What is Schroth Best Practice®?
Schroth Best Practice® is the Schroth Method improved. Our Schroth Method program is modeled after the Best Practice® program and incorporates the newest updates by Dr. Hans-Rudolf Weiss (third generation Schroth family (2,3). Dedicated to advancing the contributions of his grandmother and mother for patients desiring three-dimensional conservative treatment for scoliosis(5), Dr. Weiss has modernized the method. He has created a program where learning is experiential making it less challenging to understand and implement the Schroth principles so patients are more likely to integrate a scoliosis exercise during the course of their day (3).
These newest program developments offer patients the opportunity for improved chances at reducing curvature compared to ‘original Schroth’(4). Simple adjustments during daily life, depending on a patient’s curve, (see photos below), can and do make a difference for someone with scoliosis.
The purpose of Schroth Best Practice® load-altering protocols are to allow patients to effect optimal postural control. Methods used enable patients to more easily internalize their newly formed posture and process it as a motor engram (think recoding the brain through repetitive practice). The purpose of self-correction is so the new postures become second nature.
A recent RCT (Level 1) has validated the principles used in our Schroth Best Practice® program.
“The findings…show that a rehabilitation program including specific and task-oriented exercises is superior to a programme including traditional exercises in reducing spinal deformities and enhancing the HRQL [health-related quality of life] in patients with mild AIS. The effects lasted at least 1 year after the intervention ended.” (1)
How does Best Practice® compare to ‘original Schroth method’?
Schroth Best Practice® is the Schroth Method for scoliosis made simpler and easier, yet still efficient and results-oriented. Back-school instruction remains according to individual-curve pattern and the scoliosis-specific exercises still incorporate Schroth rotational breathing. Add-ons, simplifications, correction-boosting modifications, and reduced instruction times create added benefits:
- Patients learn self-correction according to their curvature during all sorts of daily activities (ADLs). They learn which postures are favorable and unfavorable and why (2).
- Outpatient immersion programs with a proven track record (6,7,8).
- Sagittal plane exercises, exclusive to Schroth Best Practice®, are validated by recent research (9,10).
- ‘3D Made Easy’ Schroth exercises are simple, powerful, and can be done anywhere – no equipment.
- Fewer props make patient compliance more likely.
- Power Schroth is used for enhanced muscle engagement.
- Side-shift, a successful component of scoliosis-specific exercise (SSE) is built into the protocols (11).
- Gait training incorporates curve pattern corrective movements while walking.
- Mobilizations are taught, for increased flexibility and range of motion.
- Schroth exercise has been found to positively impact self-esteem (12).
- Overall, Schroth Best Practice® is a more user-friendly program for active, integrated scoliosis management.
For mild scoliosis, physio-logic® sagittal plane exercises (A), ADLs (B), and mobilizations (C) are the first line of defense. They are relatively easy to learn and offer a proactive and viable alternative to the prevailing tenet of ‘watch and wait’.
Once these program components are learned, patients begin practicing rotational angular breathing or “Schroth breathing” with simplified exercises known as 3D Made Easy (D).
The final component of the program is “Power Schroth” (E), which is exclusive to Schroth Best Practice®. These scoliosis-specific exercises succeed in helping the spine shift into an over-corrected position (encouraging curve reduction) and challenging the core. Elongation and over-correction mean that more muscles (that support the trunk) are being engaged.
Schroth and Schroth Best Practice® Efficacy
When patients incorporate the Best Practice® concepts regularly, results consistently show halted progression in adults and halted or reduced Cobb angle measurements in adolescents. Documented Schroth results include improved Cobb angle measurements (13,14,15), improved postural appearance and imbalances (15), a reduction or elimination of pain (16), improved vital capacity and chest expansion (17), and an improved self-concept (12).
The effectiveness of Schroth Best Practice® has been documented internationally (4,6,7,8). Dr. Moramarco is an expert in both ‘original Schroth’ and Best Practice®. As a result of his affiliation with Dr. Weiss, he was on the ground floor of Best Practice® during its development. He has lectured internationally on its merits and is a Schroth Best Practice Academy board member. He has tens of thousands of hours of instructional experience and patients from all over the globe travel to Boston for his Schroth expertise and outpatient intensive programs for scoliosis.
Best Practice® protocols are not part of most Schroth instructional programs offered elsewhere in the U.S. – a practitioner must be Schroth Best Practice® trained and certified by Dr. Moramarco and/or Dr. Weiss.
(1) Monticone M, Ambosini E, Cazzaniga D, Rocca B. Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomized controlled trial. Eur Spine J. 2014 Feb 28.
(2) Weiss HR, Seibel S. Scoliosis short-term rehabilitation (SSTR) —a pilot investigation. The Internet Journal of Rehabilitation 2010;1 Number
(3) Weiss HR, Hollaender M, Klein R. ADL based scoliosis rehabilitation—the key to an improvement of time-efficiency? Stud Health Technol Inform. 2006;123:594–598.
(4) Weiss HR, Klein R. Improving excellence in scoliosis rehabilitation: a controlled study of matched pairs. Pediatr Rehabil. 2006;9:3. 190–200 Jul/Sep.
(5) Lehnert-Schroth Christa: Three-dimensional treatment for scoliosis. A physiotherapeutic method to improve deformities of the spine. Palo Alto, CA, 2007; The Martindale Press.
(6) Borysov M, Borysov A. Scoliosis short-term rehabilitation (SSTR) according to ‘Best Practice’ standards – are the results repeatable? Scoliosis. 2012 Jan 17;7(1):1.7.
(7) Pugacheva, N. Corrective exercises in multimodality therapy of idiopathic scoliosis in children – analysis of six weeks efficiency – pilot study. Stud Health Technol Inform. 2012; 176:365-371.
(8) Lee SG. Improvement of curvature and deformity in a sample of patients with Idiopathic Scoliosis with specific exercises. OA Musculoskeletal Medicine. 2014; Mar 12;2(1):6.
(9) van Loon PJ, Kühbauch BA, Thunnissen FB: Forced lordosis on the thoracolumbar junction can correct coronal plane deformity in adolescents with double major curve pattern idiopathic scoliosis. Spine. 2008, Apr 1;33(7):797–801.
(10) Weiss HR, Dallmayer R, Gallo R. Sagittal counter forces (SCF) in the treatment of idiopathic scoliosis: a preliminary report. Pediatr Rehabil 9:1; 2006:24-30 Jan/Mar.
(11) Maruyama T, Matsushita T, Takeshita K, Kitagawa K, Nakamura K, Kurokawa T: Side shift exercises for idiopathic scoliosis after skeletal maturity. Journal of Bone and Joint Surgery (Br) 2003; 85B; Supp 1: 89.
(12) Weiss HR, Cherdron J. Effects of Schroth’s rehabilitation program on the self concept of scoliosis patients Rehabilitation. 1994; 33:1. 31-34 Feb.
(13) Fusco C, Zaina F, Atanasio S, Romano M, Negrini A, Negrini S: Physical exercises in the treatment of adolescent idiopathic scoliosis: an updated systematic review. Physiother Theory Pract. 2011; Jan;27(1):80-114.
(14) Weiss HR, Weiss G, Petermann F. Incidence of curvature progression in idiopathic scoliosis patients treated with scoliosis inpatient rehabilitation (SIR): an age- and sex-matched controlled study. Pediatr Rehabil. 2003;6(1):23–30.
(15) Otman S, Kose N, Yakut Y: The efficacy of Schroth s 3-dimensional exercise therapy in the treatment of adolescent idiopathic scoliosis in Turkey. Saudi Medical Journal 2005; 26: 1429–1435.
(16) Weiss HR. Scoliosis-related pain in adults – treatment influences. Eur J Phys Rehabil Med. 1993;3:91–94.
(17) Weiss HR. The effect of an exercise program on VC and rib mobility in patients with IS. Spine. 1991;16:88–93.