Non-Surgical Scoliosis & Kyphosis Treatment

When treating our patients with spinal curvatures such as scoliosis and kyphosis (Scheuermann's disease or round back), we design a therapeutic program based on the Schroth Method from the Barcelona Scoliosis Physiotherapy School (BSPTS). The Schroth™ Method was originally developed in Germany in the 1920s by world pioneer in scoliosis treatment, Katharina Schroth. The Schroth Method as taught by the BSPTS has been recognized by the Scoliosis Research Society as a viable conservative approach (one of seven PSSE schools) to the treatment of spinal deformities.

The Rationale

The muscle and postural imbalances that are typically seen in patients with either scoliosis or kyphosis can create uneven forces in the spine, and potentially contribute to the aggravation of the curve. Temporarily correcting these imbalances using scoliosis specific exercises can improve posture and help prevent curve progression.

The First Visit - Evaluation The PSSE therapist needs to review your spine x-rays and perform an intensive evaluation before treatment is rendered. A prescription for “physical therapy services for scoliosis/kyphosis” from a medical doctor is not required but preferred. We strive to be a part of the traditional medical model working closely with other professionals. We believe the best quality care comes when medical doctors, physical therapists, orthotists, and patients are all on the same team and have an understanding of the three-dimensional nature of scoliosis. The initial evaluation on the first visit includes:

•	Movement, strength, balance and functional mobility examination
•	Posture exam with digital photographs
•	Breathing and lung capacity assessment
•	Analysis of most recent full spine x-ray (confirmation of curve pattern, adult's modifiers if present, lumbopelvic parameters)
•	Curve pattern classification according to the Rigo classification system.
•	Determination of risk for curve progression

Specialized Treatment using the Schroth Method

For the treatment of patients who are not in the surgical range, we utilize elongation exercises specific to the curve, opening of the concavities or collapsed areas by muscular transverse forces, targeted breathing into the concavities, active and passive corrections of the postural asymmetries, trunk stabilization in the corrected position, and home program education.

The program is recommended for both adolescents and adults with idiopathic scoliosis. Adults with de novo degenerative scoliosis can experience reduced associated back pain and improved trunk stability.

Patients who have undergone spinal fusion surgery for scoliosis can be treated after healing is complete post-surgery. The specific exercises will address the trunk imbalances above and below the fusion, maximizing symmetrical forces in the spine after the fusion.

For patients in need of bracing, we can make recommendations for orthotists who specialize in scoliosis bracing following Rigo-Chenêau bracing principles. The Rigo System Chenêau brace is specifically designed to work well with the Schroth-based exercises in patients who are skeletally immature. For more information about scoliosis bracing you may visit: www.align-clinic.com.

Physiotherapy Scoliosis Specific Exercises (PSSE)

Physiotherapy Scoliosis Specific Exercises: A Comprehensive Review of Seven Major Schools. Scoliosis and Spinal Disorders. June 2016.

Family Resources

Effectiveness of the Rigo Cheneau versus Boston-style orthoses for adolescent idiopathic scoliosis: a retrospective study. (Scoliosis and Spinal Disorders Journal, March 2017)

Research article supporting rigid brace over soft brace. SpineCor associated with increased risk of curve progression (January 22, 2016)

The efficacy of three dimensional Schroth exercises in adolescent idiopathic scoliosis: a randomised controlled clinical trial. February 8th, 2015.

The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis-an assessor and statistician blinded randomized controlled trial: "SOSORT 2015 Award Winner". September 2015.

Scoliosis Research Society (SRS) Statement on Physiotherapy. By M. Timothy Hresko, MD. May 2014.

Physical Therapy for Adolescents with Idiopathic Scoliosis. Physical Therapy Perspectives in the 21st Century - Challenges and Possibilities. Refer to page 12 for Barcelona Scoliosis Physiotherapy School.

Straight Talk with the Curvy Girls. By Terry Mulvaney and Robin Stoltz.

New York Times article featuring Schroth physical therapy. Hope for an S-Shaped Back. By Rachel Rabkin Peachman. March 2014.

Philadelphia Inquirer article sharing a patient's experience with Schroth physical therapy. Beyond Braces for Scoliosis Patients. By Melissa Dribben.

International Society on Scoliosis Orthopaedic and Rehabilitative Treatment (SOSORT): founded in January 2004 by a group of physicians (from Europe and Asia) who are interested in studying the efficacy of various methods of conservative treatment. Dr. Manuel Rigo was the first president.

Paying for services

Insurance

We do not bill insurances. We are an out-of-network provider, which means patients pay us directly at the time of service based on an hourly rate. We do not sell packages, so you or we can discontinue your sessions at any time if needed be, without attachments. We can provide patients with a "paid" receipt. The patient will then submit any paperwork to try to obtain reimbursement from the insurance company. We cannot guarantee insurance coverage after providing you with this receipt and we will not contact your insurance on your behalf to obtain reimbursement for you.

Scheduling

Following the evaluation, you may schedule your sessions at the frequency and duration that better matches your specific case:

If you live locally you may attend 1-2 hour sessions 1-2 days per week for 20-30 sessions.

International patients may schedule for extended 3-4 hour sessions, for 7-14 days.

Our goal is to give you a strategy to care for your own back. You will learn how to perform a routine of exercises specific to your curve pattern with the purpose to facilitate the correction of the asymmetric posture and maintain the corrected posture during your daily activities. We will provide you with the tools to help you adopt a more centered and balanced posture.

Please note that enrolling in this program will require a high level of commitment from your part. We may discontinue your participation in the program at any time. For questions about the program you may fill out the Inquiry Form or call at 305-428-2790. Make sure to leave a detailed message if we are unable to answer your call.

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