Scoliosis Short-Term Rehabilitation (SSTR) – A Pilot Investigation

Abstract

There is evidence that physiotherapy is an effective treatment module used in the management of patients with scoliosis. There is a RCT from China as well as a prospective controlled study from Germany supporting physiotherapy. The latter study was on scoliosis in-patient rehabilitation with patient samples treated intensively for 6 weeks. Today in-patient rehabilitation programs have changed and the length of the program has been reduced. Therefore, there is doubt that the results of the study are reproducible today. This is why new concepts of scoliosis rehabilitation have been developed on the basis of the latest methodological studies in this field. Material and Methods: In June 2010 the new 5-day scoliosis short-term rehabilitation was introduced based on experiential learning and the methods of treatment described in literature. 10 patients from New Zealand, US, Canada, Belarus, Rumania and Russia took part. Nine had a scoliosis, one was treated for kyphosis. The concept consisted of two guided 90 min. sessions and one experiential learning session of another 90 min on a daily basis. Finally, 9 patients with the diagnosis of AIS (Adolescent Idiopathic Scoliosis), two males and seven females with an average Cobb angle of 46° (29 – 64°) and with an average age of 14 (11 – 18) years were included. ATR (Angle of Trunk Rotation = Scoliometer) measurements were taken before and after the treatment. Additionally, the ability to correct themselves was measured after four days of treatment. A questionnaire to measure patient satisfaction was also used.Results: The ATR was reduced significantly from 10.3° to 8.2° (p < 0,001) after treatment in the nine patients with scoliosis. The ability to correct themselves as measured with the help of the Scoliometer (ATR 8.2° / ATR auto-corrected (without additional help by the therapist ) 5.7) was 1,45 and the difference between ATR 8.2° / ATR auto-corrected 5.7 was significant as well (p = 0,0035). Patient satisfaction was over average and the patient examination at the end clearly showed that all goals set were achieved for all patients.Conclusions: This new concept of rehabilitation is less time consuming and seems as effective as in-patient rehabilitation of 3-4 weeks. Therefore, in-patient rehabilitation lasting several weeks today seems necessary no more for children and adolescents with scoliosis. Studies with increasing patient samples are needed to substantiate these conclusions. Only the group of patients with scolisois is needed to be included. More explanation is needed. BACKGROUND There is evidence that physiotherapy is an effective treatment module used in the management of patients with scoliosis. In their systematic review Negrini and Coworkers (2008) reported on a RCT from China. There is also a prospective controlled study from Germany supporting physiotherapy in the in-patient mode (Weiss, Weiss and Petermann 2003). The latter study was on scoliosis in-patient rehabilitation with patient samples from 1989 to 1991 treated intensively for 6 weeks. Today, the in-patient rehabilitation program has changed widely and the length of the program has also been shortened. Therefore, there is doubt that the results of the prospective study (Weiss, Weiss and Petermann 2003) are reproducible today. The latest in-patient programs have not been investigated so far, no evidence has been achieved for their use (Yilmaz and Kozikoglu 2010) and this is why new concepts of scoliosis rehabilitation have been developed on the basis of the latest methodological studies in this field. As early as 2006, it has been shown that the outcome of scoliosis in-patient rehabilitation can be improved by adding on the physio-logic® program (Weiss and Klein 2006). Moreover, it has also been shown, that rehabilitation times can be reduced drastically (Weiss, Hollaender and Klein 2006) by adding on treatment methods based on the Scoliosis Short-Term Rehabilitation (SSTR) – A Pilot Investigation 2 of 8 activities of daily living (ADL, see also figure 1 and 2.).