«Conscious correction of scoliosis and posture disorders» in the complex rehabilitation treatment of degrees 1–3 thoracic spine idiopathic scoliosis

Abstract

BACKGROUND: Severe functional disorders in the internal organs and systems of the body, increased fatiguability, and cosmetic body shape defects that lead to social and psychological problems, as well as the potential adverse effect of the progression of scoliotic deformity, necessitate the constant monitoring and timely treatment of sick children until their bone growth is completed. Thus, early diagnostics of scoliosis and timely combination therapy at the early stages of the disease are required.
 AIM: This study aimed to compare the efficiency of spinal deformity correction and apical vertebrae derotation in pediatric patients with thoracic spine idiopathic scoliosis and justification of the use of physiotherapy exercise method, Conscious correction of scoliosis and postural disorders (DCS) in children and adolescents with degrees 13 thoracic spine idiopathic scoliosis (IS).
 MATERIALS AND METHODS: This study included 98 patients with IS under supervision (78 (79.6%) females and 20 (20.4%) males). The average age of subjects was 12.5 years (916 years), namely 25 patients aged 911 years, 42 patients aged 1214 years old, and 31 patients aged 1416 years old. The anatomical type of deformity and its parameters were determined according to radiographs and clinical examination data (81 cases of right-sided thoracic scoliosis and 17 left-sided thoracic scolioses). The angular deformity was assessed according to J.R. Cobb, and the angle of curvature was 736. At baseline, all patients had active growth bone plasticity of the spine. Depending on the degree of deformity, they were distributed into groups of 37 patients with 716, 33 patients with 1722, and 28 patients with 2336. The radiograph analyses of the spine were performed in frontal and lateral projections in an upright position (frontal and sagittal plane curvature in degree measurements). Radiography was performed before the complex therapy and 2 years thereafter, which included individual isometric, derotation, respiratory, and other complexes of physiotherapy exercises according to the methods of DCS, K. Schroth, and Chneau corsetting.
 RESULTS: The changes over time of scoliotic deformity angle correction are closely related to the time of diagnosis, which was noted in all patient groups under study.
 CONCLUSIONS: Early diagnostics of thoracic spine IS and the use of DCS remedial gymnastics within the program of timely conservative treatment eliminated the disease progression in patients with deformity up to 17. In the case of IS of 20 and more, the combined use of the Chneau corset and exercise therapy using the DCS method achieved significant stabilization and correction.