SEAS (Scientific Exercises Approach to Scoliosis): a modern and effective evidence based approach to physiotherapic specific scoliosis exercises

Abstract

Background: SEAS is the acronym for "Scientific Exercise Approach to Scoliosis", a name related to the continuous changes of the approach based on results published in the literature.

Rehabilitation program: SEAS is an individualized exercise program adapted to all situations of conservative treatment of scoliosis: stand-alone in low-medium degree curves during growth to reduce the risk of bracing; complimentary to bracing in medium-high degree curves during growth, with the aim to increase correction, prepare weaning, and avoid/reduce side-effects; for adults either progressing or fused, to help stabilising the curve and reduce disability. SEAS is based on a specific active self-correction technique performed without external aid, and incorporated in functional exercises. Evaluation tests guide the choice of the exercises most appropriate to the individual patient. Improvement of the stability of the spine in active self-correction is the primary objective of SEAS. SEAS exercises train neuromotor function so to stimulate by reflex a self-corrected posture during the activities of daily life. SEAS can be performed as an outpatient (two/three times a week 45 for minutes) or as a home program to be performed 20 minutes daily. In the last case, expert physiotherapy sessions of 1.5 hours every three months are proposed.

Results: Different papers, including a randomized controlled trial (2014), published over the past several years, documented the efficacy of the SEAS approach applied in the various phases of scoliosis treatment in reducing Cobb angle progression and the need to wear a brace.

Conclusions: SEAS is an approach to scoliosis exercise treatment with a strong modern neurophysiological basis, to reduce requirements for patients and possibly the costs for families linked to the frequency and intensity of treatment and evaluations. Therefore, SEAS allows treating a large number of patients coming from far away. Even if SEAS appears simple by requiring less physiotherapist supervision and by using fewer home exercises prescribed at a lower dose than some of the other scoliosis-specific exercise approaches, real expertise in scoliosis, exercises, and patient and family management is required. The program has no copyrights, and teachers are being trained all over the world.

Figure 1

Patient 1. Posterior view.

Figure 2

Patient 1. Posterior view in active self-correction.

Figure 3

Patient 1. Postero-Anterior Spine X-ray.

Figure 4

Patient 1. Posterior view Postero-Anterior Spine X-ray while the patient maintains the active slf-correction learned during the exercise session.

Figure 5

Patient 2. Sitting position: start of exercise. Patient in uncorrected relaxed posture.

Figure 6

Patient 2. Active self-correction in sitting position.

Figure 7

Patient 2. Standing position: start of exercise, Patient in uncorrected relaxed posture.

Figure 8

Patient 2. Active self-correction in standing position.

Figure 9

Example Exercise 1. Patient in sitting and uncorrected relaxed posture.

Figure 10

Example Exercise 1. The patient perform the active self-correction.

Figure 11

Example Exercise 1. The patient lean forward preserving the physiological sagittal curves and the active self-correction.

Figure 12

Example Exercise 1. The patient reaches the standing position and maintains the active self-correction.

Figure 13

Example Exercise 1. The patient relaxes from the active self-correction.

Figure 14

Example Exercise 2. The patient in standing position in front of a wall. The patient is in uncorrected relaxed posture.

Figure 15

Example Exercise 2. The patient performs the active self-correction.

Figure 16

Example Exercise 2. The patient falls against the wall, landing on both hands and keeping the active self-correction.

Figure 17

Example Exercise 2. The patient bends the elbows and then pushes back with the arms keeping the active self-correction.

Figure 18

Example Exercise 2. The patient return to the starting position without losing the active self-correction.

Figure 19

Example Exercise 2. The patient relaxes, losing the active self-correction.