1
Feb, 2015

Scoliosis Review: some reports

Regular readers will know that is was my intention to  conduct a lot of research on scoliosis and then publish some results. I am however, getting quite a lot of interest, so rather than sit on research , Ill publish thoughts and theories as i come across reports and Journals;  There is a risk that i can publish something that could be wrong and need to correct it later  However, the  value in people feeding back, digging out reports or treatments,  is worth a  possible public U turn!
regards
Andrew  Stemler ( andrew@crossfitlondonuk.com)
Is physical activity contraindicated for individuals with scoliosis? A systematic literature review
[Sports capacity of patients with scoliosis].
von Strempel A, Scholz M, Daentzer M
Sportverletz Sportschaden. 1993 Jun; 7(2):58-62.
Cobb angle less than 20. No  restrictions
For curves of 20° to 30°, they recommended restriction from what they call  performance sport; but school sports and competitive sports were allowed.
For curves of 30° to 50° or 20° to 30° with progression of 5° in 6 months, they allowed school sports with patients wearing a brace
Recommended these sports,:horseback riding, tennis, table tennis but not “performance sport or competitive sports at club level”. competitive sports allowed at school under the watchful eye of a teacher. For curves of 50° or more, they  recommended endurance sports (eg, cycling, swimming, hiking, jogging)”
Idiopathic scoliosis and spondylolysis in the female athlete. Tips for treatment.
Omey ML, Micheli LJ, Gerbino PG 2nd
Clin Orthop Relat Res. 2000 Mar; (372):74-84.
Scoliosis is not a contraindication to participation in sports and asserted that, unless a scoliosis was severe, it would not reduce physical function..
“Scoliosis is not a contraindication to participation in sports by the young athlete”; and they suggested  examination for underlying pathology (eg, syringomyelia, disk herniation, degenerative spinal disease) if pain accompanied scoliosis.
They also encouraged active strengthening and flexibility exercises for the spine during brace wearing and maintained that sports may be played while the athlete was not wearing a brace. Specifically asserted that swimming and water activity may be helpful to maintain flexibility, strength, and endurance.
Professional volleyball should be avoided, but recreational/amateur volleyball is acceptable.
Spinal deformity in the adolescent athlete.
Wood KB
Clin Sports Med. 2002 Jan; 21(1):77-92.
 “There is no objective evidence in the literature to suggest that active participation in any sport is directly associated with worsening of scoliotic curvatures beyond that of the natural history of the disorder.”
Recommended active exercise for  brace wearers  and encouraged brace wearing during exercise. No study exists showing negative effects of contact sports on the curve of a braced individual.  He encouraged  all athletics  out of a brace, not only for physical benefit, but for psychologic and social well-being!
Spinal deformity and athletics.
Schiller JR, Eberson CP
Sports Med Arthrosc. 2008 Mar; 16(1):26-31.
Recommends flexibility training and indicated that patients with scoliosis treated non-operatively can participate in all sporting activities.
Sport participation while wearing a brace was allowed and that sport participation out of a brace was also possible.
Conditioning should focus on flexibility of the spine and core strengthening and felt that the addition of plyometrics and power lifting after appropriate conditioning was acceptable. Athletes with scoliosis should be encouraged to participate in sport.
For postoperative patients, they maintained that sports participation should be at the discretion of the surgeon.
They did not recommend against torque sports for postoperative patients (eg, gymnastics, ballet, swimming, wrestling, javelin), as had previous authors.

30
Jan, 2015

Serial Case Reporting Yoga for Idiopathic and Degenerative Scoliosis: my justification for the side plank

Should  a client with Scoliosis perform the side Plank? I think so, as a strong side plank, when  matched with a strong plank and a good “brace” means the torso is “nice and locked down” ( highly scientific stuff)
The paper, “Serial Case Reporting Yoga for Idiopathic and Degenerative Scoliosis” came to my attention as it was reported In the Wall street Journal. I chased the actual study down to  an obscure Journal
Global advances in Health and Medicine.
So, it  got some people to perform the side plank
“Results: The mean self-reported practice of the side plank was 1.5 minutes per day, 6.1 days per week, for a mean follow-up period of 6.8 months. Among all patients, a significant improvement in the Cobb angle of the primary scoliotic curve of 32.0% was found. Among 19 compliant patients, the mean improvement rose to 40.9%. Improvements did not differ significantly among adolescent idiopathic and degenerative subtypes (49.6% and 38.4%, respectively).
Conclusions: Asymmetrically strengthening the convex side of the primary curve with daily practice of the side plank pose held for as long as possible for an average of 6.8 months significantly reduced the angle of primary scoliotic curves. These results warrant further testing”
My own take on this  is that  no harm resulted from this experiment, and it makes sense to test  strengthening both sides. The core  and torso needs to be braced: lets do it all! I should say the self reporting , does not make this the best evidence ever, but , interesting . The side plank is used by Stuart McGill in the treatment of back pain. It seems safe, if monitored, to use and test.
We will see how my client responds

will this help clients with scoliosis?
will this help clients with scoliosis?

22
Jan, 2015

Scoliosis research

Although its a bit away from the Backaholic agenda, I’m doing some  research on the efficacy of exercise on Scoliosis, using human Guinea Pigs (easer to feed, less pouch room). Ill park some generic observations and research on  this site, so we can all see where this is going.

Role of exercise in treatment of scoliosis: A quote from “Physical exercises in the treatment of idiopathic scoliosis at risk of brace treatment – SOSORT consensus paper”

“Exercise based therapies, alone or in combination with orthopedic approaches, are a logical approach to improve and maintain flexibility and function in patients at risk for pain, pulmonary dysfunction, and progression. Data from the Schroth clinic in Bad Sobernheim, Germany reveal improved pulmonary function  and reduced pain  in response to an intensive scoliosis in-patient rehabilitation (SIR) regime. Among the small number of studies which have examined it formally progression was less in patient populations who were treated with exercise [reviewed in (Negrini 2003)

The role of exercise based therapies as discussed in the spine literature has been controversial, however, with often-repeated claims that research has shown that such approaches are ineffective in treating scoliosis . A systematic review of articles published in English throughout history produced no data in support of such claims (Hawes 2003) . As pointed out by Focarile et al., in 1991, ‘Experimental controlled studies of different therapies seem to be justified both on ethical and scientific grounds.’

Hawes M. The use of exercise in the treatment of scoliosis: an evidence-based critial review of the literature. Ped Rehab. 2003;6:171–18

Negrini S, Antonini G, Carabalona R, Minozzi S. Physical exercises as a treatment for adolescent idiopathic scoliosis. A systematic review. Ped Rehab. 2003;6:227–235. doi: 10.1080/13638490310001636781.