Abstract

Background: The aim of this study is to evaluate the effect of a Schroth Best Practice^® program in an out-patient regimen on the signs of scoliosis in patients with adolescent idiopathic scoliosis (hereafter referred to as AIS). The second aim is to evaluate in-brace correction with the Gensingen Brace^® in the first sample of patients with AIS. Both authors have undergone training in this special approach to scoliosis rehabilitation. The first author has undergone PT (physical therapy) and CAD-CAM (computer-aided design and manufacturing)bracing training, the second author PT training.

Materials and Methods: 23 patients with AIS, 19 girls and 4 boys, with an average age of 13.6 years, average Risser sign of 2.52 and an average Cobb angle of 36.9 degrees (20-88 degrees), underwent an out-patient Schroth Best Practice^® program with an intensity of two days a week of 2 x 60 min sessions/day. The angle of trunk rotation (ATR) was measured before and after the course.

Eleven of the patients were fit with Gensingen Braces^®. Braces were produced via CAD-CAM. In-brace correction was measured and compared with initial data.

Results: After an out-patient Schroth Best Practice® program ATR was reduced significantly from 9.58 degrees to 7.47 degrees in thoracic and from 8.9 to 6.6 degrees in lumbar. An average in-brace correction of 59% was achieved in CADCAM braces.

Discussion: The results achieved with out-patient rehabilitation in the investigations published previously are repeatable. The deformity of the trunk can be reduced significantly after out-patient rehabilitation according to Schroth Best Practice® standards. In-brace correction comparable with published results on CAD-CAM bracing can be achieved in braces according to Gensingen^® standards after appropriate training.

Conclusion: Out-patient rehabilitation following the Schroth Best Practice^® standards seems to provide an improvement of signs of scoliosis patients in this study using a pre-/post prospective design. The results of the recent studies on Schroth Best Practice^® program seem to be repeatable.

Following appropriate training, the in-brace corrections achieved with the CAD / CAM technology can be compared to the in-brace corrections as published in recent literature. CAD / CAM allows for repeatable results globally.

Keywords: Brace treatment, CAD / CAM, conservative management, scoliosis, physical therapy