The Effect Of Schroth Best-Practice Therapy Combined With Core Stability Training On Mild Adolescent Idiopathic Scoliosis

Background and purpose:The treatment of mild adolescent idiopathic scoliosis(AIS)is controversial internationally.The Scoliosis Research Society(SRS)and The Society on Scoliosis Orthopaedic and Rehabilitation Treatment(SOSORT)guidelines recommend different solutions.The summary falls into two broad categories.Some think the physiotherapeutic scoliosis-specific exercises(PSSE)treatment for patients with mild adolescent idiopathic scoliosis is invalid and should be regular follow-up observations,because firstly mild adolescent idiopathic scoliosis patients generally do not show obvious symptoms,secondly they daily life with age-matched healthy children basic no distinction,finally some patients have the possibility of self-healing or ease,and short-term general won’t seriously deteriorated.Another group recommends the use of PSSE for patients with mild adolescent idiopathic scoliosis,because they believe that PSSE is effective and can prevent the progression of scoliosis.In this experiment,the control group and the experimental group correspond to these two viewpoints respectively.This experiment further explore whether PSSE is more effective in patients with mild adolescent idiopathic scoliosis compared with regular follow-up.This experiment explore whether PSSE can prevent the further progression of scoliosis and improve the quality of life of patients,so as to try to provide simple,easy to learn,safe,effective,popularized and applied training methods for adolescent idiopathic scoliosis patients.Methods:Thirty patients with mild adolescent idiopathic scoliosis who were admitted to the rehabilitation department of Tianjin hospital from 2018 to 2019 were selected as the study subjects.Thirty patients were divided into two groups.The experimental group included 15 patients.The patients regularly received the treatment training supervised by the therapist according to the prescribed prescription,and received the24-week schroth best practice exercise combined with core stabilization exercise.The control group of 15 cases,including age,gender,Cobb Angle and so on,should be matched with the experimental group.Routine health education should be carried out,and regular observation and follow-up treatment should be made.Patients should return to the hospital regularly every month for posture monitoring and evaluation,and daily life health guidance should be given to prevent the obvious deterioration of scoliosis of subjects in the control group.Cobb Angle,Clavicle Angle(CA),Pelvic Obliquity(PO),Coronal Balance(CB),Trunk Shift(TS),Sacral Obliquity(SO),Sacral Slope(SS),Pelvic Tilt(PT),Pelvic Incidence(PI),Lumbar Lordosis(LL),Raimondi value,Thoracic Kyphosis(TK),T1 Pelvic Angel(TPA),Sagittal Vertical Axis(SVA),Angle of Trunk Rotation(ATR)and the Scoliosis Research Society-22Questionnaire(SRS-22)were measured as the monitoring indicators.Result:(1)Changes in coronal plane indicators In the experimental group,the Cobb angle decreased from 17.30±5.56° to11.81±3.88° after intervention compared with that before intervention,showing a significant statistical difference(P<0.01),and the rate of Trunk Shift decreased from33.33% to 13.33%.CA,PO and SO also decreased,with statistical differences.In the control group,the Cobb angle increased from 15.43±4.53° to 16.89±5.32° after intervention compared with before intervention,with statistical difference(P<0.05),and the the rate of Trunk Shift increased from 26.67% to 33.33%.There was no statistical difference between CA,PO and SO before and after intervention.(2)Changes in sagittal index TK,PT and TPA increased in the experimental group after intervention compared with before intervention,with statistical significance(P < 0.05),and the rate of spinal sagittal imbalance decreased from 53.33% to 20.00%.There was no significant difference in sagittal index between the control group and the control group after intervention,and the rate of spinal sagittal imbalance increased from 46.67% to53.33%.(3)Changes in horizontal index and body surface test index Compared with the experimental group before intervention,Raimondi decreased after intervention with significant change(P<0.05),and ATR also decreased after intervention with very significant change(P<0.01).There were no significant differences in Raimondi and ATR values between the control group before intervention and the control group after intervention.(4)Changes in the score of SRS-22 Questionnaire of quality of life Compared with before intervention,the scores of pain,self-perceived image and mental health in the experimental group increased after intervention,and the differences were statistically significant(P < 0.05).After intervention,compared with before intervention,the mean values of self-perceived image and mental health in the control group decreased,and the differences were also statistically significant(P <0.05).Conclusion:After 24 weeks of schroth best practice exercise combined with core stabilization exercise,the degree of scoliosis in AIS patients was significantly reduced in the coronal plane,effectively controlling the progress of scoliosis,and significantly reducing the differential height of shoulder and hip morphology on both sides of the body,thus reducing the rate of Trunk Shift.In the sagittal plane,the posterior convex curvature of the thoracic vertebra was increased,which also had a significant corrective effect on the forward tilt of the pelvis and the backward tilt of the spine.In the horizontal plane,the rotation of the patient’s vertebral body can also be corrected.Pain,self-perceived image and mental health scores on the SRS-22 Questionnaire all increased.Moreover,through the evaluation of the therapeutic effect,the efficacy of schroth best practice exercise combined with core stabilization exercise was significantly better than that of the control group.Therefore,it is more effective for patients with mild adolescent idiopathic scoliosis to receive schroth best practice exercise combined with core stabilization exercise,which can correct the three-dimensional spine,improve the body shape,and improve the quality of life of patients.This therapy is simple,safe and effective,and is worthy of recommendation and application.