Manipulative and Rehabilitative Therapy as a Treatment of Idiopathic Scoliosis Without Psychological Sequelae
SOURCE: J Chiropractic Medicine 2012 (Jun); 11 (2): 109–114
Jorge H. Villafañe, PT, MSc, PhD, Guillermo B. Silva, MSc, PhD, Andrea Dughera, MSc
Physical Therapist, Department of Physical Therapy,
Residenze Sanitarie Assistenziali
“A. Maritano,” Sangano, Italy.
OBJECTIVE: The purpose of this case report is to describe management and outcomes of a patient with scoliosis.
CLINICAL FEATURES: A 9-year-old female patient with a double curve pattern with Cobb angles of 18° and 24° (thoracic/thoracolumbar) compatible with scoliosis presented for physical therapy treatment.
INTERVENTION AND OUTCOME: Physiotherapy treatment with a combination of manipulative and rehabilitation techniques was used. After finishing the treatment, the patient had Cobb angles of 7° and 11°, an improvement of 55% and 54%, respectively. After 6 months, these effects were maintained, as the patient had Cobb angles of 11° and 11°. The clinical appearance of the patient improved after the course of care. The patient was evaluated for psychological outcomes by applying the following tests: Scoliosis Research Society 22, Bad Sobernheim Stress, and the Brace Questionnaire The patient had the maximum score in all tests at the conclusion of therapy.
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CONCLUSION: The patient responded favorably to manipulative and rehabilitation techniques. At the end of care, the patient did not show psychological sequelae with selected outcome measures.
From the Full-Text Article:
Adolescent idiopathic scoliosis, the most common form of scoliosis, is a structural 3-dimensional deformity of the spine and trunk that occurs in otherwise healthy children during puberty.  Curvatures less than 10° are viewed as a variation of normal, as those curves have little potential for progression. [2, 3] Idiopathic scoliosis is estimated to affect about 2% to 3% of young females. [1, 4-6]
The conventional treatment of a child or an adolescent with idiopathic scoliosis often lasts months or years.  Not only does the disease produce a visible deformity of the body, but also the treatment itself may cause psychological stress and induce stress reactions.  Wearing a corrective brace at school or outside home is the reason for both physical and psychological discomfort because there is still an insufficient level of acceptance of such a treatment at school society.  Outcomes from psychosocial and health-related quality of life (QoL) studies indicate that body image is a complex and significant issue for patients with scoliosis and their clinicians.  In patients with adolescent idiopathic scoliosis, the prevalence of associated psychological disorders may be as high as 19%. [9, 10]