Date Approved

5-1-2021

Graduate Degree Type

Project

Degree Name

Physical Therapy (D.P.T.)

Degree Program

Physical Therapy

First Advisor

Corey Sobeck

Second Advisor

Paul Stephenson

Academic Year

2020/2021

Abstract

INTRODUCTION: Adolescent Idiopathic Scoliosis (AIS) is a spine condition affecting 1-3% of the adolescent population in the United States. Of this group, approximately 0.5% require surgical intervention to correct the curvature.This results in approximately 29,000 surgeries performed in the United States each year on adolescents to treat AIS. This represents a considerable financial burden along with the risk of surgical complications, so exploring conservative alternatives to surgical treatment is a worthwhile area of research. The literature is lacking on the conservative treatment of scoliosis regarding the Schroth Method as a primary intervention. The purpose of this study was to determine the effectiveness of the Schroth Method on improving the curvature of the spine, pain ratings, and quality of life in pre-adolescent, post-adolescent, and adult subjects. METHODS: A retrospective chart review was performed to examine the research question. A total of 245 subjects met the inclusion criteria (17% males and 83% females). Subjects were reviewed on angle of trunk rotation (ATR), pain level, and Modified Oswestry Disability Index (m-ODI) at evaluation, progress note, and at discharge. Each outcome measure was analyzed for significant change between evaluation and discharge using the Wilcoxon Signed Ranks Test due to the non-parametric nature of the data, and difference in efficacy between age groups was examined using the Kruskal-Wallis Test. The Mann-Whitney U test was used to compare relative efficacy in outcome measures between specific age groups. RESULTS: Average improvements in the ATR outcome measure included 2.75 degrees for pre-adolescent subjects, 3.47 degrees for adolescent subjects, and 3.4 degrees for adult subjects. In the ATR outcome measure, there were no significant differences between groups. Average pain score changes included a 1.21 point improvement for adolescent subjects and a 2.05 point improvement for adult subjects. In the pain category, an adult group (ages 18-39) performed significantly better than both an adolescent age group (ages 10-17) and another adult group (ages 40-69) when compared with one another. Average improvements in the m-ODI outcome measure included 10.3 points in adolescent subjects and 20.12 in adult subjects. In the m-ODI outcome measure, two adult groups (ages 40-69 and 70+) performed significantly better than the adolescent group (age 10-17) when compared with one another. DISCUSSION: All age groups improved in ATR with no significant differences found between the age groups. In the subjective outcome measures of pain rating and m-ODI both the adolescent and adult groups improved but the adolescent group improved the least which was likely influenced by the initial low scores. The results of this study suggest that the Schroth Method can be an effective treatment in improving function and reducing pain and disability in patients diagnosed with scoliosis. CONCLUSION: This study supports that conservative treatment that included Schroth Method exercises provided by a Schroth trained physical therapist were effective in treating scoliosis. The Schroth Method's efficacy should be further explored with more detail to specific Schroth interventions and their biomechanical and physiologic mechanisms.

Comments

We would like to thank Alicia Canos for her assistance and expertise in furthering our knowledge of the Schroth Method examination and treatment.

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