Conservative treatment of idiopathic scoliosis according to FITS concept: presentation of the method and preliminary, short term radiological and clinical results based on SOSORT and SRS criteria

Abstract

Background: Conservative scoliosis therapy according to the FITS Concept is applied as a unique treatment or in combination with corrective bracing. The aim of the study was to present author's method of diagnosis and therapy for idiopathic scoliosis FITS-Functional Individual Therapy of Scoliosis and to analyze the early results of FITS therapy in a series of consecutive patients.

Methods: The analysis comprised separately: (1) single structural thoracic, thoracolumbar or lumbar curves and (2) double structural scoliosis-thoracic and thoracolumbar or lumbar curves. The Cobb angle and Risser sign were analyzed at the initial stage and at the 2.8-year follow-up. The percentage of patients improved (defined as decrease of Cobb angle of more than 5 degrees), stable (+/- 5 degrees), and progressed (increase of Cobb angle of more than 5 degrees) was calculated. The clinical assessment comprised: the Angle of Trunk Rotation (ATR) initial and follow-up value, the plumb line imbalance, the scapulae level and the distance from the apical spinous process of the primary curve to the plumb line.

Results: In the Group A: (1) in single structural scoliosis 50,0% of patients improved, 46,2% were stable and 3,8% progressed, while (2) in double scoliosis 50,0% of patients improved, 30,8% were stable and 19,2% progressed. In the Group B: (1) in single scoliosis 20,0% of patients improved, 80,0% were stable, no patient progressed, while (2) in double scoliosis 28,1% of patients improved, 46,9% were stable and 25,0% progressed.

Conclusion: Best results were obtained in 10-25 degrees scoliosis which is a good indication to start therapy before more structural changes within the spine establish.

Figure 1

Examination of flexibility of the scoliotic spine in functional positions.

Figure 2

Making child aware of trunk deformity due to scoliosis.

Figure 3

Active myofascial relaxation for hamstrings and erector spinae.

Figure 4

Active myofascial relaxation for erector spinae.

Figure 5

The myofascial structures limiting the corrective shift (a-before therapy, b-after therapy).

Figure 6

Active relaxation for rectus femoris with scoliosis derotation maneuver.

Figure 7

Sensory-motor control training on one leg.

Figure 8

Sensory-motor control training on the balance trainer.

Figure 9

Stabilization of lower trunk with 3-dimensional correction of scoliosis.

Figure 10

Stabilization of lower trunk with pillows sensorimotor and the ball.

Figure 11

Corrective chest movement for thoracic scoliosis.

Figure 12

An example of corrective pattern in functional position.

Figure 13

An example of corrective pattern in functional position.

Figure 14

An example of corrective pattern in functional position.

Figure 15

Cobb angle values before and after therapy in A group.

Figure 16

Percentage of improvement, stabilization and progression in A1 subgroup.

Figure 17

Percentage of improvement, stabilization and progression in A2 subgroup.

Figure 18

Percentage of improvement, stabilization and progression in B1 subgroup.

Figure 19

Percentage of improvement, stabilization and progression in B2 subgroup.

Figure 20

Clinical image before therapy.

Figure 21

Clinical image after therapy.

Figure 22

Radiography before treatment.

Figure 23

Radiography after treatment.

Figure 24

Exercise in pattern correction.

Figure 25

Clinical image before therapy.

Figure 26

Clinical image after therapy.

Figure 27

Radiography before treatment.

Figure 28

Radiography after treatment.

Figure 29

Exercise in pattern correction.

Figure 30

Clinical image before therapy.

Figure 31

Clinical image after therapy.

Figure 32

Radiography before treatment.

Figure 33

Radiography after treatment.

Figure 34

Exercise in pattern correction.