Efficacy of Physiotherapy on Spinal Mobility Parameters and Pain in Persons with Adolescent and Adult Idiopathic Structural Scoliosis

Abstract

Background: Scoliosis cause changes in spinal alignment, mobility, flexibility rrecruitment of Paraspinal muscles and postural reflex mechanism. Ssubjects might have hump on one side of spine,functional difficulties, and pain in multiple regions of body, change in lung function, nerve compression,dysmenorrhea and constipation in severe curves. Some studies shows mood changes, depression,handicap and social involvement. Gradually it is becoming clear that if good non operative treatmentis given, only 1 in 25, or 0.1% cases may require surgery. Hence this study is aimed at effectiveness ofphysiotherapy on spinal mobility parameters.Methods: Study was conducted at Nizam’s institute of Medical sciences, department of Physiotherapy.13 adolescent idiopathic scoliotic subjects aged between 12 to 40 years were taken into the study.Subjects had curve specific exercise for 25 weeks. Outcomes measures include 1.spinal mobility(flexion, extension, left bending right bending), 2. Flexibility of pectorals, Iliopsoas and hamstringson both sides, 3. VAS (Visual analog scale) for pain, 4. Cobb angle for curve measurement.Change inVAS scores were significant (P <0.0001) and mean changes from 5.23 ±1.64 to 1.384 ±0.65 with IQRwas from 6-4 to 2-1. Spinal flexion (p value: 0.003) and extension (P-Value: 0.007) showed significantresults on Wilcoxon signed rank test. The improvements in Cobb angle was were more at lumbar regionthan the other areas in this study.Conclusion: Though there is less curve correction may be up to 2 degrees, rate of progression wasreduced. Pain levels reduced along with improvements in flexibility and mobility with exercise program.In conclusion results of this study shows scope for consideration exercise program to improve pain,spinal mobility, Flexibility along with a Cobb angle improvement.