Hans-Rudolf Weiss Knihy

Increasingly, evidence can be found for the use of physiotherapeutic treatment for scoliosis. Bracing, once controversial, is now regarded as having a scientific basis. In contrast, evidence is lacking for the surgical treatment of scoliosis and recent studies on long-term results raise questions. The future, therefore, belongs to the conservative, nonsurgical treatment of scoliosis. The good news is that the latest developments in bracing and practices aimed at helping the patient according to individual curve pattern, now offer improved chances of stopping curvature progression and even the potential to reduce curvatures in the 20 to 50 range. Therapy specific to scoliosis aims for results acceptable for everyday living and to minimize its effects on the afflicted. After a short time and without major theoretical training, patients can learn a sense of postural awareness and help themselves by learning to avoid curvature-stimulating behavior.

Currently, there is the highest level of evidence for physiotherapy and bracing for scoliosis. In contrast, evidence for spinal fusion surgery remains questionable. Moreover, recent improvements in bracing now strive to improve curvature rather than merely stopping progression during the pubertal growth spurt. Adolescent patients can potentially achieve significant corrections via bracing and improve postural imbalances. Pattern-specific exercises, based on long-established Schroth methodology, have also been updated. Used during phases of significant growth velocity, patients have potential for improvement without surgery. 'Original Schroth' exercises, developed by Katharina Schroth, were initially for curvatures in excess of 90. Schroth Best Practice(R) simplifies the exercises so adolescents, as well as adults, of all curve magnitudes can benefit. The protocols include new additions with respect to the sagittal profile. Patients acquire a new sense of postural awareness and are able to help themselves by learning to avoid curve-stimulating behaviors.