Authors (including presenting author) :
Lui MWM, Kwong SSF, Au AYY, Chan CKM
Affiliation :
Physiotherapy Department, Ruttonjee and Tang Shiu Kin Hospitals
Introduction :
Spinal deformity has a significant impact on quality of life (QOL). Apart from idiopathic scoliosis, 15%-30% of normal adult would also develop degenerative scoliosis. The prevalence of adult scoliosis (ADS) ranged from 8.3%-68%. Among ADS, 61% would develop spinal pain. Schroth Method, is a world-wide asymmetrical trunk exercise therapy to correct scoliosis, originated from Germany. Most studies proved its effectiveness in Adolescent Idiopathic Scoliosis. Limited studies were available to investigate its effectiveness in ADS.
Objectives :
This study aimed to evaluate the effectiveness of Schroth Method for ADS in (1) pain; (2) functional tolerance; (3) QOL, with 12-month follow-up.
Methodology :
A tailor-made Schroth Method Program including specific-postural exercise, breathing patterns and home exercise was employed in Tang-Shiu-Kin Hospital from October 2016 to June 2018. Each treatment session lasted for 1 hour with close guidance. Subjects, aged 19-65 with scoliosis and spinal pain without operation, were recruited. The photos of standing posture and the spinal deformity were captured with consent at pre and post treatment for quality comparison of spinal deformity. Wilcoxon signed-ranks test and Friedman test were used.
Result & Outcome :
32 subjects (mean aged 39.9, 81.3% females) were recruited. 3 subjects dropped out (n=29). There was overall 69% improvement in 9 sessions. Pain decreased from 4.8 to 2.0 (p=0.000). Functional tolerance in sitting/ walking improved from 74 mins to 129 mins (p=0.000). Scoliosis Research Scoiety-22 Patient Questionnaire improved including function (4.2/5 to 4.6/5; p=0.009), self-perceived image (3.2/5 to 3.6/5; p=0.000) and mental health (3.5/5 to 4.0/5; p=0.000). The satisfactory rate of SRS-22 was 4.6/5. At 12-month follow-up, there was further improvement to 76.4% (p=0.025) while the pain decreased to 1.2 (p=0.004). Functional tolerance further improved to 158 mins (p=0.044). In conclusion, Schroth Method was effective in decreasing pain, improving functional tolerance and sustaining QOL for ADS. The sustainability of improved quality of life is important for ADS patients who are naturally progressive deteriorated. Therefore, it can be a new approach in ADS rehabilitation.
