Scoliosis: Life, Support & Friends

Useful exercises for Scoliosis

2014-09-02T17:29:00.000+02:00

Hey guys. I was looking up some exercises that are ideal for Scoliosis and came across some very useful ones.

Stretch Up and Reach Down

The stretch up and reach down exercise is recommended for those with scoliosis by SportsInjuryClinic.net. Stand with your back against a wall, both arms dangling freely at your side. Standing with your back against the wall to perform this exercise helps you avoid bending forward or backward. If the left side of your back is your tight side, lift up your left arm so that it's pointing straight toward the ceiling. Reach up toward the ceiling with your left hand. At the same time, reach toward the floor with your right hand. You should feel a subtle shift in your spinal alignment with this stretch. Hold your stretch for five seconds, then relax. Repeat your stretch up and reach down exercise a total of 10 times, and perform your stretch two to three times per day. If you're not sure which side of your back is tighter or which arm you should raise, schedule an appointment with your primary care provider or a bodyworker trained in the treatment of scoliosis to have your spine and back assessed.

SportsInjuryClinic.net also recommends the side stretch for those with scoliosis. This exercise is intended to stretch your tight back muscles and provide you with relief from symptomatic back complaints. Stand with your feet about shoulder-width apart and your back against a wall, both arms dangling freely at your side. This is your starting position. If the left side of your back is your tight side, lift your left arm above your head and bend sideways to your right, away from your tight muscles. Put your right hand on your right hip to brace your movement, and apply gentle pressure into your right hip to augment your stretch. Reach over your head with your left arm as far as you're capable of reaching. You should feel a gentle stretch in your tight, left-sided back muscles and in the muscles between your ribs. Hold your stretch for five seconds before slowly returning to your starting position. Repeat your side stretch exercise a total of 10 times, two to three times per day.

IScoliosis.com recommends you perform arm and leg extension exercises on an exercise ball or stability ball to help strengthen your back and improve your posture. Begin your arm and leg extension exercise by carefully centering your hips on an exercise ball. The exercise ball should be supporting almost your full body weight. With your left toes and right fingertips contacting the floor for balance and support, extend your left arm and lift your left hand up to the level of your head. At the same time that you're lifting your left arm, lift up your right leg using your right gluteus maximus muscle until your leg is at the level of your buttocks. Hold your pose for three to four seconds before lowering your limbs and repeating the exercise. Perform a total of 10 repetitions before switching directions and lifting your opposite limbs for 10 more repetitions. Rest for 30 to 60 seconds before performing another set of arm and leg extensions. Perform a total of three sets of 10 repetitions on both sides of your body. Breathe in during the lowering phase and breathe out during the lifting phase.

I hope you guys find these exercises useful to you. Hopefully they'll subside the pain a little and make your day a lot more easier!

Kat x

Shailene Woodley's Scoliosis

2014-08-17T13:48:00.003+02:00

Many teenagers will probably recognize Shailene Woodley. She plays Hazel Grace in "The Fault in our Stars" and Tris Prior in "Divergent". But did you know that she also suffers from Scoliosis?

Shailene Woodley was diagnosed with Scoliosis when she was 15 years old. She had to also wear a back brace,18 hours a day for two years. When doing an interview for Marie Claire, Woodley said "Some people have crooked teeth, some people have broken fingers; and I've got a back that has my initial on it". Such an inspiration to us twisties, eh?

There are many more celebrities that have scoliosis; whether they've had bracing, or whether they've had the surgery. But I will be posting more celebrities, possibly once a week! I find that many of their stories are such an inspiration, and it shows that you can still go out there and do what you want even with Scoliosis!

If you want to read more about Shailene Woodley's Scoliosis then here's a link to an article about it: http://www.webmd.com/pain-management/features/actress-shailene-woodley-takes-scoliosis-in-stride_

Kat x

New Blogger!

2014-08-14T15:28:00.003+02:00

I thought for my first blog I'd introduce myself and tell you a bit about my Scoliosis journey.

So, my name's Kat and I'm currently 16 years old. I was diagnosed with Scoliosis in 2009 after a holiday to Florida where my Dad noticed my ribs were sticking out. My first appointment with my surgeon was 2 months later, where I was told I'd have to have surgery as my curve was already at 44 degrees and was too late for bracing. When I had surgery in January 2010, my curve had increased to 53 degrees. My surgery took 6 hours and I came out with an almost fully straight spine (3 degrees). My recovery was quite a speedy one, so when I finally went back to school I only missed an hour of it as I went home early.

From having the surgery, I can tell you that having the surgery is really worth it! The pain decreases a lot after surgery. You may get a few bad days, but nowhere near as many bad days as you had before surgery. There are so many reasons why having the surgery is worth it! If you're scared or need someone to talk to, I'll be here to listen and help you out! Just comment on this post if you have any questions.

I'll be blogging frequently about different topics, mainly about pain management tips that I've picked up along my journey; so I hope I can help as many of you as I can!

Kat x

Scoliosis Brace Correction & Quality of Life

2014-03-21T11:07:00.000+01:00

ScoliosisJournal posted a new article which talks about the correlation study between in-brace correction, compliance to spinal orthosis and health-related quality of life of patients with Adolescent Idiopathic Scoliosis

Authors: Siu Ling Chan, Kenneth MC Cheung, Keith DK Luk, Kenneth WH Wong and Man Sang Wong

Background
It has been proposed that in-brace correction is the best guideline for prediction of the results of brace treatment for patients with Adolescent Idiopathic Scoliosis (AIS). However, bracing may be a stressful experience for patients and bracing non-compliance could be psychologically related. The purpose of this study was to assess the correlation between brace compliance, in-brace correction and QoL of patients with AIS.

Methods
Fifty-five patients with a diagnosis of AIS were recruited. All were female and aged 10?years or above when a brace was prescribed, none had undergone prior treatment, and all had a Risser sign of 0?2 and a Cobb angle of 25-40?. The patients were examined in three consecutive visits with 4 to 6?months between each visit. The Chinese translated Trunk Appearance Perception Scale (TAPS), the Chinese translated Brace Questionnaires (BrQ) and the Chinese translated SRS-22 Questionnaires were used in the study. The in-brace Cobb angle, vertebral rotation and trunk listing were also measured. Patients? compliance, in-brace correction and patients? QoL were assessed. To identify the relationship among these three areas, logistic regression model and generalized linear model were used. Result For the compliance measure, a significant difference (p?=?0.008) was detected on TAPS mean score difference between Visit 1 and Visit 2 in the least compliant group (0?8?hours) and the most compliant group (17?23?hours). In addition, a significant difference (p?=?0.000) was detected on BrQ mean score difference between Visit 2 and Visit 3 in the least compliant group (0?8?hours) and the most compliant group (17?23?hours). For the orthosis effectiveness measure, no significant difference was detected between the three groups of bracing hours (0?8?hours, 9?16?hours, 17?23?hours) on in-brace correction (below 40% and 40% or above). For the QoL measure, no significant difference was detected between the two different in-brace correction groups (below 40% and 40% or above) on QoL as reflected by the TAPS, BrQ and SRS-22r mean scores.

Conclusion
The results showed a positive relationship between patients? brace wear compliance and patients? QoL. Poor compliance would cause a lower QoL.

To read the completre article please follow the link for a PDF version.

Simone: From the Heart

2013-10-07T16:24:00.001+02:00

Simone Icough August 2011

Well, I haven't posted here for some time, not from my own words anyway! I wanted to try and touch base with everyone again as it seems my Scoliosis support has lacked some enthusiasm since the death of my husband (Chris Icough) and I have been trying to find the strength to get involved again and be who I used to be - this journey has been hard so far and I know I will struggle with it for the rest of my life, however, Chris helped me start my great support group (which ended up being called "howtolookgoodtwisted") and he would be sad if I chose to give it up, we helped create so many great friendships for people with Scoliosis and when all is said and done, I hope that can continue.

I suppose this post is mainly an apology to the members of the group for slipping away into the darkness and hiding, but to be honest I didn't know what else to do, this was an inevitable reaction from my mind, body and soul and I guess it has taken me this long (30 months) to step back into the light and fight again. These days I struggle to focus, before I could do 10 things at once and not be fased by it but now the majority of my thoughts are filled with wonderful memories of Chris and this sidetracks me quite a bit, don't get me wrong I am not complaining about that but it does make me very, very sad and then the rest of my day just seems so pointless. The easiest way I can explain the feelings is; every thought or feeling you have which is remotely happy and makes you laugh or smile, you are left feeling guilty because you are alive and they are not - it has taken me 30 months to find a way to swallow those thoughts................and place them deep inside me so I can continue my day.

My life is a lot more hectic now as I am still running the business which Chris and I did together but now I am doing a lot more of the work so my time is very limited. I am trying my best to organise myself efficiently so I have plenty of time for my twisty friends, my group and the website, however, this is what I have been failing to do the most: ORGANISE, it always used to one of my biggest strengths but due to the trauma of losing Chris I have lost my way somehow, however, I am now back in our home and I can feel Chris all around me which is helping me build the strength to fight, not only for me but for the cause of Scoliosis.

Scoliosis: Making People Stronger from Within

I have had many a moment where I have hovered over the delete button for the howtolookgoodtwisted facebook group as I felt I couldn't cope. I felt I was letting the members and the moderators down, I wasn't replying to messages, creating new content and fund raising ideas; I just stopped. BUT, from somewhere within me there has always been a voice telling me that I would actually be heartbroken if I walked away after 9 years of running support groups. Luckily that voice was right and I walked away from the button!

It has been a rocky road, for me, my family and friends, but in so many ways I am lucky girl, I have a great family on both sides, some stunning friends and I know Chris will always be with me; I just wish it didn't have to hurt this much!

Thanks to all the members of the group for bearing with me and for offering support. To my amazing moderators, I love and adore you all so much you have no idea, thanks sooooooooo much for all that you do, you all deerve a medal!

I will be making more of an appearance from now on and gathering information from as many places as I can to keep supporting you through your journey - let's do it together and in true TWISTED style!

Simone

Pulmonary Function after Anterior Instrumentation

2013-08-28T14:50:00.000+02:00

iScoliosis recently published an article in relation to: Pulmonary function after less invasive anterior instrumentation and fusion for idiopathic thoracic scoliosis

Published: 21 August 2013

Purpose: Standard thoracotomy for anterior instrumentation and fusion of the thoracic spine in idiopathic scoliosis may have detrimental effects on pulmonary function. In this study we describe a less invasive anterior surgical technique and show the pre- and postoperative pulmonary function with a minimum follow-up of 2 years.

Methods

Twenty patients with Lenke type 1 adolescent thoracic idiopathic scoliosis were treated with anterior spinal fusion and instrumentation. The mean preoperative Cobb angle of the thoracic curve was 53[degree sign] +/- 5.8. Pulmonary function tests (PFT) and radiographic evaluation was performed.

Results

The mean postoperative correction in Cobb angle of the thoracic curve was 27[degree sign] +/- 8.2 (49%).

The mean preoperative FEV1 was 2.81 +/- 0.43 L, which increased to 3.14 +/- 0.50 L at 2 years postoperatively (P = 0.000). The mean FEV1% did not change (89.60 +/- 7.49% preoperatively, versus 90.53 +/- 5.95% at 2 years follow-up, P = 0.467). The TLC increased from 4.62 +/- 0.62 L preoperatively to 5.17 +/- 0.63 L at 2 years follow-up (P = 0.000). The FEV1% at two years of follow-up improved to 104% of the FEV1% predicted value. The FEV1 improved to 97% of the FEV1 predicted value.

Conclusion

Anterior spinal fusion for idiopathic scoliosis by means of a minimal open thoracotomy proved to be a safe surgical technique that resulted in an improvement of pulmonary function. Our results are similar to those of thoracoscopic procedures reported in literature.

Download this article about pulmonary function after less invasive anterior instrumentation and fusion for idiopathic thoracic scoliosis as a pdf

Scoliosis Charity Ball

2013-03-04T11:04:00.000+01:00

Jess contact How To Look Good twisted to talk to us about her Scoliosis Charity Ball which is taking place on the same day as our own event in York.

Jess is 15 years old and is raising money for Scoliosis, her event will be held at Jocasta's Lincoln.

Jess says "Scolio is a charity that I set up which sends gifts and grants wishes to children around the UK with serious conditions and illnesses. I set up Scolio after an operation to correct my Scoliosis where unfortunately I suffered rare complications (I have now made an almost full recovery)"

Tickets for the ball are £40 which includes a welcome drink, 3 course meal, coffee, raffle, disco, auction, photographer and live entertainment by Off Limits!

This will be a brilliant night which shouldn't be missed, says Jess.

"I really hope you are able to join us as it would be great to see as many people as possible there."

For tickets to the Scolio Ball, please contact Jess via her Facebook Page: Scolio Ball

The How To Look Good twisted team would like to wish Jess the best of luck for her event and hope she has some fun and raises the amount she needs.

Physical Therapy Intervention - AIS

2013-01-15T19:15:00.000+01:00

ScoliosisJournal recently reported about physical therapy intervention studies on idiopathic scoliosis-review with the focus on inclusion criteria.

Authors: Hans-Rudolf Weiss, MD, Elisabete Santos Leal, OMT, Ulrike Hammelbeck BSc

Background
Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT).

Materials and methods
A PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used.

Results
Real outcome papers (start of treatment in immature samples/end results after the end of growth; controlled studies in adults with scoliosis with a follow-up of more than 5 years) have not been found. Some papers investigated mid-term effects of exercises, most were retrospective, few prospective and many included patient samples with questionable treatment indications.

Conclusion
There is no outcome paper on PT in scoliosis with a patient sample at risk for being progressive in adults or in adolescents followed from premenarchial status until skeletal maturity. However, papers on bracing are more frequently found and bracing can be regarded as evidence-based in the conservative management and rehabilitation of idiopathic scoliosis in adolescents.

To read the whole story and see the diagrams then you may do so by visiting ScoliosisJournal

It's time to Get Mad....

2013-01-14T18:40:00.001+01:00

If there's one thing I've gotten very good at, it's complaining. Not about pain, mind you. Pain is inevitable and there is no point in complaining about it beyond the average "Ow, I hurt" and "Darling could you pretty please get me a heat pack?" followed by the batting of eyelashes. No, there is no point in complaining about pain.

Unless you are really, super mad. I'm talking rage-infused-throttling-mind-blowing-full-of-hate mad. And over the holidays, literally a day before I had to pack up my world and move to a new city (incidentally, big cities are pretty sweet), I got mad.

You see, I've been battling with the Alberta Government for some time to get AISH support. AISH either stands for Assured Income for the Severely Handicapped or As If, Shit, Hahahaha! I'm beginning to lean slightly towards the latter simply from this experience. I can't work full time. That's a given because of the pain. I also can't really afford my medication, which is also a given. Essentially, I am poor, in pain, and caught in the biggest Catch-22 someone in this situation can imagine. I was rejected from AISH because my condition was not considered severe nor permanent (Apparently the concept of a 'fused spine' was lost on the AISH worker making the decision.) But hey, I can appeal the decision so that's good! Appeal it I will! I will charm them with my banter and my rhetoric! I will stun them with the pieces of metal they pulled from my back! I will-

Wait, I'm sorry, what? Oh, you say because I am moving in with my boyfriend my financial eligibility now has to be reevaluated? You say because he is employed full time, and because we are living together, we are considered cohabitating and financially interdependent even though we are not financially interdependent? He doesn't pay for me, I don't pay for him. Oh, oh I see, that doesn't matter even though the legal terms for adult interdependent relationships in Alberta say that we have to be living together for three years? Oh? The rules don't apply to AISH? Well, why the hell do we even have- no, no don't answer it, I don't want to know.

So there you have it folks, now not only do I have to appeal my original rejections. I now have to appeal my financial eligibility based off of this ridiculous rule. Apparently the legal terms used in Alberta Legislation do not apply to AISH. Go figure.

Needless to say I was upset. This whole process has been going on for almost a year, and I am not getting in any less pain, nor am I miraculously getting richer. So, what do we say when we are upset by the Alberta Government?

Not today, Alberta Government.

Aaaand then we write a mass email to every. single. MLA. in. Alberta. (For the record, MLA's are our Members of the Legislative Assembly. They represent us on a provincial level. Essentially they go to bat for us in the legislature.) And when you write an email to every single MLA in Alberta decrying their poor treatment of you and the rest of the province, and telling them that they are pathetic and their laws are pathetic, and how ridiculous it is for someone in pain to be going through all this for a measly $200 bucks a month to cover medication... well, you eventually catch someone's attention.

Now, as it turns out, by moving to a new city I actually ended up moving into the Constituency of the Alberta Premiere. That's right, Alison Redford is my local MLA. As soon as I was told that I got the biggest shit-eating grin on my face, because who better to make waves at (or poke relentlessly in an effort to say "you there, notice me! Notice my pain!) than the person that is allegedly running the Province.

I got a lot of generic emails back. A lot of "Please tell us your address so we can forward this message to your MLA" yadda yadda. But then one email stood out above the rest. An email from another MLA in Calgary who is a member of the Wildrose Opposition Party. I don't like their politics, but I damn well appreciate what happened next. As it turned out, this MLA was the official Health Critic for the Opposition. Essentially, it is her job to hear these complaints and beat her fist in the legislature in an effort to draw attention to the problems. So I made contact with her assistant, who passed my angry (and perhaps vaguely insulting email) on to Premiere Redford's MLA office, as well as the office of the human services minister (who I still haven't heard from) and someone else (whose job is probably primarily to dance in a circle going "alalalala").

Well brilliant! Thank you for actually responding to my email! That made me happy. Then lo' and behold, I get back from school last week and there is a follow up email from the assistant asking if I had heard anything from them. When I told her no, she resent the email requests to the three offices and then emailed me right back to update me on the situation.

I'm not saying anything is going to happen. I will still end up appealing my financials, and if I don't end up winning that, I will still send my speech to every MLA and every newspaper in the Province in an effort to draw attention to the needs to those in Chronic Pain. I have an appointment with the Chronic Pain Clinic in the next month, so I'll speak to my nurse and ask her to help me go through the letter and see what else can be said. If it comes to that point, it won't be an appeal for help (at least not personally), but an appeal for attention to the problems of my Provincial Health Care System. Crusading by halves won't accomplish anything, but so help me god I will do whatever it takes to have people notice me and this problem that myself, and so many others must be suffering day in and day out.

And after that, well I suppose I'll just have to find something else to get mad at.

Scoliosis Campaign Fund Run

2012-10-25T12:03:00.001+02:00

As we seem to be blogging about people raising money of late, Laura pone of our very own moderators on the How To Look Good Twisted fan page, sent me some details of other people who are raising money for the SCF. Teamscoliosis will be running 13.1 miles which starts and finishes at the O2 Arena, London, 28th October, 2012.

The people who are running this 13 miles were inspired to do this by one of our very own Moderators, Laura Campbell.

They said

"Our friend Laura has suffered with scoliosis since she was 13. At 18 her curve had progressed to 72 degrees and she underwent 10 hours of major life threatening surgery at the University Hospital of North Staffordshire, when surgeons drilled titanium rods and screws into her spine to straighten it. After three days in intensive care and a week in hospital, Laura made a great recovery. However, she has since broken her back twice and two years ago her spine showed further signs of curving. She has recently had to have three more major operations to add more rods and screws down into her pelvis.

So after seeing what a painful struggle it can be to cope with this condition, we would love to raise as much money as possible for The Scoliosis Campaign Fund and perhaps help to improve treatment and support for patients"

ScoliosisNutty would like to wish them well for this weekend and hope you can raise a good amount of money for this event that will help people with Scoliosis.

You can donate to their charity page and pay with either Visa, Mastercard, Delta, etc

Good luck guys and thanks for sharing

Fundraising for Scoliosis Research

2012-10-08T14:46:00.001+02:00

Dan Bell contact me via email to ask if we can share the news about the fund raising he and his girlfriend Nichola Stott will be doing for Scoliosis Research.

They will be putting on their running shoes to raise money for the Scoliosis Campaign Fund.

Dan had corrective surgery at the age of 13 to correct Scoliosis which is curvature of the spine. The operation involved the removal of 6 discs and the spine being fused, along with 2 titanium rods inserted in his back.

"This event is all about giving a little back to a charity that does great work and also to raise some awareness of the condition.

We really hope you can donate even a small amount in an effort to hit our target."

On Saturday 10th November Dan will be taking part in the Brooks Hell Runner Down South, The Brooks HellRunner Hell Down South takes place at Longmoor Military Training Camp, near Bordon in Hampshire.

Brooks HellRunner offers trail running at its toughest and most enjoyable. 10 -12 miles of challenging off-road running… tough, twisting trails… including the famed Hills of Hell and the Bog of Doom!

The Finish will bring redemption… but only to successful HellRunners.

From everyone at ScoliosisNutty and HowToLookGoodTwisted we wish you all the best for your run at Hell Down South! ;)

Calling it a Complaint Letter just doesn't sum it up...

2012-09-04T22:56:00.000+02:00

Well, it's been a while. I was fortunate to finally obtain full time employment outsideof the retail sector (gasp) which has made earning money a bit easier on my spine. It has been a sad couple weeks for reasons I won't go into right now. Instead, I want to present you lovely folks with a bit of information.

See, I lost my insurance coverage in April. Problematic, as I am a 'pre-existing condition' felon, and as such, the plans available to me through my regional insurance companies are limited. And do any of them cover my most important, most expensive medication? No, because that would make sense.

So, since April I have been on a crusade to find coverage for my BuTrans patches. You think it wouldn't be hard, given that patches are more difficult to abuse and they provide long term (a week!) coverage that is delivered in even strides. None of the up and down of oral medications. BuTrans really improved my life when I began taking it, which says a lot given how my back feels now.

For a single month of coverage, I am giving up $200. That is for a single medication. Essentially 1/4 of my pay check goes towards covering all my medication. That's an awful lot given that I have to move out in January and switch cities to go to school. I will be paying rent, utilities, food, everything. I can do it, but it will be tight (and bless my lovely boyfriend who took on some of my debt so I could start improving my credit score.)

So the three major insurance companies are out. Oddly enough, Manulife will cover BuTrans, but only $500 per year. Not exactly worth the amount I'd be paying for the whole package in the first place. The rest of the companies go by the Alberta Drug Benefit Guide, which, through a snarky letter, is determined through advisory by the Canadian Expert Drug Advisory Committee.

Expert Drug Advisory Committee. Haha. You can probably imagine how I felt about that terminology. So, given the nature of the situation, and that I am almost out of ideas about who to go to or who to complain to, I sent the CEDAC a lovely letter trying to ascertain how they justified their recommendation that BuTrans not be on the Alberta Drug Benefit Guide.

The letter is as follows:

To the Canadian Expert Drug Advisory Committee

RE: September 28th, 2011 Final Recommendation for Buprenorphine Transdermal Patch

Dear Sirs and Madams,
While I am aware that I am almost a year late on appealing to your better senses regarding the decision to not recommend BuTrans Transdermal Patches for coverage by the Government of Alberta, I hope that the committee will take a moment to consider my own personal appeal. Should you feel at the outset that my appeal is not worth your time, I would remind you that until recently I had no idea the fate of my medical coverage was in the hands of a series of ‘experts’, and I have swung through so many hoops in order to find a way to pay for my BuTrans that I might be referred to as some form of circus animal.

I suffer from chronic pain. Actually, that’s not fair. I have chronic pain. It is a condition that, due to its ‘chronic’ nature, will be with me for the rest of my life. You must appreciate that for a 23 year old who has been putting up with said pain for over 11 years, the rest of my life seems like a dreadfully long time to be in pain

I was fortunate enough to have sufficient coverage for my medications right until the end of April, 2012, when my coverage was unexpectedly cancelled due to bureaucratic nonsense. That meant that not only were my BuTrans patches suddenly not covered, but neither were my morphine tablets for breakthrough pain, my Lyrica to help with nerve pain, my Baclofen for my muscle pain, or my Tecta for the ulcer that has developed due to the stress of being in pain and taking so much medication. This may all seem a bit outrageous for a 23 year old, but if you consider my position as one with severe scoliosis who has had 5 spinal surgeries and is fused from T1 to L4 (with anticipation of another surgery to fuse the remainder of my spine within the next 3 to 5 years), the amount of medication I am taking is fairly tame. After all, I had my fusion done at the age of 13 when my curve, diagnosed at 11, jumped from 30 degrees to 75 degrees, and my lung capacity was becoming diminished due to the curvature.

Five spinal surgeries. I want you to hold onto that thought for a moment. How many spinal surgeries have you had? No, this isn’t a ‘My boat is bigger than your boat’ sort of comparison. My case has been quite unique, which is unfortunate for me. What I am urging you to realize is that my pain is not describable, and unless you have suffered the exact circumstances, you can hardly claim to understand what it is like to try and get up in the morning, or suffer through the long winters that aggravate the degenerative arthritis that is swelling in my two free vertebrae. It is not an easy life I lead, but I soldier on because, hey, what else am I going to do with my time? Do I want to be one of those whiney Rig Workers who injuries his back and goes onto AISH for the rest of his life? Heck no. I have a life to lead; I have things to accomplish; I have dreams to strive towards. It is difficult to do these things when pain is a constant factor that must be taken into account before I make my daily decisions, but there you go.

Upon losing my coverage, I came into a very annoying situation for any individual with a pre-existing condition. The number of plans available are limited; this isn’t surprising given that no company wants to have money sucked from their pockets by someone who has to spend upwards of $300 a month on medication alone. Nonetheless, I have, I believe, a greater need for coverage than the average person, and yet my access to the coverage that I need for my unique situation is denied to me by your expert panel. Don’t take my snark to be a form of lack of respect. I have looked over your panel and I am fully willing to admit that you all bring something important to the group. However, do any of you bring chronic pain to the table? Do you understand the situation – I can guarantee that if you don’t suffer chronic pain, you cannot begin to comprehend what it is like living with it.

It is frustrating, it is difficult. I have no appetite because of pain, and as a consequence I have anemia and a B12 deficiency. Things are falling apart left and right and my access to the medication that I require is denied to me because why? It’s too expensive? That is precisely why it should be covered. BuTrans will not remain on the market if it cannot be sold. On the other hand, should it be covered, even a tiny bit (50 dollars would make a world of difference), then the market will adjust. BuTrans will become a favorite with physicians who identify the fact that it is A) a patch and thereby difficult to abuse and B) provides consistent, long term coverage to be a benefit over oral drugs. The more it is prescribed, the more quickly Purdue Pharma will recognize its importance and be able to lower the price. Think of it like buying a used car that has been soup up. The car can be amazingly efficient. There can be absolutely nothing wrong with it thanks to the work of the previous owner, but you get to benefit because it has been around the block.

The fact of the matter is that a decision was made by your expert panel, and now it is time to reexamine the facts that are being presented you. I am asking, practically begging, to present my case for BuTrans before your expert council. As one who has finally found a medication worth my time, that makes daily life bearable, I deserve the chance to present what I feel is a strong case for the coverage of BuTrans before you and anyone else who might have vested interest in the success or failure of it as a product. You have made a decision not for yourselves, as you are not the ones who use it, but you have made a decision for patients everywhere that have benefited from the use of BuTrans. In that regard, you owe me the chance to state my case before you. You owe me, because you have made a decision that is affecting my life in a gross and unacceptable way. You owe me, because my future is hinged on my ability to save money, work, go to school and do all this while functioning with chronic pain. You owe me because you made a decision that affects me, and because of that, you owe me the chance to stand before you and present my case. Besides, two of your members weren’t present at the final vote, which seems to me an unacceptable situation when deciding whether to recommend a medication for coverage or not.

I look forward to speaking to you, as a panel of experts, in person and soon. This situation must be remedied. You hold the lives of individuals just like me in your hands, and it is not fair for you to pull the strings without hearing first-hand how your decision will affect the lives of others.

Sincerely,

Kathleen A. Sawisky.

What is humourous about this whole situation is that when I sent my original complaint letter to the Alberta Government (I do love me a good complaint letter) the response I received said this:

For the different government-sponsored prescription drug programs, as is the case with any publicly funded program, the Government of Alberta must ensure that public funds are spent as wisely and effectively as possible, in order to maximize the benefits and make them available to as many Albertans as possible.
I know there is a huge international scene in our family, so for those of you who don't know, there has been a huge backlash about mispent funds and severance packages being dolled out to these Health Region Officials who have buggered up and are fired but rewarded with massive amounts of money thrown at them as they leave the office. I was annoyed with this little bit, and the fact that they ended the email with "Wishing you good health". So I responded with this: Dear Sir and/or Madam,

Are you kidding me? The Government of Alberta must ensure that public funds are spent as wisely and effectively as possible, in order to maximize the benefits and make them available to as many Albertans as possible. Are you actually joking? My tax money is going towards outrageous severance packages for morons who do jackshit, and you're telling me that public funds have to be spent wisely?

Where is my severance fund? How dare anyone within the Government have the gall to say something so ludacrious given the attention that has been placed on the moronic handling of funds within the Alberta Health System. And how dare you leave the fate of people's lives and their capacity to live in the hands of a committee who is probably getting paid the same outrageous amounts as Mr. I Want A Bottle of Champagne With My Frite-Tar-Tar Merali. Don't even get me started on the Stephen Ducket fiasco.

The failure to format the system to the needs of the people that use it is a disgusting show of self-entitlement and self-importance developed by the people who want to drive flashy sports cars and spit on the little people.

Further more, your little comment at the end about my good health just proves how little the Government of Alberta cares about its people. Had you, or the writer of the previous response (whoever that may be) had even the smallest amount of tact or empathy, you would realize that I don't have good health and that is the damn problem. I don't have good health because the wait times for clinics is outragoues because you can't afford to hire one or two more doctors. I don't have good health because you leave my ability to afford my medication in the hands of people who will never have to use it. I don't have good health because the Government of Alberta has done everything in its power to prevent me from receiving the care that I need to live a reasonable existence. I don't have good health, plain and simple. And my ability to access the resources that might improve my lifestyle are denied to me because the Government of Alberta has deemed that those resources aren't worth putting a few extra dollars into.

God help you if you ever need to take advantage of more than the average medical options available in Alberta. Maybe then you'll realize how pathetic all these excuses you've thrown at me really are. Not my finest moment, but I admit that I feel much better knowing that I said it. Someone has to say it. Legally they have to respond within 3 days. We shall see. Meanwhile, my good doctor is bantering with the marketing department for Purdue Pharma, trying to convince them that I am a long-term customer, and offering me a discount of BuTrans would be a good move for them. Fingers crossed. Until then, I am at the mercy of my bank account.

2012-08-22T13:25:00.001+02:00

Sarah who is a member of our How To Look Good twisted Fan Page on Facebook, wanted to share some news with us about a new project they are undertaking with another not for profit organisation Simple Stuff Works CIC - they are looking to support four young people to use therapeutic night positioning.

There is no cost to the individuals involved (they are setting aside just under £10k for the project to include all equipment)

About PosturalCare
We are looking for FOUR young people with idiopathic scoliosis to work with us on a fully funded project.

BACK TO BASICS is just that, we want to see what happens when we address a really basic element of a person’s day - the position they sleep in. Young people spend on average three times longer in bed than they do in school, if it makes sense to you to think about this time then please read on!

Back to Basics is a small, exciting project being funded by 2 Social Enterprises, Postural Care CIC and Simple Stuff Works CIC. Both not for profit organisations are well respected within their field. Postural Care CIC has worked since 2004 to develop nationally accredited courses in protection of body shape, measurement of body symmetry and the use of therapeutic positioning. In 2010 they were shortlisted for an Accolade Award, the very highest recognition for those working in health and social care. Their work with families supporting children and adults with complex healthcare needs led to a national campaign in partnership with Mencap

Simple Stuff Works CIC are an equipment supplier. As their name suggests their positioning system is simple, easy to use and transportable, it is recognised as the best in the market being the preferred system for flagship teaching hospitals such as Alder Hey Children’s Hospital. Simple Stuff Works won the British Health Trades Association Independent Living Design Award 2011

Postural Care CIC and Simple Stuff Works CIC are both experienced in supporting development of statutory provision of equipment and support, enabling people to access services based on need rather than ability to pay.

So… if our organisations are so good at what we do with the people we usually support, why do we want to work with people who have idiopathic scoliosis?

The answer to this is simple, we suspect that the conservative techniques used to successfully correct scoliosis in people with complex healthcare needs can be applied to those with idiopathic scoliosis. We make no claims to fully understand the causes of body shape distortion in this group of people, but we do know that the patterns of distortion are the same as for those with more complex disability. The techniques follow basic biomechanical principles and are easily understood by those using therapeutic positioning. The approach is gentle, non-invasive and its effectiveness can be objectively measured. We would like to work with a small number of people to determine whether our suspicions are correct, before we begin to work towards larger trials. Providing postural care to protect body shape is entirely complimentary to surgical intervention: it may lead to some individuals avoiding or delaying surgery; it will enhance results and prevent the complications caused by returning to damaging postures post operatively. Knowing whether this approach is effective will be beneficial both to those with idiopathic scoliosis and to the NHS who fund expensive surgical treatment.

What do we propose?
• An initial 2 hour consultation with our physiotherapist to include measurement of body symmetry (a fully validated and objective measure called the Goldsmith Indices of Body Symmetry). This is carried out by a female team of 3, all of whom are fully qualified in measurement and hold enhanced CRB Checks. Participants will need to wear shorts and a vest top
• An equipment assessment to determine what participants will need to take home that day
• Demonstration of how to use the positioning system
• Photographs will be taken throughout for the development of a personal profile for use when participants get home
• Re-measurement every 4 months for 2 years
If at the end of 2 years participants see no improvement in their curve they can give us back the equipment and we will go our separate ways. If however after 2 years participants are happy with the equipment and with the results they achieve the equipment becomes their property.
Conditions of participation:
• You must be between 12 and 18 years old
• Your scoliosis must be greater than 30 degrees and you should be considered a potential candidate for surgery
• You must not have had any surgical intervention
• You need to have a personal commitment to this conservative approach – we may need you to change aspects of your night position and this will only happen if you are prepared to work at it
• Your parent or guardian needs to be prepared to support you, both in terms of helping you learn to use the equipment and attending for measurement
• You need to agree to attend for re-measurement every 4 months for 2 years, you will also need to complete a short questionnaire each time you attend clinic
• Postural Care CIC will provide telephone, email, text or social media support as best suits participants needs throughout the project

Young people spend on average three times longer in bed than they do in school during the course of a year. Destructive night time positions have been shown to have predictable consequences in relation to changes in body shape. This project involves using gentle techniques to take advantage of this potentially destructive time. We are looking for 4 committed and motivated young people to take part in this project, it won’t cost them anything (the full cost of £2450 per person is being met by Postural Care CIC and Simple Stuff Works CIC) Please send completed application forms to Sarah Clayton, Postural Care CIC, The Sharratts, School Lane, Hopwas, Tamworth, Staffs, B78 3AD. Closing date for applications is the 10th August, successful applicants will be informed by email before the 17th August.

If you have any questions regarding the project please email Sarah@posturalcareskills.com or call 07729 552 626 (Sarah works mainly out of the office but if you leave a message she will get back to you as soon as she can).

Proposed initial consultation date: 28th August 2012

Useful references:
1. Hill, S. and Goldsmith, J., ‘Biomechanics and Prevention of Body Shape Distortion’, The Tizard Learning Disability Review, Vol. 15, Issue 2, pgs. 15 – 29, 2010
2. Waugh, A. “Protect Body Shape, Protect Quality of Life” ARC’s Changing Perspectives, Issue 4 - Health, December 2009
3. Goldsmith, J. Goldsmith, L. Hill, S. “Working Together to Protect Body Shape” Posture and Mobility, Volume 26:2, ISSN 1752-1629, December 2009
4. Hill, S. “Therapeutic Positioning: working in partnership towards tangible outcomes for children” Interconnections Quarterly Journal, Issue 6 July 2009
5. Hill, S. Waugh, A. “Body Shape Distortion: Promoting Postural Care At Night” Learning Disability Practice, 12, 7, 25-29, 2009
6. Goldsmith, L. Golding, RM. Garstang, RA. Macrae, AW. “A technique to measure windswept deformity” Physiotherapy, 78, 4, 235-242, 1992

Soft Braces, AIS a Review

2012-08-17T16:44:00.002+02:00

ScoliosisJournal recently reported about soft braces in the treatment of AIS - Review the literature and description of a new approach

Authors: Hans-Rudlof Weiss and Mario Werkmann

Background
The use of soft braces to treat scoliosis has been described by Fischer as early as 1876. With the help of elastic straps, as the authors suggested, a corrective movement for individual curve patterns should be maintained in order to inhibit curve progression. Today this concept has been revived besides soft 3 point pressure systems. Some shortcomings have been revealed in literature in comparison with hard braces, however the concept of improving quality of life of a patient while under brace treatment should furtherly be considered as valuable. Purpose of this review is to gather the body of evidence existent for the use of soft braces and to present recent developments.

Method
A review of literature as available on Pub Med was performed using the key words ,scoliosis and ,soft brace at first. The search was expanded using ,scoliosis and the known trademarks (1) ,scoliosis and ,SpineCor, (2) ,scoliosis and ,TriaC, (3) ,scoliosis and ,St. Etienne brace, (4) ,scoliosis and ,Olympe. The papers considered for inclusion were new technical descriptions, preliminary results, cohort studies and controlled studies.

Results
When searching for the terms ,scoliosis and ,SpineCor: 20 papers have been found, most of them investigating a soft brace, for ,scoliosis and ,TriaC: 7 papers displayed, for ,scoliosis and ,St. Etienne brace: one paper displayed but not meeting the topic and for ,scoliosis and ,Olympe: No paper displayed. Four papers found on the SpineCor? were of prospective controlled or prospective randomized design. These papers partly presented contradictory results. Two papers were on soft Boston braces used in patients with neuromuscular scoliosis.

Discussion
There is a small but consistent body of evidence for the use of soft braces in the treatment of scoliosis. Contradictory results have been published for samples treated during the pubertal growth spurt. In a biomechanical analysis the reason for the lack of effectiveness during this period has been elaborated. Improved materials and the implementation of corrective movements respecting also the sagittal correction of the scoliotic spine will hopefully contribute to an improvement of the results achievable.

Conclusion
The treatment of scoliosis using soft braces is supported by some papers providing a small body of evidence. During the growth spurt the use of soft braces is discussed contradictory. There is insufficient evidence to draw definite conclusions about effectiveness and safety of the intervention.

Braces, Scoliosis, Thermobrace

2012-08-17T16:41:00.003+02:00

ScoliosisJournal reported recently about Adolescents, bracing and the results from an everyday clinic using Thermobrace.

Authors: Sabrina Donzelli, Fabio Zaina and Stefano Negrini

Background

The effectiveness of bracing relies on the quality of the brace, compliance of the patient, and some disease factors. Patients and parents tend to overestimate adherence, so an objective assessment of compliance has been developed through the use of heat sensors. In 2010 we started the everyday clinical use of a temperature sensor, and the aim of this study is to present our initial results.

Methods

Population: A prospective cohort of 68 scoliosis patients that finished at least 4 months of brace treatment on March 31, 2011: 48 at their first evaluation (79% females, age 14.2+/-2.4) and 20 already in treatment. Treatment: Bracing (SPoRT concept); physiotherapic specific exercises (SEAS School); team approach according to the SOSORT Bracing Management Guidelines.

Methods
A heat sensor, "Thermobrace" (TB), has been validated and applied to the brace. The real (measured by TB) and referred (reported by the patient) compliances were calculated. Statistics. The distribution was not normal, hence median and 95% interval confidence (IC95) and non-parametric tests had to be used.

Results
Average TB use: 5.5+/-1.5 months. Brace prescription was 23 hous/day (h/d) (IC95 18-23), with a referred compliance of 100% (IC95 70.7-100%) and a real one of 91.7% (IC95 56.6-101.7%), corresponding to 20 h/d (IC95 11-23). The more the brace was prescribed, the more compliant the patient was (94.8% in 23 h/d vs. 73.2% in 18 h/d, P<0 .05=".05" 0-12.95="0-12.95" 0="0" 1="1" 29="29" 45="45" 90="90" and="and" at="at" been="been" compliance="compliance" days="days" had="had" hour="hour" involved="involved" least="least" non-wearing="non-wearing" of="of" patients.="patients." patients="patients" percent="percent" prescribed.="prescribed." remained="remained" sixty="sixty" span="span" the="the" were="were" what="what" within="within">

Conclusion
This is the first study using a TB in a setting of respect for the SOSORT criteria for bracing, and it states that it is possible to achieve a very good compliance, even with a full time prescription, and better than what was previously reported (80% maximum). We hypothesize that the treating team (SOSORT criteria) plays a major role in our results. This study suggests that compliance is neither due to the type of treatment only nor to the patient alone. According to our experience, TB offers valuable insights and do not undermine the relationship with the patients.

Download the PDF version about the results of the Thermobrace

Cotrel-dubousset Instrumentation: AIS

2012-08-17T16:38:00.003+02:00

ScoliosisJournal recently reported about Cotrel-dubousset instrumentation for the correction of AIS. Long term results with an unexpected high revision rate.

Authors: Franz Mueller and Herbert Gluch

Background
For many years, the CD instrumentation has been regarded as the standard device for the surgical correction of adolescent idiopathic scoliosis (AIS). Nevertheless, scientific long-term results on this procedure are rare. Therefore, we conducted a retrospective follow-up study of patients treated for AIS with CD instrumentation and spondylodesis.

Methods
A total of 40 patients with AIS underwent CD instrumentation in our department within 3 years and between 1990 and 1992. For the retrospective analysis, first all the patient documents were reviewed, and pre-/postoperative X-ray images as well as those at the latest follow-up were analysed. Furthermore, it was attempted to conduct a clinical survey using the SRS-24 questionnaire, which was sent to the patients after a preceding announcement on the phone.

Results
Radiologically, the frontal main curvature was improved from a preoperative angle of 69.2degrees to a postoperative angle of 35.4degrees, and the secondary curvature was improved from a preoperative angle of 42.6degrees to a postoperative angle of 20.5degrees. The latest radiological followup at average 57.4 months post surgery showed an average loss of correction of 9.6degrees (main curvature) and 4.6degrees (secondary curvature), respectively.Within the first 30 days post surgery, 3 out of 40 patients (7.5%) received early operative revision for the dislocation of hooks or rods.At an average of 45.7 months (range 11 to 142 months), 19 out of 40 patients (47.5%; including 2 patients with early revision) received late operative revisions: The reasons were late infection (10 out of 40 patients; 25%) with the development of fistulae (7 cases) or putrid secretion (3 cases), which was resolved with the complete removal of instrumentation after all. The average time until revision was 35.5 months (range 14 to 56 months) after CD instrumentation. Furthermore, complete implant removal was necessary in 8 out of 40 patients (20%) for late operate site pain (LOSP). The average time until removal of instrumentation was 62.7 months (range 18 to 146 months) post surgery; and one patient received partial device removal for prominent instrumentation 11 months post surgery. Altogether, only 22 out of 40 CD instrumentations (55%) were still in situ. After an average period of 14.3 years post surgery, it was possible to follow-up 14 out of 40 patients (35%) using the SRS-24 questionnaire. The average score was 93 points, without showing significant differences between patients with or without their instrumentation in situ.

Conclusions
Retrospectively, we documented for the first time a very high revisions rate in patients with AIS and treated by CD instrumentation. Nearly half of the instrumentation had to be removed due to late infection and LOSP. The reasons for the high rate of late infections with or without fistulae and for LOSP were analysed and discussed in detail.

Download the PDF version about Cotrel-dubousset

iPhone vs Scoliometer: Rib Hump Measurement

2012-08-17T16:32:00.000+02:00

ScoliosisJournal have just recently reportyed about the evaluation of the iPhone with an acrylic sleeve versus the Scoliometer for rib hump measurement in Scoliosis

Authors: Maree T Izatt, Gary R Bateman, Clayton J Adam

Background
Vertebral rotation found in structural scoliosis contributes to trunkal asymmetry which is commonly measured with a simple Scoliometer device on a patient's thorax in the forward flexed position. The new generation of mobile 'smartphones' have an integrated accelerometer, making accurate angle measurement possible, which provides a potentially useful clinical tool for assessing rib hump deformity. This study aimed to compare rib hump angle measurements performed using a Smartphone and traditional Scoliometer on a set of plaster torsos representing the range of torsional deformities seen in clinical practice.

Methods
Nine observers measured the rib hump found on eight plaster torsos moulded from scoliosis patients with both a Scoliometer and an Apple iPhone on separate occasions. Each observer repeated the measurements at least a week after the original measurements, and were blinded to previous results. Intra-observer reliability and inter-observer reliability were analysed using the method of Bland and Altman and 95% confidence intervals were calculated. The Intra-Class Correlation Coefficients (ICC) were calculated for repeated measurements of each of the eight plaster torso moulds by the nine observers.

Results
Mean absolute difference between pairs of iPhone/Scoliometer measurements was 2.1 degrees, with a small (1 degrees) bias toward higher rib hump angles with the iPhone. 95% confidence intervals for intra-observer variability were +/- 1.8 degrees (Scoliometer) and +/- 3.2 degrees (iPhone). 95% confidence intervals for inter-observer variability were +/- 4.9 degrees (iPhone) and +/- 3.8 degrees (Scoliometer). The measurement errors and confidence intervals found were similar to or better than the range of previously published thoracic rib hump measurement studies.

Conclusions
The iPhone is a clinically equivalent rib hump measurement tool to the Scoliometer in spinal deformity patients. The novel use of plaster torsos as rib hump models avoids the variables of patient fatigue and discomfort, inconsistent positioning and deformity progression using human subjects in a single or multiple measurement sessions.

Download the whole article as a PDF. iPhone vs Scoliometer

Power Plate: The Second Batch!

2012-06-12T17:16:00.000+02:00

So, here we are again, back at the gym after a 2 week break (a much needed one!). I must admit I was a little "ugh I don't want to start beating up my body again" but as per usual I surprise myself at what this twisty body of mine can actually achieve!

We talked about how I was doing Power Plate twice weekly now, however, I have noticed that I am a little knackered after doing these exercises every Tuesday and Thursday so this week I decided to go back to once a week and see how that makes me feel. I will use the time I would have spent at the gym on Thursdays to concentrate on my yoga, plus I will be utilising my exercise ball to keep up with my sit ups. I am also swimming daily which is helping a great deal - now all I have to do is stop eating so many carbs! ;=)

I always start my routine with squats and I am doing this so much better now, the strength in my legs is so much greater which of course has positive benefits to my lower spine.

Below I have added some images for you to see me actually on the Power Plate vs talking about it all the time!


Massaging my cellulite


Straight legs, supported by arms, tightening of stomach

Tricep dip using a ball

Leg lunges

Physical therapy intervention studies on AIS

2012-06-11T13:58:00.000+02:00

ScoliosisJournal reported an article about the physical therapy intervention studies on idiopathic scoliosis - review with the focus on inclusion criteria

Background
Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT).

Materials and methods
A PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used.

Results
Real outcome papers (start of treatment in immature samples/end results after the end of growth; controlled studies in adults with scoliosis with a follow-up of more than 5 years) have not been found. Some papers investigated mid-term effects of exercises, most were retrospective, few prospective and many included patient samples with questionable treatment indications.

Conclusion
There is no outcome paper on PT in scoliosis with a patient sample at risk for being progressive in adults or in adolescents followed from premenarchial status until skeletal maturity. However, papers on bracing are more frequently found and bracing can be regarded as evidence-based in the conservative management and rehabilitation of idiopathic scoliosis in adolescents.

Background
Scoliosis is a three dimensional deformity of the spine and trunk, which may deteriorate quickly during periods of rapid growth . Although scoliosis may be the expression or a symptom of certain diseases, eg. neuromuscular, congenital, due to certain syndromes or tumors, the majority of the patients with scoliosis (80-90%) are called ‚Idiopathic' because a certain underlying cause still has not been found. The treatment of the symptomatic scoliosis may primarily be determined by the underlying cause. The treatment of the so-called idiopathic scoliosis is determined by the deformity itself. As most of the scoliosis progress during growth, some also in later life, the main aim of any intervention is to stop curvature progression .

While children grow until they have fully matured, there are certain times with more or less growth during childhood and adolescence and curvature progression is more or less probable during different phases of growth (Figure 1). The ‚baby spurt' ends at the age of five and a half to six years followed by a ‚flat phase,' which lasts until the first signs of maturation. With the first signs of breast development or pubic hair, the pubertal growth spurt begins (P1) and in its ascending phase 2/3 of progression may occur. Shortly after the growth peak (P3) menarche in girls/voice change in boys appears to indicate the onset of the descending phase of growth up to its cessation (P5).

View the whole study and images at ScoliosisJournal

2011 SOSORT Guidelines: Orthopaedic & Rehab Treatment of AIS

2012-06-11T13:07:00.001+02:00

ScoliosisJournal posted an article regarding; 2011 SOSORT guidelines: Orthopaedic and Rehabilitation Treatment of Idiopathic Scoliosis during growth.

Authors: Stefano Negrini, Angelo G Aulisa, Lorenzo Aulisa, Alin B Circo, Jean C de Mauroy, Jacek Durmala, Theodoros B Grivas, Patrick Knott, Tomasz Kotwicki, Toru Maruyama, Silvia Minozzi, Joseph P O'Brien, Dimitris Papadopoulos, Manuel Rigo, Charles H Rivard, Michele Romano, James H Wynne, Monica Villagrasa, Hans-Rudolf Weiss and Fabio Zaina

The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), that produced its first Guidelines in 2005, felt the need to revise them and increase their scientific quality. The aim is to offer to all professionals and their patients an evidence-based updated review of the actual evidence on conservative treatment of idiopathic scoliosis (CTIS).

Methods
All types of professionals (specialty physicians, and allied health professionals) engaged in CTIS have been involved together with a methodologist and a patient representative. A review of all the relevant literature and of the existing Guidelines have been performed. Documents, recommendations, and practical approach flow charts have been developed according to a Delphi procedure. A methodological and practical review has been made, and a final Consensus Session was held during the 2011 Barcelona SOSORT Meeting.

Epidemiology
In approximately 20% of cases, scoliosis is secondary to another pathological process. The remaining 80% are cases of idiopathic scoliosis. Adolescent idiopathic scoliosis (AIS) with a Cobb angle above 10° occurs in the general population in a wide range from 0.93 to 12% : two to three percent is the value the most often found in the literature, and it has been suggested that epidemiology changes according to latitude.

Approximately 10% of these diagnosed cases require conservative treatment and approximately 0.1-0.3% require operative correction of the deformity. Progression of AIS is much more frequently seen in females. When the Cobb angle is 10 to 20°, the ratio of affected girls to boys is similar (1.3:1), increasing to 5.4:1 for Cobb angles between 20 and 30°, and 7:1 for angle values above 30°. If the scoliosis angle at completion of growth exceeds a"critical threshold" (most authors assume it to be between 30° and 50°), there is a higher risk of health problems in adult life, decreased quality of life, cosmetic deformity and visible disability, pain and progressive functional limitations.

Etiology
The etiopathogenesis of scoliosis has not been elucidated. The causes of scoliosis are being sought in congenital or acquired disorders of vertebral structure. Patients with this type of deformity are usually noted to suffer from such co-existent abnormalities as asymmetrical structure of the brain stem, sensory and balance impairment, disorders of blood platelet and collagen function. The role of genetic factors in the development of spinal axial disorders is also emphasised and is confirmed by the tendency of scoliosis to run in families, with researchers suggesting a hereditary disorder of oestrogen receptor structure and function.

Numerous authors indicate that the causes of scoliosis are systemic disorders of, among others, mucopolysaccharide and lipoprotein synthesis. In the 1990s a group of researchers under the guidance of Dubousset proposed that scoliosis develops as a result of melatonin synthesis disorder. They produced spinal curvatures in chickens via pinealectomy and later ameliorated the melatonin deficiency to find decreased incidence of scoliosis in the animals. Machida reported reduced serum melatonin levels in girls with rapidly progressive idiopathic scoliosis. His finding has been questioned by other authors, who found no differences between melatonin levels in scoliotic girls and those in a healthy control group. Currently, melatonin is attributed only a limited role in scoliosis pathogenesis. The possible role of melatonin in scoliosis etiology is also discussed in connection to age at menarche in different geographic latitudes.

According to more recent studies, calmodulin may disturb melatonin levels. Kindsfater assessed calmodulin levels in order to determine the risk of curve progression. Basing on this hypothesis, melatonin plays a secondary role in the spontaneous induction of scoliosis. It is a consequence of interaction with calmodulin, a protein that has receptors for calcium ions and is thus able to influence the contractility of skeletal muscles; it can also be found in blood platelets (its level in platelets was higher in patients with scoliotic progression rates of more than 10° over 12 months). Other authors have evaluated the possibility that gene variants of IL-6 and MMPs might be associated with scoliosis and suggests that MMP-3 and IL-6 promoter polymorphisms constitute important factors for the genetic predisposition to scoliosis. Association Between IL-6.

All in all, the etiology of scoliosis has not been fully elucidated. Based on the variety of opinions on idiopathic scoliosis development, we can assume a multifactorial origin. The opinions presented above are supplementary rather than mutually exclusive. At the same time they explain the complex determinants of and relationships between disorders of spinal development in children and adolescents.

Natural History
Idiopathic scoliosis (IS) may develop at any time during childhood and adolescence. It is most common in periods of growth spurt-between the ages of 6 and 24 months, 5 and 8 years and 11 and 14 years of life. The rate of development of spinal curvature changes the most rapidly at the beginning of puberty. According to the Tanner scale, which assesses tertiary sex characteristics, this period corresponds to stage S2 and P2 in girls, and T2 and P2 in boys. The pubertal growth spurt begins with accelerated longitudinal growth of limbs, which causes a temporary disproportion of the body (long limbs and short trunk). Then longitudinal growth is seen in the axial skeleton. It is the period of the most marked progression of IS. After approx. 2/3 of the period of pubescent growth spurt, girls experience menarche, which indicates a slow, gradual decrease in the risk of scoliosis progression:

There is a much lower potential for progression of idiopathic scoliosis after the spinal growth is complete. In adulthood, IS may intensify as a result of progressive osseous deformities and collapsing of the spine. This phenomenon is reported especially in scoliosis that is more severe than 50°, while the risk of progression starts to increase as the curve grows above 30°; less severe idiopathic scoliosis curves often remain stable. Nevertheless, the natural history of adult scoliosis is not well known to date, and it is still possible the progression can have some peak periods. A "de novo" scoliosis has been recognized as a possible form in adulthood.

To download the PDF on the SOSORT guidelines for 2011 you can do so from the ScoliosisJournal websiteb

Pulmonary Function in Children with Idiopathic Scoliosis

2012-06-07T11:10:00.001+02:00

ScoliosisJournal posted an article regarding the pulmonary function in children with AIS. Details are listed below.

Authors: Thefanis Tsiligiannis and Theodoros B Grivas

Idiopathic scoliosis, a common disorder of lateral displacement and rotation of vertebral bodies during periods of rapid somatic growth, has many effects on respiratory function. Scoliosis results in a restrictive lung disease with a multifactorial decrease in lung volumes, displaces the intrathoracic organs, impedes on the movement of ribs and affects the mechanics of the respiratory muscles. Scoliosis decreases the chest wall as well as the lung compliance and results in increased work of breathing at rest, during exercise and sleep. Pulmonary hypertension and respiratory failure may develop in severe disease. In this review the epidemiological and anatomical aspects of idiopathic scoliosis are noted, the pathophysiology and effects of idiopathic scoliosis on respiratory function are described, the pulmonary function testing including lung volumes, respiratory flow rates and airway resistance, chest wall movements, regional ventilation and perfusion, blood gases, response to exercise and sleep studies are presented. Preoperative pulmonary function testing required, as well as the effects of various surgical approaches on respiratory function are also discussed.

Idiopathic scoliosis has direct effects on many aspects of the respiratory function and, although there have been reviews on the subject, the purpose of this review is a detailed discussion on how scoliosis is affecting different aspects of breathing and especially how it is reflected in the results of the various tests of respiratory function.

Scoliosis is the most common 3-dimensional deformation abnormality of the spine with direct effects on the thoracic cage, with a reported prevalence in the general population varying significantly from 0.3% to 15.3%. It is the result of a pathologic process which leads to lateral curvature of the spine. It can be congenital, due to vertebral or rib malformation, secondary to a variety of systemic or neuromuscular disorders, or idiopathic. Idiopathic scoliosis accounts for approximately 85% of cases and it is defined as a structural scoliosis for which no specific cause can be established. Based on population studies it is considered a single-gene disease with variable penetrance and heterogeneity. Idiopathic scoliosis is further categorized as infantile, juvenile and adolescent, according to the age at which the spinal deformity is first noticed. Its diagnosis can be made after exclusion of a primary etiology such as vertebral anomaly, neuromuscular disorder, Marfan syndrome or other disorder. Another classification is based on the quantification of the severity of the scoliosis by the use of radiographic measurements of the angle of the curvature in the spine (Cobb angle), as well as the level of the apex of the spinal curvature (cervical, high thoracic, thoracolumbar, lumbar), and the number of curves (single or double). These characteristics are used for comparison, prognosis and development of treatment guidelines.

The effects of scoliosis in the anatomy of the chest are quite complex. It was reported that the plot of segmental thoracic ratios by age groups, a method of assessment of the morphology of rib cage in anteroposterior radiographs, is one way of expressing the proportional changes of thoracic viscera, mainly the heart and lungs and principally the lungs during growth. The relative narrowing of the girls’ lower thorax between childhood and puberty is consistent with the proportionate change in the girl’s lung in the later stages of growth reported by Simon et al. The narrowing of the girls’ lower thorax between childhood and puberty is also documented assessing the segmental rib-vertebra angles (RVAs) in Segmental patterns of chest radiographs in children.

The upper chest in Infantile Idiopathic Scoliosis (IIS) is funnel – shaped. It was reported that the narrow rib – cage at T1–4 in children with IIS compared with the controls is very highly significant. The funnel – shaped upper thoracic cage of IIS is like that of each of: a) a normal human foetus, b) asphyxiating thoracic dysplasia (Jeune’s disease) and c) a normal adult rabbit. The rib cage in Adolescent Idiopathic Scoliosis (AIS) patients was also documented to be narrower than in the non scoliotic counterparts. Consequently if the chest cannot develop normally during growth, there is insufficient space available for pulmonary alveolar growth, with resultant extrinsic restrictive lung disease. Scoliosis can affect pulmonary function in many ways. At an early stage it is usually painless and asymptomatic. Most investigators who have studied the impairment of pulmonary function in scoliosis generally agree that (1) a Cobb angle greater than 90 degrees greatly predisposes to cardiorespiratory failure, (2) lung function abnormalities are detectable when a Cobb angle is greater than 50 to 60 degrees, (3) lung function abnormalities are mainly of the restrictive type and (4) the duration of scoliosis correlates with the patients degree of disability. Its natural history is associated with curve progression, cardiopulmonary impairment, back pain, cosmetic deformity and neurologic compromise. A great variety on the degree of these manifestations exists, depending on age of onset, genetic background and curve pattern.

To read the full article (13 pages) on pulmonary function in children with idiopathic scoliosis, download the PDF.

Hotel Review: Bond Hotel Blackpool

2012-05-30T13:52:00.000+02:00

ScoliosisNutty were invited to review The Bond Hotel in Blackpool as part of the new service we are providing to people with a disability, worldwide. This is our first review and we hope we can do many more in the near future. In conjunction with the Disability Directory we will be adding disability hotels for our members to view. Our lovely Laura Campbell is our resident journalist so she was the most appropriate member of our team to send for a free holiday and report back on her stay with The Bond Hotel. Her review is below, we look forward to your comments.

Walking into the reception of The Bond Hotel on that rainy Friday, I have to admit that I didn't know quite what to expect, but I knew I was interested in spending time in a hotel that provides accessible holidays especially for people who have disabilities and special needs. I've had my fair share of spinal surgeries and have suffered through all sorts of associated pain and problems, but thankfully I've only ever been temporarily disabled by my condition and so I've never had to face what must be the incredibly daunting battle of going on holiday when you have special requirements. So I was compelled to see for myself a specialised, tailor made, disabled establishment.

However, my experience turned out to be a mixed one.

Catching a taxi from Blackpool North train station, we were driven through the bustling bright lights of Blackpool town - past fish and chip shops, brightly coloured arcades, the infamous tower and the re-vamped trams running along the seafront. We also spotted several hen and stag parties stumbling around - a reflection on the town's renowned status as a modern party hotspot.

The further south we drove, the quieter things became and also, unfortunately, the more run-down things started to look. A 10 minute taxi ride and £8 later, we finally arrived at a rather tired looking Bond Hotel. Our stomachs sank.

Despite our first impressions, we were in fact greeted very warmly and the management were more than accommodating, providing us with sandwiches because we arrived after the evening meals had ended. This lovely welcome was extended for the rest of our stay and we were well looked after by friendly, helpful and talkative staff, in particular Graham who made us laugh and made our evening there very entertaining.

However, our tired room reflected the tired exterior of The Bond Hotel - it had unfortunately seen better days and we both felt that this was a big let down. When we opened the door, we were greeted by a small blue room crammed with a double bed and single bed, the wardrobe was a hole in the wall with a tired looking curtain pulled across it, the bathroom door was rather battered and did not lock, the TV did not work and the neglected décor sadly matched the rest of the hotel.

Because nowadays my back is mostly made out of metal, a comfy bed is vital so that I can keep on top of my pain but sadly the bed I slept in was rock solid and I suffered a bit the next day. We were also disappointed with our view; a peeling exterior wall, looking out onto the smoking area, above the kitchen, which, added to the extremely creaky, squeaky floors and neighbouring corridors, made sure we were awake at 6am.We had tea and coffee making facilities and soap but apart from that there were no extras. If we were staying for a week's holiday, as most of the guests were, I'm not sure we could've coped!

However, we did see a positive side to the hotel. As far as disabled accessibility is concerned, I was very impressed with the equipment throughout the hotel; wide corridors; a fully functioning lift; hoists; en suite wet rooms; non-slip floors; shower seats and handles around the toilets, to name but a few. In fact, if I had half of this equipment in my house following my surgeries I think my life (and the lives of those looking after me!) would've been a great deal easier!

As far as food is concerned, it was all pretty basic but nevertheless decent traditional British favourites. Breakfast offered a choice of cereals, fruit juice, tea and coffee and buffet style English breakfasts, and evening meals comprised three generous courses, also served buffet style.

So putting aside the poor quality and comfort of the room, we decided to embrace the whole experience and spent our evening in the hotel function room, getting to know the staff, chatting to guests and taking part in the evening's entertainment. The bar area, which opens up into an equally nice dining area, was well kitted out with themed pictures and decorations, a variety of different chairs to suit everyone's comfort, lights and a dance floor. All staff were first aid trained and had the patience, local knowledge, courtesy and friendliness to be able relate to all guests and their carers and try to include them safely in the evenings entertainment, no matter what mental or physical difficulties they had. And it was this dedication that I think is the hotel's strongest plus point.

So all in all, even though we felt that personally the standard of the room left a lot to be desired and the hotel may not be to everyone's taste or standard, the fact that guests and carers come back year after year is a testament to the management's dedication to provide safe, fun accessible holidays for everyone. The evening we spent there was full of friendly banter and laughter and guests loved the tailored entertainment that was laid on – a variety of cabaret, singing, a disco and party games such as bingo which really got everyone involved; after a glass or two of wine even we were doing the hokey-cokey and shaking it all about!

Come and join in the discussions and share your thoughts on disability hotels around the world on our Facebook page, maybe you have some highs and lows to share too?

Power Plate The Final Session

2012-05-30T13:16:00.000+02:00

I promised I would keep you upto date with my progress on the Powerplate and I have now completed my 10 sessions :)

During the last few weeks we started doing the PowerPlate twice weeekly vs once - I started off with once a week because I wasn't sure how my back would feel and going on previous experience in a gym I didn't want to rock the boat too much with something new, however, I have enjoyed the powerplate so much; I was always excited about going!

Our trainer Daisy Mae Scott said that if I do it twice weekly I will notice the benefits more; so after 4 weeks of my training I went on to twice weekly. The training got a little harder and I did find that the first week of doing the powerplate twice a week was a little hard for me as the intensity had also increased and some of the poses felt like my rod was shaking itself to bits!

I did 6 sessions in 3 weeks and now I am taking a week's break before I continue again next week. I must admit I feel stronger and more able. I can now lift myself up while laying on my stomach, before I would have to roll over onto my side and then get onto my knees.

What else have I noticed?
I am more self confident
Stronger in my legs
Stronger in my arms
Less pain from the lower back (discs)
Less cellulite (which is always a bonus)
Leg definition on the upper leg is greater
More energised

I start with the follow on sessions next week, I will be doing Tuesdays and Thursdays every week

Twisted Annual Affari (Second Meeting)

2012-04-14T10:26:00.000+02:00

On Saturday 31st March our How To Look Good Twisted Facebook group met in Manchester, Piccadilly for the second meeting of our twisties.

It was all rather hectic, I started my journey with my friend James Fooks from Spain on Thursday 29th March. I was very anxious, nervous and excited for many reasons really, the main one being Chris was not beside me for support which I have always leant on heavily, and if it wasn't for him (who sadly died 11 April 2011) the group would never have been formed.

Secondly, I was about to meet one of the moderators; Laurie Knutowski Skusevich, who had left the previous day to start her journey from the USA across the pond to the UK. I was extremely touched by the reason Laurie decided to join us and travel 4,000 miles! Laurie had told me that one night on her way home from work she had paid particular attention to the moon and Chris came into her thoughts. She had never been to the UK before and felt that due to the sudden death of Chris she felt compelled that night to come and meet me, Laurie said "Chris told her to go and meet his beautiful wife" and there is no better time to do this, especially as the group was also having a meet.

Laurie arrived friday morning after a very long flight, bang on the dot at 8am. I was all excited so I was up early anyway, pacing around my room, waiting for Laurie to call. We met in the hotel lobby and I cried as soon as we hugged one another, we chatted for a while over a coffee before going up to the room for a lay down; Laurie now needed to try and adjust to UK time and get over her jeg lag! We settled Laurie in and went shopping to buy a present for Janice (also one of the moderators) because we were meeting in a little Italian restaurant at 8pm for a celebration dinner.

During the celebration dinner I decided to have a word with the restaurant manager about using their venue for our twisted meeting, the reaosn for this was because the B Lounge who we originally had chosen were not very accommodating which left me no choice but to try and arrange something more suitable. Bella Italia is a wonderful venue and the staff are amazing, helpful and on the ball, they cornered off an area for the the meeting, giving us enough tables for people to sit, chat and eat. Chris was our concierge (that's what we like to call him anyway!) for the day and made everyone feel at ease, the food was delicious and the portions on the generous side :)

After everyone arrived we all got to know one another and ordered our lunch, I had Bruscheta and Lasagne which was delightful and very filling! The wine that Bella Italia laid on for us for free was flowing well and all our twisties shared, cared and advised one another, the atmosphere was truly stunning.

After lunch everyone had another mingle and then we decided to sign the t-shirt that my Dad had made for the event, supporting the ScoliosisNutty logo :) Everyone present signed the t-shirt which was lovely and is great memorabilia from the day. While the excitement of the signing was going on I found myself talking to the lovely Jayne Bostock; about how we can continue to raise money, Jayne said she would love to do a parachute jump, it is one of the activities she has on her "things to do before I am 40" list. So, this led me to thinking about the next event for the How To Look Good Twisted group, Jayne lives in Stafford and there is an air field near where she lives, this will be the next venue for our twisty meeting and I am looking forward to sponsoring her for this jump!

We managed to raise some money from the members who bought wristbands, keyrings, heat and cool pads and lanyards, thanks for the support to those who bought some of our merchandise, every penny counts towards us having a real charity status :)

Along with our own merchandise we had some information regarding adjustable beds with memory foam from OroMed, a few of our members were interested in these beds as I have been sleeping on one for 6 years.

I am very proud of the moderators who were just as caring and helpful in the flesh as they are online, I take my hat off to every person I have ever met with Scoliosis, one thing we have as a collective is outstanding strength, courage and beauty from the inside out.

It was interesting to see how we all sit in very similar ways, shift about, leaning forward, back and forward again. Something else I noticed was how many of us carried a cushion of some sort to use in the lower back or around the "rib hump" - in fact this common demoniator has led me to my design for a back cushion and the twisty meeting helped me think about that cushion even more to get the ball rolling for production!

On a final note, I would like to thank each and every one of the people who joined us on Saturday 31st March, it was a pleasure to meet you all, I am more inspired after meeting such a strong group of people, thanks for your support and we will continue to support you all as we have done in the past. The photos are on the Facebook group - How To Look Good Twisted if you want to have a look.

Power Plate Part IV

2012-03-28T17:56:00.000+02:00

WOW! I can't believe it I have been doing this gym thing now for 4 weeks and my trainer Daisy Hudson is really starting to crack the whip with me and boy oh boy can I feel it!

Now, as I mentioned before with my previous gym efforts, it had all gone very sour by now, simply because I had over strained something and the trainer didn't understand the mechanics of a twisted spine, however, this time round is very, very different. Daisy has listened to my tales of woe regarding my back, tried her best to understand what I can and cannot do due to the Harrington Rod and generally been a great support for my work-outs - I am starting to love it!

As per usual I started off with the Power Plate session which lasts just 20 minutes, Daisy works a lot on my legs during this time and I carry out a lot of squat movements 1of which is a deep squat for 45 seconds - she has me laying on both sides for cellulite which is also a bit of a time out and relaxation. We then do some of the yoga movements I have been doing for many years, such as "The Warrior" pose. Now I am into week 4 the intensity has been moved up slightly and the length of time - we started with 30 seconds per movement and I am now on 45 seconds. I am even doing "girly" push-ups - amazing I can actually even try!

I went to see Daisy on Saturday and while there we got talking about my gym efforts, my main concern was the stomach, all the years of exercising to keep strong core muscles, my stomach has always been left out - it is also the most difficult part on a Scoliosis patient to treat as we struggle with sit-ups - normal push-ups, crunches and the like. So, Daisy got out her gym ball and showed me some small movements I could make using the ball - I managed beyond belief to do small sit-ups and today I can feel it in my stomach (OUCHY hahaha).

When I went back to the gym on Tuesday I wanted to get working on my abs as we had discussed the previous Saturday, so after the Power Plate session Daisy took me over to the "Parallel Abs" machine.

What is the Parallel Abs Machine?
Well, simplu put, it is the best machine for getting rid of the ab fat. Our abdomens are the most sensitive and important part of our bodies. It is the first place where the unwanted fat continues to accumulate.

Anyway, I did as I was told and was surpirsed at how comfortable this machine was for someone with such a straight back, I fitted into the handles nice and was able to bring my legs up to my chest (with knees bent) for 25 repetitions. I didn't do these reps all at once, I did 12, stopped and then did a further 10, stopped and fitted in the extra 3 at the end :)

Gym Ball & Sit Ups
Along with all this other exciting exercise I also had another go with a gym ball. I laid back on the ball and shifted forward until the arch of my back and knees were comfortbale. I then raised my neck and head as if I were holding an orange under my chin before laying back down again. I managed to 45 of these in repetitions of 15, a 30 second wait, followed by the next 15. This is what I can feel in my stomach muscles today and I have to say I love the feeling of knowing I am doing some good to my core muslces and hope I can strengthen some lower back tissue while I am at it! Along with the sit ups I did another movement with the ball where I sat down straight (not hard for many twisties hehehe), head up and then raised my leg out straight, swapped legs and raised, in repetitions of 20 - I did this 4 times managing to achieve 80 of these movements (40 per leg).

So, after all that I hear you wonder what pains I am getting as a result of this? Well last week I did feel some shooting pains in the lumbar (which to be fair is nothing new for me anyway), I think this was a direct result of the sitting down movement I did on the Power Plate without a cushion for support - this week we had a cushion and those pains have ceased. Natutrally my legs ache from the training and my arms a little too - I am very weak in my upper body so I hope this will improve. I do feel much better in overall health, dare I say a little sprightly at times? I was expecting some stiffness when I got up from chairs but so far fingers crossed this has not happened. Long may this continue and I will keep writing about the experiences of the gym, power plate, yoga and a gym ball!

Perhaps a twisty really can conquer the world?

Scoliosis: Life, Support & Friends

Useful exercises for Scoliosis

Side Stretch

Arm and Leg Extensions

Shailene Woodley's Scoliosis

New Blogger!

Scoliosis Brace Correction & Quality of Life

Conclusion
The results showed a positive relationship between patients? brace wear compliance and patients? QoL. Poor compliance would cause a lower QoL.

To read the completre article please follow the link for a PDF version.

Simone: From the Heart

Pulmonary Function after Anterior Instrumentation

Methods

Results

Conclusion

Scoliosis Charity Ball

Physical Therapy Intervention - AIS

Background
Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT).

Materials and methods
A PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used.

It's time to Get Mad....

Scoliosis Campaign Fund Run

Fundraising for Scoliosis Research

Calling it a Complaint Letter just doesn't sum it up...

Soft Braces, AIS a Review

Braces, Scoliosis, Thermobrace

Background

Methods

Cotrel-dubousset Instrumentation: AIS

iPhone vs Scoliometer: Rib Hump Measurement

Power Plate: The Second Batch!

Physical therapy intervention studies on AIS

Background
Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT).

Materials and methods
A PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used.

2011 SOSORT Guidelines: Orthopaedic & Rehab Treatment of AIS

Pulmonary Function in Children with Idiopathic Scoliosis

Hotel Review: Bond Hotel Blackpool

Power Plate The Final Session

Twisted Annual Affari (Second Meeting)

Power Plate Part IV

Scoliosis: Life, Support & Friends

Useful exercises for Scoliosis

Side Stretch

Arm and Leg Extensions

Shailene Woodley's Scoliosis

New Blogger!

Scoliosis Brace Correction & Quality of Life

ConclusionThe results showed a positive relationship between patients? brace wear compliance and patients? QoL. Poor compliance would cause a lower QoL.

To read the completre article please follow the link for a PDF version.

Simone: From the Heart

Pulmonary Function after Anterior Instrumentation

Methods

Results

Conclusion

Scoliosis Charity Ball

Physical Therapy Intervention - AIS

BackgroundStudies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT).

Materials and methodsA PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used.

It's time to Get Mad....

Scoliosis Campaign Fund Run

Fundraising for Scoliosis Research

Calling it a Complaint Letter just doesn't sum it up...

Soft Braces, AIS a Review

Braces, Scoliosis, Thermobrace

Background

Methods

Cotrel-dubousset Instrumentation: AIS

iPhone vs Scoliometer: Rib Hump Measurement

Power Plate: The Second Batch!

Physical therapy intervention studies on AIS

Background Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT).

Materials and methods A PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used.

2011 SOSORT Guidelines: Orthopaedic & Rehab Treatment of AIS

Pulmonary Function in Children with Idiopathic Scoliosis

Hotel Review: Bond Hotel Blackpool

Power Plate The Final Session

Twisted Annual Affari (Second Meeting)

Power Plate Part IV

Conclusion
The results showed a positive relationship between patients? brace wear compliance and patients? QoL. Poor compliance would cause a lower QoL.

Background
Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT).

Materials and methods
A PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used.

Background
Studies investigating the outcome of conservative scoliosis treatment differ widely with respect to the inclusion criteria used. This study has been performed to investigate the possibility to find useful inclusion criteria for future prospective studies on physiotherapy (PT).

Materials and methods
A PubMed search for outcome papers on PT was performed in order to detect study designs and inclusion criteria used.