ISST Schroth

Information

Scoliosis patients need to have information about the disease to help themselves to develop pro-active coping strategies. Such information should include a calculation of the risk of progression even when it is difficult to assess accurately the risk of progression for immature children with scoliosis <25°Cobb.
To interrupt the circular process of scoliosis progression, the main therapeutic aspect is to reduce the asymmetric loading on the spine and its effects for the body statics and the postural and structural adaptations before the end of skeletal maturity.

Trained and experienced experts

PTs and physicians should have specific knowledge about radiological and clinical assessment, pathomechanism of scoliosis, documentation and scoliosis management regarding postural aspects, implementation of specific exercises, specific mobilization, and if necessary high standard braces. Because of the long term aspect of the treatment, therapists and patients must develop a special trustful relationship.

A standardized teaching process including physical examination, functional classification, documentation for therapists as well as for patients leads to an individual therapy plan followed by clearly defined follow-up evaluations.

Treatment

Specific scoliosis treatment (Asklepios Katharina Schroth), individual (out-patient by certified Schroth therapists), and possibly in groups (in-patient at the Asklepios clinic, Germany) is based on the above mentioned standardized teaching and clinical-reasoning management.
Conservative scoliosis treatment is targeting towards deceleration or prevention of progression to avoid bracing in cases with a low risk of progression and most important preventing surgery.
Treatment also includes teaching and planning scoliosis specific exercises and breathing techniques following the principles of Schroth Posture Variations to enable and encourage patients to perform a home-exercise program and achieve postural changes in activities of daily living. The intensity of the treatment program has to be individually tailored to the exercise capacity of the patients and the inherent risk of progression. Specific passive-assistive and active mobilization techniques are mandatory in case of structural-functional limitations.
Motivation, compliance, commitment, and discipline of the patients are following a deep understanding and the recognition of the main focus on long term postural changes.
Therapists should be able to accompany patients sometimes for months, years even lifelong.

Goals and main objectives

• Avoidance of surgery
• Deceleration or prevention of further progression
• Stabilization of spinal corrections in three dimensions
• Increase of chest mobility and respiratory function
• Trunk symmetry – cosmetic improvements
• Postural awareness and control of postural changes
• Home exercise program (HEP)
• Support regarding brace treatment – compliance – cosmetic
• Pain relief
• Help for self-help, self-competence, development of coping strategies