combined patients (James 1955, Scott & Morgan 1955, Mehta 1972, Ceballos et al. 1980, McMaster 1983, Lloyd-Roberts 1965). However, it has been known since 1959 that out of the cases which do progress, the vast majority (98%) will develop into severe curvatures measuring 70 degrees or greater (James et al. 1959). According to Branthwaite 1986 and McMaster 1985, cases of infantile scoliosis which progress to this level have a high likelihood of resulting in death or disability before early adulthood.

Also, the chance that the scoliosis will improve without treatment lessens progressively with age. In one study, 104 out of 109 cases of juvenile IS (between the ages of 3 and 10), progressed; only 5% improved by >5 degrees (Robinson and McMaster 1996). Lonstein and Carlson (1984) reported a spontaneous regression of 11%, and Brooks et al (1975) reported 22%. However, in all of these instances, the magnitude of the curvature was initially measured to be mild (less than 30 degrees), and also included cases that did not technically classify as scoliosis at all (less than 10 degrees).

Even during the growth spurt, the chance of spontaneous regression remains very small: "Spontaneous regress of the curve almost never occurs in adolescent idiopathic scoliosis." (Sevastik JA: Idiopathic Scoliosis: What is it? Research into Spinal Deformities I, J.A. Sevastik and K.M. Diab (Eds.), IOS Press 1997, p. 37-40.)

There has never been an instance published in the literature where a moderate to severe scoliosis (above 30 degrees) spontaneously regressed post-skeletal maturity; rather, among 584 cases of adult spinal deformity followed without treatment for up to fifty years, sixty to one-hundred percent were found to demonstrate significant progression (Ascani et al. 1986, Bjerkrein & Hassan 1982, Collis & Ponseti 1968, Korovessis et al 1994, Weinstein & Ponseti 1983).

I hope this information is helpful in combatting the myth that scoliosis is a benign condition, undeserving of treatment, with little effect upon a person's physical & psychological status. In my personal opinion, this point of view is often put forward by individuals who have no real answers to give to the problem of scoliosis, so they insist that efforts to treat it are without value, when in truth - as anyone knows who has scoliosis or has a friend or family member who does - research into early detection & treatment is desperately needed to prevent the significant physical & psychosocial burdens that oft accompany this condition in his later stages.


Warmest Regards,
Dr. Josh Woggon
Director of Research
CLEAR Institute
jwoggon@clear-institute.org