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. 2024 Apr;60(2):331-339.
doi: 10.23736/S1973-9087.24.08177-2. Epub 2024 Mar 19.

Physiotherapeutic Scoliosis-Specific Exercises (PSSE-Schroth) can reduce the risk for progression during early growth in curves below 25°: prospective control study

Nikos Karavidas  1 , Paris Iakovidis  2 , Ioanna Chatziprodromidou  2 , Dimitrios Lytras  2 , Konstantinos Kasimis  2 , Athanasios Kyrkousis  2 , Thomas Apostolou  2
Affiliations

Physiotherapeutic Scoliosis-Specific Exercises (PSSE-Schroth) can reduce the risk for progression during early growth in curves below 25°: prospective control study

Nikos Karavidas et al. Eur J Phys Rehabil Med. 2024 Apr.

Abstract

Background: The main treatment aim in mild scoliosis is to prevent progression and if possible, to avoid bracing. Physiotherapeutic Scoliosis Specific Exercises (PSSE) are curve pattern specific exercises, based on 3D self-correction and activities of daily living training.

Aim: The objective of this study was to evaluate the efficacy of PSSE - Schroth, as an exclusive treatment, during the riskiest period of rapid growth.

Design: Prospective control study.

Setting: Outpatient treatment.

Population: Adolescents with scoliosis.

Methods: One hundred and sixty-three patients (148 girls,15 boys; mean age 12.6 years, Risser sign 1.1, thoracic (Th) Cobb angle 20.8° and lumbar/thoracolumbar (L/TL) Cobb angle 20.7°) performed PSSE - Schroth exercises in our clinic. They were asked to regularly attend supervised sessions and to follow a home-program at least 5 times per week. Our inclusion criteria were Cobb angle 15°-25°, Risser 0-2 and angle trunk rotation (ATR) >5°, measured by scoliometer. The outcome parameters were the Cobb angle before and after the intervention (improvement or progression were defined as angle difference more than 5°) and the number of patients that finally needed a brace. Average follow-up time was 29.4 months. Control group was consisted of 58 patients (54 girls, 4 boys; mean age 13.1 years, Risser sign 0-2, Th Cobb 19.4°, L/TL Cobb 19.2°), that were retrospectively analyzed and performed general or no exercises. Compliance was self-reported. Statistical analysis was performed by paired t-test.

Results: For PSSE - Schroth group, 103 patients (63.2%) remained stable, 39 (23.9%) improved and 21 (12.9%) worsened. The success rate (87.1%) was significantly higher compared to Control group (P=0.002), where 15 subjects (25.9%) were stable and 43 (74.1%) worsened. Similarly, 16 patients (9.8%) from PSSE - Schroth group finally needed a brace, while 39 (67.2%) from control group (P=0.01).

Conclusions: PSSE - Schroth reduced the risk of progression in Adolescent Idiopathic Scoliosis (AIS) patients, during early growth. Our results are in accordance with the recently published literature, showing the effectiveness of PSSE and their superiority compared to general exercises or natural history.

Clinical rehabilitation impact: Scoliosis specific exercises can be the first step of scoliosis treatment in mild curves, to avoid progression and bracing.

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Conflict of interest statement

Conflicts of interest: Nikos Karavidas is the inventor of PSSE-Schroth method. All other authors have no conflict of interest.

Figures

Figure 1
Figure 1
—PSSE-Schroth classification by Nikos Karavidas include eight different curve types.
Figure 2
Figure 2
—Algorithm to classify curve types in PSSE-Schroth classification.
Figure 3
Figure 3
—Clinical and radiological representation of the corrective forces during thoracic counter traction.
Figure 4
Figure 4
—Clinical and radiological representation of the corrective forces during shoulder counter traction.
Figure 5
Figure 5
—Treatment result with PSSE-Schroth exercises.
Figure 6
Figure 6
—Clinical and radiological improvement with PSSE-Schroth exercises.
See this image and copyright information in PMC

Comment in

References

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