SCOLIOSIS 3DC-Schroth Method Exercise

Our Adolescent Idiopathic Scoliosis (AIS) Treatment

Schroth Goals for Adolescents

Halt scoliotic curve progression and strive for some degree of reduction

Spinal stabilization through improved body mechanics

Improved pulmonary capacity

Improve strength and flexibility

To prevent or delay surgery

Improved postural appearance and awareness

Maintenance of corrections during daily activities

To empower the patient and to instill ability to manage one’s own unique curve(s)

Mild Curves: 10-20°

For patients who are skeletally immature and at risk for curve progression, we do not subscribe to the traditional ‘watch and wait’ philosophy regarding scoliosis. We recognize that at this juncture it may be a bit early to initiate an aggressive scoliosis rehabilitation program; however, according to our way of thinking, to ‘observe’ while a scoliotic curve gets worse is a questionable practice and it should be up to the parents and child to make the decision to wait and see. Our answer to this dilemma is to teach patients the ‘Best Practice’ approach devised by Dr. Hans-Rudolf Weiss, former medical director of the Asklepios Katharina Schroth Clinic in Germany. The postural modifications he has devised for scoliosis patients have been developed as a result of his experience in working with more than 30,000 scoliosis patients over the course of his career. The purpose of these modifications is to halt, and possibly reduce curve progression in adolescents with scoliosis. Statistics show that if a curve’s progression can be halted until growth is complete, the likelihood of curve progression is reduced over time. Of course, we are unable to offer any guarantees, but it is our philosophy and experience that learning these techniques and incorporating them consistently into daily life improves a patient’s odds against scoliotic curve progression.

‘Best Practice’ includes:

• Physiologic®-a technique used to mobilize the spine in the sagittal plane.
• 3D Made Easy-instruction in ADL’s (activities of daily living). The patient learns to correct the spine during a variety of dynamic activities. ADL’s are practiced to increase patient awareness of posture during daily activities. These are relatively easy to learn, but require compliance and intensive work to become cognizant of the new posture. The primary advantage of daily activities instruction is that, with practice, ADL’s allow the patient to relieve the asymmetric loading of the main scoliotic curve reducing the possibility of scoliotic progression.
• Spinal Mobilization-hands on therapy- above, at and below the apex of a curve- providing derotation and deflexion of the spine.

Upper Mild to Lower Moderate Curves: 20-30°

Our program for patients with curves in this range incorporates everything in our Mild Program, plus introduces Schroth curve-pattern specific scoliosis exercises that are appropriate to each individual’s curve.

Moderate to Severe Curves - 30°+

This program includes everything in the mild and moderate programs, but also institutes additional Schroth exercises, offering the most comprehensive ‘Best Practice’ and Schroth programs available for patients with scoliosis.

How we schedule: We understand that adolescents are busy people, not to mention the parents who must accompany them to each sessions. We typically schedule local patients for ten, two-hour appointments over the course of about a month. The closer together, the better for learning Schroth since the program builds upon itself and spacing gaps may require additional insturction time. For out-of-town patients, we offer a seven day intensive course, or two intervals consisting of three or four days. A typical patient will arrive Monday morning for an comprehensive examination and anatomy lesson pertaining to her/his specific scoliotic curve. The patient is then scheduled daily through the following Saturday for appointments of three-hours duration. Dr. Moramarco offers one to one instruction to learn and master ADL’s, spinal mobilization and Schroth exercises. On the patient’s final visit we create a DVD of the adolescent’s specific program to take home as a reference when practicing.

When Your Child Becomes a Patient at Scoliosis 3DC:

Patient and parents meet with Dr. Moramarco to review, in detail, the history of the child’s scoliosis, and x-rays, followed by a comprehensive examination based on a complete scoliosis history considering age, type of curve, Cobb angle(s), bone maturity, age of puberty, health and family medical history, experience with bracing and/or scoliosis alternatives.

•Visual Inspection: observation of curve(s), shoulders, hips, head, pelvis, knees, ankles, feet-from front, back and sides.

•Specific tests: range of motion, flexibility, scoliometer measurement, spirometry, chest expansion, palpation, muscle strength and gait analysis.

An anatomy lesson focusing on child’s unique scoliosis. This is central to understanding the Schroth breathing exercises because a patient must be able to internalize the concepts of the Schroth three-dimensional corrections that are the foundation of the scoliosis exercises and rotational breathing technique.

Each patient will receive a scoliosis manual, and a workbook, to document the status of his/her unique scoliosis – past, present and future.

Digital photos are taken to document posture for future comparison.

The patient is instructed in ‘Best Practice’ and Schroth postural corrections as determined by an individual’s curve including Schroth exercises, Schroth rotational breathing and stabilization.

Instruction in corrections in the sagittal, frontal and transverse planes.

Instruction in activities of daily living to help maintain postural corrections to reduce the risk of curve progression.

A DVD as a helpful resource to refer to when performing the exercises at home.