Recently, a parent reached out to ask about what treatment options are available for her adolescent girl.
They had saw a scoliosis specialist and also went for physiotherapy treatment in a public hospital. Initially, they opted out of bracing but they have decided to go ahead now.
By this stage, the physiotherapist had discharged them from the hospital and they are looking for options to what more they could do to optimise recovery.
Schroth Method for Scoliosis
The Schroth Method is a exercise-based treatment for scoliosis.
The program is prescriptive and customised to each patient’s scoliosis. The end goal is to de-rotate, lengthen, and stabilise the spine. In doing so, they restore “normal” spinal alignment and muscular symmetry.
This was the program that the hospital had prescribed to the patient.
While the recommended duration of Schroff program is at least six months, there is research to suggest that patients’ scoliosis improve with programs as short as 12 weeks.
A systematic review of the Schroth program found that a 36-supervised sessions over 12 weeks study (Kim & HwangBo, 2016) had the largest decrease Cobb angles compared to 24-week programs published in other studies. In that study, the Cobb angle decreased from 23.6 to 12 degrees. An improvement of 11.6 degrees on average or at least 5.4 degrees (after taking standard deviation into account).
Interestingly enough, the pilates group in the study by Kim & HwangBo saw an improvement of 8 degrees (before taking standard deviation into account).
It should be noted that measurement of Cobb angle is done through x-rays and there is an approximately 4° to 8° variability in its assessment.
Scientific Exercise Approach to Scoliosis Method (SEAS)
It should be noted at this stage that SEAS is a branded, structured exercise program.
While the SEAS program is different from Schroff, they largely follow the same ideas – using exercise to correct for the alignment/muscular asymmetry. It would seem that SEAS place a greater emphasis on proprioception (i.e. awareness training).
A review of eight studies published earlier this year did find minimal evidence that Scientific Exercise Approach to Scoliosis Method to superior to traditional exercise approaches.
Non Scoliosis-specific Core or Strength Training
It should be noted at this stage that core stabilisation training had similar outcomes to the SEAS method.
An older study also found trunk rotation strength training to be useful at reducing Cobb angle.
Chiropractic Adjustments for Scoliosis?
When it comes to scoliosis treatments, chiropractic care inevitably comes into the picture: Can chiropractic adjustments cure scoliosis?
When many chiropractors in Singapore claim to be able to help with scoliosis through chiropractic adjustments, the latest systematic review found no good indication that chiropractic adjustments can improve Cobb angle. Research studies that supported spinal manipulation at improving scoliosis are all found to be at high risk of bias.
Read more: The Truth Behind A Chiropractic Adjustment
The big question always comes down to which program is better or what treatment works.
The truth is we don’t really know.
Between scoliosis-specific exercise programs, there is no clear superiority in which works better.
When we compare scoliosis-specific programs to general, traditional exercise, both seems to work as well as each other!
Research, at this point, suggests that exercise is likely to help with scoliosis. However, we are unable to ascertain which ones are better.
At the same time, there is no high quality research to suggest that chiropractic adjustments may be useful when it comes to management of scoliosis patients.