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KIN 207 > Exercise for Idiopathic Scoliosis > Flashcards

Exercise for Idiopathic Scoliosis Flashcards

1
Q

Cue when addressing kyphosis:

A

bring your bra line back

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2
Q

All autocorrection exercises integrate:

A
  • elongation
  • pelvis corrections
  • side-shift
  • derotational breathing
  • shoulder corrections
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3
Q

With muscle dysfunction, _____-_____ affected.

A

length-tension

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4
Q

With scoliosis, muscles are _____ on concave and ______ on convex side.

A
  • shorter

- longer

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5
Q

There is a lack of research to document ____ of _____ _____ that could be targeted by interventions.

A
  • deficits

- muscle dysfunction

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6
Q

Why is there a lack of research to document deficits?

A
  • most studies were cross-sectional
  • unknown if imbalances are causal or symptomatic of the curve
  • unknown if treating the imbalances will improve the curve
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7
Q

Studies on AIS differences vs controls showed:

A
  • prolonged EMG activity during gait in AIS
  • increased contralateral:ipsilateral activity ratio during side bending in AIS
  • weakness in paraspinal or abdominal muscles in AIS group
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8
Q

Studies on AIS side to side asymmetry vs controls showed:

A
  • increased contralateral EMG activity during side bending in AIS
  • different patterns of asymmetry during isokinetic contractions
  • prolonged latencies on the side opposite to he curve in AIS
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9
Q

Studies on associations between muscle impairment and curve progression showed:

A
  • larger convex:concave EMG ratios can predict progression
  • correlations are more pronounced for EMG measured in sitting postures
  • prolonged latency can predict progression
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10
Q

AIS model =

A

adolescent idiopathic scoliosis model

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11
Q

Theoretical AIS model consists of what 3 components?

A
  • postural component
  • sensory integration deficits
  • structural component
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12
Q

What questions are asked when AIS is being classified?

A
  • other exercise related dysfunctions in play?
  • is there soft tissue hyper/hypomobility?
  • motor control issues?
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13
Q

Motor control issues can include:

A
  • balance control
  • latency issues
  • neural representation of the body (Body Schema)
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14
Q

The issue with a heterogenous diagnostic category:

A

many factors may be in play

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15
Q

PSSE =

A

physiotherapeutic scoliosis-specific exercises

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16
Q

SRS RX guidelines for Cobb Angle of 15-20 degrees:

A

observe + early bracing in cases

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17
Q

SOSORT RX guidelines for Cobb Angle of 15-20 degrees:

A

educate + early bracing in cases + PSSE

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18
Q

SRS RX guidelines for Cobb Angle of 25-45 degrees:

A

brace

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19
Q

SOSORT RX guidelines for Cobb Angle of 25-45 degrees:

A

brace + educate + PSSE

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20
Q

SRS RX guidelines for Cobb angle of 45-50 degrees:

A

surgery

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21
Q

SOSORT RX guidelines for Cobb angle of 45-50 degrees:

A

surgery

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22
Q

SRS RX guidelines for adult scoliosis:

A

N/A or surgery

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23
Q

SOSOT RX guidelines for adult scoliosis:

A

PSSE + optional bracing prior to surgical decision

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24
Q

Potential goals of using exercise in combination with bracing:

A
  • to stop curve progression at puberty (or reduce it)
  • to prevent or treat respiratory dysfunction
  • to prevent or treat spinal pain syndromes
  • to improve aesthetics via postural correction
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25
Q

The use of a rigid brace always implies the associated use of:

A

PSSE

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26
Q

Using exercise alone depends on:

A

Risser and Curve severity

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27
Q

Immature curves:

A

between 11 degrees and over 30 degrees

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28
Q

Mature patients:

A

curves 11 to 45 degrees

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29
Q

Exercise alone or combined is incorporated for _____ maturities (____ ____).

A
  • all

- all rissers

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30
Q

Exercise alone or combined is used for curves between ____ and over _____ if non-surgical.

A
  • 11 degrees

- 50 degrees

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31
Q

Objectives of PT treatment:

A
  • slow/stop progression
  • prevent or treat respiratory dysfunction
  • control pain and eliminate cause
  • correct posture
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32
Q

PTs correct posture via:

A
  • balanced muscular tension (flexibility, facilitation, etc.)
  • balance exercises
  • static and dynamic sensory integration
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33
Q

Is PT used in North America?

A

only 15% of patients with AIS were referred to PT

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34
Q

Characteristics of those referred to PT in North America:

A
  • average age at time of referral: 16 years

- largest mean Cobb angle at time of referral: 26 degrees

35
Q

PSSE treatments:

A

Schroth approach

36
Q

Schroth approach is aka…

A

Barcelona Scoliosis PT School (BSPTS) approach

37
Q

Common elements among PSSE treatments:

A
  • individualized 3D self correction
  • isometric and stabilization-type contractions of the torso muscles in a corrected posture
  • integration of corrections into ADLs
38
Q

Individualized 3D self correction consists of:

A

self-attaining the best possible correction through muscle contraction with some use of external aids

39
Q

3 types of correction through muscle contraction:

A
  • side shift of the torso towards the concavities
  • self-elongation with derotational controlled breathing exercises
  • derotation and creation of kyphosis
40
Q

What treatment goals are PSSE dosages consistent with?

A
  • strength
  • endurance
  • motor control
41
Q

Schroth approach since _____ , _____.

A
  • 1924

- Germany

42
Q

Schroth approach consists of specific exercises progressed from:

A
  • lying to sitting and standing
  • static to dynamic
  • with progressively less and less feedback
43
Q

Schroth approach used to help patients…

A

understand and maintain corrected postures and break the progression cycle

44
Q

4 principles of Schroth Approach:

A
  • self-elongation
  • corrections in 3D (pelvis, side shifts, shoulder corrections)
  • breathing control (expand concavities/depress convexities)
  • stabilization
45
Q

All autocorrection exercises integrate:

A
  • elongation
  • pelvis corrections
  • side shift
  • derotatonal breathing
  • shoulder corrections
46
Q

Aim of Schroth exercises aim to ______ the curve ….

A
  • overcorrect

- past midline

47
Q

SETS =

A

Schroth Exercise Trial for Scoliosis

48
Q

SETS study supervised:

A

1 weekly or 8-10 visits a year front loaded then spaced out

49
Q

SETS study home program:

A
  • with handouts or videos
  • daily or 4-5x/week for 15-40 min.
  • 3-8 exercises
  • each 3-5 sets of 4-10 breathing cycles or 5 minutes each
  • progress based on correct performance
50
Q

SETS take home instructions consist of:

A
  • visual of set up and diagram of corrections
  • corrective instructions with breathing steps
  • dosage/frequency
  • tracking compliance
51
Q

SEAS =

A

Scientific Exercise Approach to Scoliosis

52
Q

SEAS challenges the….

A

maintenance of autocorrections

53
Q

Strength asymmetry weakness when…

A

rotating towards the concavity of their primary curve

54
Q

Scoliosis patients were significantly weaker than healthier teens when…

A

rotating toward the concave-left from the midline or concave/left pre-rotated positions

55
Q

Methods to improve rotation strength over time:

A
  • 4 month supervised machine rotation training
  • 2x/week for 25 min.
  • 4 more months home rotation training with elastic bands 3-5x/week
56
Q

Results of study looking to improve rotation strength over time:

A
  • after 4 months supervised, strength gains of 28-50%
  • after 4 months of home training, strength remained improved
  • all 3 curves > 50 degrees had curve progression
  • 20-40 degree curves: 100% had no curve progression at 8 months, 64% did not have curve progression at 24 months (typical)
57
Q

Larger improvements for ______ and patient specific _____ _____ scores with supervised therapy.

A
  • pain

- functional scale

58
Q

No significant between group effect on _____ ____ _____ ____endurance test and ______ scores.

A
  • prone double leg raise

- Oswestry

59
Q

No between-group differences in the _____ _____ of _____ after the 8 week PT intervention.

A

global rating of change

60
Q

How to use side-planking:

A
  • concave side facing down
  • held daisy for as long as possible
  • improvement in Cobb angle by 32%
61
Q

Why do we have to use caution when side-planking?

A

poor research methodology

62
Q

What is 3D ultrasound imaging used for?

A
  • looking at the immediate effect of exercise

- determining the in-exercise correction that can occur during postural and therapeutic positions

63
Q

Curve angle:

A

angle between most tilted vertebrae limiting the curve

64
Q

Interapical distance:

A

distance between the most deviated vertebrae in each curve

65
Q

Thoracic curve angles were reduced in fully corrected….. positions.

A
  • prone
  • sitting
  • active standing
66
Q

Lumbar curve angles were reduced in the fully corrected ______ and _____ -_____ positions compared to their respective habitual and passively-corrected positions.

A
  • prone

- side-lying

67
Q

Which position had the lowest thoracic and lumbar curve angles?

A

sitting active with hip flexion

68
Q

What positions reduced max AVR twist compared to their habitual position?

A
  • active prone
  • sitting with hip flexion
  • standing active
69
Q

…. was less rotated than in passive side-laying.

A

active side-lying with leg left

70
Q

Which position demonstrated the lowest max AVR twist?

A

prone active with hip flexion

71
Q

Which positions with active correction significantly reduced the interapical distance compared to their habitual position?

A
  • prone
  • sitting
  • standing
72
Q

Which position had the lowest interapical distance?

A

sitting active with hip flexion

73
Q

What were the results of SETS?

A

most remained stable

74
Q

Monticone et al.’s RCT found improved Cobb angles at _____ _____.

A

skeletal maturity

75
Q

The study that used SEAS (not Schroth) found:

A
  • larger Cobb angle improvement
  • lower risk of progression of their sample
  • longer intervention
76
Q

There is a lack of high-quality evidence to recommend the use of ____ for ____.

A
  • SSEs

- AIS

77
Q

We need more long term studies showing exercise can:

A
  • prevent bracing and surgery in the long term

- make an impact into adulthood

78
Q

There is _____ ______ to recommend scoliosis screening.

A

insufficient evidence

79
Q

There is evidence of _____ _____ in individuals with scoliosis but we do not know if it is a _____ or a _____.

A
  • muscular dysfunction
  • symptom
  • cause
80
Q

AIS symptoms may really be the _____ of many different _____ from many _____.

A
  • summation
  • symptoms
  • pathologies
81
Q

PSSE program dosages are not truly _____ with any typical programs for physical goals.

A

consistent

82
Q

PSSE treatment approaches have _____ components and try to _____ curves.

A
  • similar

- correct

83
Q

Evidence on exercise training for scoliosis is limited by _____ and _____ of evidence available but there is research ____ and _____.

A
  • quality
  • quantity
  • ongoing
  • improving

KIN 207 (27 decks)

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