Conservative Treatment Of Scoliosis Research Articles

Schroth Therapy: Advancements in Conservative Scoliosis Treatment (3rd Edition): Book Review

Schroth Therapy: Advancements in Conservative Scoliosis Treatment (3rd Edition): Book Review

Acute Effect of Brace Use on Upper-Extremity Functionality in Adolescent Individuals With Idiopathic Scoliosis: A Cross-Sectional Study.

It is well known that scoliosis adversely affects the functions of the upper extremities. However, the acute effect of rigid braces, which are widely used in the conservative treatment of scoliosis, on upper-extremity functionality remains unknown. The aim of this study was to investigate the acute effect of a rigid thoracolumbosacral brace use on upper-extremity functionality in individuals with adolescent idiopathic scoliosis (AIS). Thirty-eight individuals diagnosed with AIS participated in this cross-sectional study, with a mean age of 14.55 ± 1.90years and a range of 10-18years. The upper-extremity functionality was assessed using the Nine-Hole Peg Test and handgrip strength, with assessments conducted under both in-brace (with their own braces) and out-of-brace conditions. Nine-Hole Peg Test durations of the AIS patients for the nondominant side were significantly lower for in-brace conditions compared with out-of-brace conditions (p = .049, effect size = 0.136). The grip strength of the nondominant side was significantly higher for in-brace conditions compared with out-of-brace conditions (p = .025, effect size = 0.365). A weak negative correlation was found between the degree of curvature and the grip strength of the dominant side for in-brace conditions (r = -.323, p = .048). It was concluded that the brace had a positive effect on upper-extremity functionality on the nondominant side by both shortening the Nine-Hole Peg Test duration and increasing grip strength. In AIS patients, the brace may positively affect daily living by improving the functionality of the nondominant extremity.

A COMPARATIVE REVIEW OF NON-INVASIVE SCOLIOSIS TREATMENT IN CHILDREN AND TEENAGERS

Pediatric and adolescent scoliosis is one of the most common and prevailing orthopedic pathologies leading to spinal deformation. Cases of scoliosis where curving of the spine is <45% treated mostly surgically. However, when the spine is straightened with an implant, there are risks and complications. Hence, interest to conservative treatment methods has increased significantly. This article discusses advantages and disadvantages of non-invasive methods for treating scoliosis. The disadvantage is the duration of treatment: treating scoliosis using conservative methods such as physical therapy and wearing bondages can take a long time to achieve results. Also, there is a need for regular control: conservative treatment of scoliosis requires regular control by doctors and specialists to assess progress and change treatment plan if necessary. The most promising methods of conservative treatment, including correction of the muscular system, have been identified – adaptation physical exercises and gymnastics due to physical impact on kyphotic and scoliotic deformity. This includes breathing and physical exercises, therapeutic horse riding and wearing rigid torsion brace.

Predictive analysis of the scoliotic curve using a subject's 3D model.

A predictive analysis of the conservative scoliosis treatment is necessary, in which a 3D model of an optimal treatment algorithm is a basic part in the design of a prosthetic corset. Since CAD technology has proven to be very useful in the field of prosthetics and orthotics, we used an open-source software to plan the correction of the scoliotic curve on a virtual model of the subject's torso. The shape of the scoliosis was simplified by means of a directional polygon, which was drawn in a reverse manner depending on the directional arcs of the scoliotic curve. The resulting scoliosis correction, simulated in a predictive analysis, was defined by changing the Cobb angle, eccentricity, and torso height. With the proposed low-cost method of predictive analysis, it is possible to help CPOs to a more accurate and effective design of orthoses and corrective aids and to comprehensively determine the entire treatment procedure.

Jean-Jacques Cheneau (1927–2022)

On July 14, 2022, at the age of 95, the world-famous orthopedic surgeon Jean-Jacques Cheneau, the creator of the famous corset for the conservative treatment of scoliosis, passed away.

Screening for adolecent idiopathic scoliosis: A literature review

BACKGROUND: Despite more than 60 years of screening for adolescent idiopathic scoliosis, it is still a controversial issue in the scientific literature. There are both opponents and supporters of the intervention, represented by government agencies, medical organizations, and individual researchers. Several countries have rejected national scoliosis screening, although some medical associations in these countries believe that screening based on the Medical Home model is feasible. By contrast, school-based scoliosis screening has been implemented nationally in a few countries. Given the lack of consensus on this issue, it is useful to systematize conflicting views on screening for adolescent idiopathic scoliosis.
 AIM: This study aimed to review publications presenting information on the status of screening for juvenile idiopathic scoliosis to identify unresolved organizational issues.
 MATERIALS AND METHODS: Data were searched in the open electronic scientific literature databases (eLIBRARY, PubMed, and Cochrane Library) using the following keywords and phrases: scoliosis screening; screening for adolescent idiopathic scoliosis (AIS); school screening for scoliosis; school scoliosis screening program. The depth of the search was 30 years.
 RESULTS: Arguments for focus on the need for the early detection of AIS through screening in terms of the effectiveness of timely treatment, proven efficacy of conservative treatment of scoliosis, and reduction of surgical interventions among screened adolescents. The arguments against are related to the lack of a unified methodology for screening, high rate of false-positive and false-negative results, unproven effectiveness of screening in reducing the frequency of surgical interventions, economic efficiency, and psychological effect on adolescents and violation of their rights during the event.
 CONCLUSIONS: Several organizational issues should be addressed with regard to screening. These include the training of staff who conducts the screening and development of a referral and follow-up system. The screening scheme and methods should be unified through the introduction of noninvasive screening methods to standardize the results and their subsequent uniform interpretation. The referral process for further examination should be standardized according to a defined protocol. The development of a special computer program to assist medical decision-making is relevant.

Scoliosis: Brace treatment - from the past 50 years to the future.

Objective:This paper deals with scoliosis treatment over the past 50 years. The review of the literature from the point of view of the current formation of opinion. From conservative forms of treatment, the pendulum has swung to surgical measures. To visualize this temporarily rejection of conservative treatment is the goal of this article.Materials and Methods:A review of the literature over the last 50 years was performed from the perspective of current opinion, this with a pinch of personal experience in bracing and scoliosis surgery since 1972. The MESH terms (scoliosis, idiopathic scoliosis, adolescent idiopathic scoliosis) are presented in their number in a flow diagram and the publications on conservative therapies (brace, physiotherapy) are compared to surgical therapies (surgery).Opinions of “eminences” in the 1980s have been replaced by the rules of evidence-based medicine (EBM) at end of the 1990s. This transition will be visualized in the graph of PubMed statistics. In a statement, the future scoliosis treatment is derived from history.Results:The total number of publications shows a ratio of brace to surgery of 13.9% and physiotherapy to surgery of 6.7% for the MESH terms “scoliosis”. When “scoliosis” is supplemented with “idiopathic”, the brace to surgery ratio changes from 24.5% and physiotherapy to surgery 8.2%. Focusing on adolescent scoliosis the addition of “adolescent” changes the brace to surgery ratio from 24.8% and physiotherapy to surgery 8.1%. In the total number of publications, “adolescent idiopathic scoliosis” is treated by 25.26%. The patient numbers of our own scoliosis outpatient clinic (1482 patients) over the last 15 years show a ratio of brace (Cobb angle 20°–50° brace-indication) to surgery (Cobb angle >50° indication to surgery) of 1 to 0.06. The scientific focus on surgical therapy is evident from the figures of PubMed mentioned. The number of conservative publications shows a depression in the 1990s. In the remainder of this article, opinion-forming developments are outlined and supported by literature citations, responsible for the recovery of publications on conservative scoliosis treatment. New technologies provide additional treatment options.Conclusions:In this sense, brace therapy is a success story with a future in the digital world of AI (artificial intelligence), mathematical model calculations, and production perhaps from the 3D printer. The central message from the history of the last 50 years is: “The scientific review of treatment results is essential for the further acceptance of brace treatment.”

Physiotherapeutic Scoliosis-Specific Exercise Methodologies Used for Conservative Treatment of Adolescent Idiopathic Scoliosis, and Their Effectiveness: An Extended Literature Review of Current Research and Practice.

Due to the multifactorial etiology of scoliosis, a comprehensive treatment plan is essential for conservative management. Physiotherapeutic scoliosis-specific exercise (PSSE) methods have lately gained popularity for the conservative treatment of scoliosis. The aim of this study was to analyze the PSSE methodologies used for conservative treatment of adolescent idiopathic scoliosis (AIS), as well as their effectiveness. The study was based on an extended literature search conducted in the PubMed, Google Scholar, PEDro, eLABA, and BioMed Central databases. A total of 123 articles were selected for this study (including articles overviewed in systematic reviews and meta-analyses) after applying the inclusion criteria. The study revealed that inappropriate management of AIS could result in serious health problems. Conservative interventions that aid in stabilizing spine curvature and improving esthetics are preferred for scoliosis treatment. Bracing has traditionally been the mainstay of treatment, but growing evidence suggests that PSSE physiotherapy allows effective management of idiopathic adolescent scoliosis. Currently, there are the following PSSE physiotherapy schools in Europe: Schroth, SEAS, BSPTS, FED, FITS, Lyon, Side Shift, and DoboMed. The methodologies of these schools are similar, in that they focus on applying corrective exercises in three planes, developing stability and balance, breathing exercises, and posture awareness. Although high-quality research supporting the effectiveness of PSSE physiotherapy in the treatment of AIS is lacking, existing evidence indicates that PSSE physiotherapy helps to stabilize spinal deformity and improve patients’ quality of life. Among the abovementioned methodologies, Schroth is the most widely studied and has been proven to be effective. However, both SEAS and BSPTS effectively stabilize and even reduce the Cobb angle of scoliosis. Data supporting the validity of other methodologies are very limited. Only the Schroth method significantly reduces the angle of trunk rotation, while both SEAS and Schroth methods greatly improve the quality of life indicators. In any case, the available evidence is insufficient to confirm the advantage of one specific physiotherapy technique over others.

CONSERVATIVE IDIOPATHIC SCOLIOSIS TREATMENT WITH BRACE PRODUCED USING 3D TECHNOLOGY

ABSTRACT Objective To evaluate the immediate correction capacity of the Wood-Chêneau-Rigo brace (WCR), produced using digital technological resources and robotic engineering, in primary and secondary curves of adolescent idiopathic scoliosis (AIS). Methods A retrospective study was conducted of 138 patients with a diagnosis of AIS and who received a WCR brace from a laboratory that makes orthoses and orthopedic prostheses between 2019 and 2021. These individuals were submitted to an independent analysis of the radiographic parameters by a single researcher, the main outcome of which was the standardized measurement of the main and secondary curves using the Cobb method. The radiographs analyzed were performed in orthostasis before and immediately after the adaptation of the brace on the patient. The correction capacity was calculated as the ratio of the difference between the pre- and post-brace curves to the pre-brace curve. Results The mean correction with the WCR was 48.4% for the main curve and 41.0% for the secondary curve. The level of correction of the main curve was significantly higher in patients with a main curve with the apex of convexity in the thoracolumbar region (p = 0.004), especially in the left thoracolumbar region (p = 0.010); curves of magnitude between 10º and 24.9º (p <0.001); and curves classified as simple (p <0.001). Conclusion The use of the WCR, which is produced using modern technological resources, was effective in the immediate correction of AIS. Long-term studies on this new modality of conservative scoliosis treatment are necessary. Level of evidence III; Retrospective study.

Use of modern spinal braces in the treatment of idiopathic scoliosis

This review presents an analysis of scientific papers on the conservative treatment of idiopathic scoliosis with spinal braces.
 Insufficient awareness of brace treatment for spinal deformities is often the reason for the negative attitude of orthopedists toward brace therapy and the conservative treatment of scoliosis in general.
 In world practice, braces have been the primary and scientifically proven technique for conservative treatment of intermediate forms (grades IIIII) of scoliosis in children and adolescents for over 50 years. Modern spinal braces are active orthopedic products that provide three-dimensional correction of the existing deformity and prevent the progression of scoliosis. The main goal of using braces is to eliminate the pathological displacement of the vertebrae, ribs, and pelvis to a physiological state by applying pressure to specific body areas and actively correcting the deformity. Using a brace is the only non-surgical method to treat scoliosis with scientifically proven efficiency. The poor results of using braces to treat scoliosis are primarily due to insufficient correction in the brace, non-compliance with the wearing time, and the lack of adjunctive therapy. The efficiency of brace therapy depends on three main factors that require the personal involvement of the patient: the time of wearing the corset per day, the degree of correction in the corset, and constant (daily) training of the back muscles. The results of recent multicenter studies confirm the efficiency of using braces to treat idiopathic adolescent scoliosis.

General principles of diagnostic and conservative treatment of idiopathic scoliosis

Scoliosis is an orthopedic disease characterized by complex multi-plane deformation of the spinal column and chest, accompanied by a violation of the functions of organs and systems of the body, which is the cause of severe physical and psychological suffering in children. It is very important to carry out effective conservative treatment of scoliosis in I and II severity to prevent further progression of spinal deformity. It is proved that physical treatment methods are required in the complex treatment of patients with scoliosis. The purpose of physiotherapy is to eliminate dystrophy, improve contractile function of the muscles of the back and abdomen, eliminate instability of the spine and reduce pain.

Current knowledge of idiopathic scoliosis among practising physiotherapists in South Africa.

BackgroundIdiopathic scoliosis (IS) is a common musculoskeletal condition with a multi-factorial aetiology characterised by a three-dimensional torsional deformity of the spine.ObjectivesTo ascertain the current level of knowledge on IS among registered practising physiotherapists who expressed an interest in orthopaedic, muscular, manual and manipulative therapy in South Africa (SA).MethodAn online survey was used to collect the data. The questions were based on an existing questionnaire, validated by a South African panel of experts in the field of musculoskeletal physiotherapy and updated based on the 2016 Society of Scoliosis Orthopaedic Rehabilitation Treatment (SOSORT) guidelines for the assessment and management of IS.ResultsTwo hundred and twenty-three physiotherapists spread across the nine provinces of SA met the inclusion criteria and were included in our study. Our findings showed that about one-third (33.6%) of the physiotherapists could answer more than 50% of these questions correctly, and 16.5% could answer 70% of the questions correctly in relation to the widely accepted guidelines on IS management.ConclusionThe participants had a poor understanding of the diagnosis and treatment involved in managing patients with IS and a lack of knowledge regarding the methods of conservative treatment for scoliosis. Future studies should be aimed at assessing intervention strategies to improve the knowledge of IS in physiotherapists in SA, especially regarding diagnosis and identifying appropriate management strategies.Clinical implicationsPhysiotherapists are often the first contact practitioners for patients presenting with scoliosis and therefore need to have the necessary clinical knowledge on the assessment and management of IS. Our study can improve the awareness among the South African physiotherapists regarding IS and its complex presentation and management.

Patient compliance during conservative treatment of adolescent idiopathic scoliosis – literature review and the experience of a tertiary Institution multidisciplinary team

Conservative treatment of scoliosis includes orthotics and physical therapy. Efficacy of orthotic treatment has been validated over time through a great number of scientific papers, and today it represents the golden standard in the conservative treatment of scoliosis. Patient compliance is key in this type of treatment, as it is only effective during growth. Scoliosis is most often seen in adolescents, which is a turbulent period in every young life, and as such poses a number of aggravating factors for this type of treatment. It is of the utmost importance to understand the psychosocial aspects of this illness and treatment, as well as the dynamics of the patient and his/her family. Improving compliance is important for the course and outcome of treatment, and requires structured psychological support. Patients who receive psychological support during treatment are better equipped to go through the treatment and score higher on the quality of life questionnaires than the ones without the stated support.

CLOVES СИНДРОМ: КЛІНІЧНІ ПРОЯВИ ТА ОСОБЛИВОСТІ ХІРУРГІЧНОГО ЛІКУВАННЯ

Мета дослідження - встановити частоту CLOVES синдрому серед пацієнтів з лімфатичними мальформаціями, визначити особливості його клінічного перебігу та оцінити результати лікування.Матеріали і методи. Серед 126 пацієнтів з лімфатичними мальформаціями, які знаходилися на лікуванні протягом періоду від грудня 2010 до березня 2017 року на клінічній базі кафедри дитячої хірургії Національного медичного університету імені О.О.Богомольця НДСЛ «ОХМАТДИТ» CLOVES синдром діагностовано у 7 дітей, що складає 5,56%. Пацієнтів жіночої статі було 5, чоловічої - 2.Результати. Діагноз CLOVES синдрому було встановлено на основі поєднання характерних ознак, зокрема, постійними симптомами в усіх дітей були надмірні жирові розростання в ділянці тулуба, судинні мальформації з повільним кровотоком, лімфатичні (n=6, 85,71%), капілярні (n=5, 71,43%), та венозні (n=4, 57,14%); ураження опорно-рухового апарату: сколіоз (n=7, 100%), «сандальний проміжок» (n=3, 42,86%), макродактилія (n=3, 42,86%), синдактилія (n=3, 42,86%), дельтовидна форма ступні (n=1, 14,29%). При народженні виявляли окремі клінічні ознаки синдрому, прояви яких з віком прогресували, діагностували нові вади розвитку. У 7 дітей з CLOVES синдромом виконано від 1 до 6 операційних втручань. Метою операцій було видалення судинних мальформацій і жирових розростань. Операційні втручання мають свої особливості: інтраопераційна антикоагулянтна терапія (гепарин 50 U/кг/годину), виділення і поетапна перев’язка змінених венозних судин, обробка резидуальних вогнищ аргоновою коагуляцією. Склерозуюча терапія проведена у трьох пацієнтів з використанням препарату ОК-432. Консервативне лікування сколіозу з використанням корсетів Шено використано у трьох пацієнтів. Операційна корекція парціального гігантизму пальців ступні проведена в однієї пацієнтки віком 11 років.

EFFECTS OF THE SCHROTH METHOD FOR TRUNK MUSCLES’ STATIC ENDURANCE AND SPINE MOBILITY IN GIRLS WITH IDIOPATHIC SCOLIOSIS

The prevalence of scoliosis in the paediatric population is increasing every year. The treatment of idiopathic scoliosis in Lithuania is based on traditional physical therapy, and it is not always the most effective. Schroth method recently is widely globally used evidence-based conservative scoliosis treatment method. The aim of the study was to assess the effects of the Schroth method treatment for trunk muscles’ static endurance and spine mobility in girls with idiopathic scoliosis. The study was conducted in 2016-2017 at the Physical Medicine and Rehabilitation Centre, Children’s Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos. In the study participated 50 girls aged 9-17 years with idiopathic scoliosis. The patients were divided into two groups: the study group (n = 25) and the control group (n = 25). Schroth treatment method for the study group and a traditional physiotherapy for the control group were used. For patients were applied 10 procedures of physiotherapy (for 30 minutes, 5 times a week). The study showed that trunk muscles’ static endurance results after rehabilitation were significantly higher in the study group than in the control group (p<0.05). The analysis of the average changes in the results between the groups revealed that in the study group the results of abdominal muscles (16.08 s more), left side trunk muscles (6.98 s more), and right side trunk muscles (7.84 s more) had changed significantly. Results of spine mobility significantly improved in both groups after rehabilitation (p<0.05). Trunk flexion amplitude estimated to have significantly greater improvement in the study group. The treatment using Schroth method had significantly improved the indicators of trunk muscles’ static endurance and mobility of the spine during spinal flexion. When compare the results inside the groups, the significant change was shown in the majority of spine and posture-related parameters in the study group. Special physiotherapy, especially Schroth method for children with idiopathic scoliosis have been shown to be an effective conservative treatment for scoliosis.

Treatment of Scoliosis-Evidence and Management (Review of the Literature)

Context: Scoliosis is a three-dimensional deformity of the spine and trunk which includes lateral deviation, rotation, and a disturbance of the sagittal profile. Treatment is indicated for scoliosis because it may lead to negative consequences with regard to the quality of life and other health issues for some patients. The purpose of this review was to gather current, up-to-date information, and to search the recent articles on scoliosis for evidence of the different modes of treatment. Evidence Acquisition: A PubMed search for review articles, prospective controlled trials (PCT), and randomized controlled trials (RCT) was performed. The search terms were: 1) scoliosis, treatment (12,045 items found); 2) scoliosis, physiotherapy (776 items found); 3) scoliosis, brace treatment (1,447 items found); and 4) scoliosis, surgery (10,485 items found). Results: When looking at the current literature, high quality evidence (level I) was found to support physical rehabilitation and brace treatments, while no evidence was found to support spinal fusion surgery. The numerous long-term complications that patients may face post-operation, and the lack of evidence for spinal fusion surgery indicate that there is no clear medical indication for this kind of treatment. Conclusions: There is a high level of evidence for the conservative treatment of scoliosis, but there are varying levels of success in the different approaches. The better the correction of the curve, the better the end result and outcome for the patient. This is supported by the current evidence reviewed in this paper. Physiotherapy and bracing should be used and, specifically, those approaches using high corrective methods. Spinal fusion surgery is not supported by the current evidence. According to the literature, the long-term complications of surgery for scoliosis far outweigh the consequences of untreated scoliosis.

Physical therapy for idiopathic scoliosis

The objective is the description and summary of the current state of idiopathic scoliosis treatment with physical therapy based on new scientific knowledge and concluded from more than 15 years of experience as a leading physician in two well-known clinics specializing in the conservative treatment of scoliosis. Based on current scientific publications on physical therapy in scoliosis treatment and resulting from the considerable personal experience gained working with conservative treatment and consulting scoliosis patients (as inpatients and outpatients), the current methods of physical therapy have been compared and evaluated. Physical therapy according to Schroth and Vojta therapy are at present the most common and effective methods in the physical treatment of idiopathic scoliosis. These methods can be applied during inpatient or outpatient treatment or intensified in the practice of specialized therapists. As there are only a few scientific studies on this subject, the author's findings are based mainly on his own experiences of the conservative treatment of idiopathic scoliosis. Athough these experiences are the results of over 15 years of working in the field of therapy, and the Schroth method in combination with corrective bracing presents highly promising results, it would nevertheless be desirable to conduct detailed scientific studies to verify the effectiveness of conservative treatment.

Research quality in scoliosis conservative treatment: state of the art.

The publication of research in the field of conservative treatment of scoliosis is increasing after a long period of progressive decline. In 2014, three high quality and scientifically sound papers gave new strength to the conservative scoliosis approach. The efficacy of treatment over observation was demonstrated by two RCTs for bracing, and one for scoliosis-specific exercises provided by a physical therapist. It is difficult to design strong studies in this field due to the long time needed for follow up and the challenge of recruiting patients and families willing to be involved in the decision process. Nevertheless, the main methodological errors are not related to the study design but rather on the way it is performed, which very frequently affects the reliability of results. The most common errors are: selection bias, with many studies including functional rather than a true structural scoliosis; inappropriate outcome measures, utilizing parameters not related to scoliosis progression or quality of life; inappropriate follow up, reporting only immediate results and not addressing end of growth results; an incorrect interpretation of findings, with an overestimation of results; and missing the evaluation of skeletal maturity, without which results cannot be considered stable. Being aware of these errors is extremely important both for authors and for readers in order to avoid questionable practices based on inconclusive studies that could harm patients.

SEAS (Scientific Exercises Approach to Scoliosis): a modern and effective evidence based approach to physiotherapic specific scoliosis exercises.

BackgroundSEAS is the acronym for “Scientific Exercise Approach to Scoliosis”, a name related to the continuous changes of the approach based on results published in the literature.Rehabilitation programSEAS is an individualized exercise program adapted to all situations of conservative treatment of scoliosis: stand-alone in low-medium degree curves during growth to reduce the risk of bracing; complimentary to bracing in medium-high degree curves during growth, with the aim to increase correction, prepare weaning, and avoid/reduce side-effects; for adults either progressing or fused, to help stabilising the curve and reduce disability.SEAS is based on a specific active self-correction technique performed without external aid, and incorporated in functional exercises. Evaluation tests guide the choice of the exercises most appropriate to the individual patient.Improvement of the stability of the spine in active self-correction is the primary objective of SEAS. SEAS exercises train neuromotor function so to stimulate by reflex a self-corrected posture during the activities of daily life.SEAS can be performed as an outpatient (two/three times a week 45 for minutes) or as a home program to be performed 20 minutes daily. In the last case, expert physiotherapy sessions of 1.5 hours every three months are proposed.ResultsDifferent papers, including a randomized controlled trial (2014), published over the past several years, documented the efficacy of the SEAS approach applied in the various phases of scoliosis treatment in reducing Cobb angle progression and the need to wear a brace.ConclusionsSEAS is an approach to scoliosis exercise treatment with a strong modern neurophysiological basis, to reduce requirements for patients and possibly the costs for families linked to the frequency and intensity of treatment and evaluations. Therefore, SEAS allows treating a large number of patients coming from far away. Even if SEAS appears simple by requiring less physiotherapist supervision and by using fewer home exercises prescribed at a lower dose than some of the other scoliosis-specific exercise approaches, real expertise in scoliosis, exercises, and patient and family management is required. The program has no copyrights, and teachers are being trained all over the world.

Lyon bracing in adolescent females with idiopathic scoliosis: assessment of results according to the SRS committee on bracing and nonoperative management standardization criteria

Background The Lyon brace, devised by Stagnara in 1950, is commonly prescribed in many European countries, and is based on the three-point pressure system. The Lyon brace also applies derotational forces to the spine, with the main thoracic plate pushing the hump from the posterior convexity toward the anterior concavity of the scoliotic curve. Lyon bracing is considered to be an effective means for conservative treatment of scoliosis.