TEI OF PATRAS DEPT. OF PHYSICAL THERAPY ORAL PRESENTATION ON SCOLIOSIS Lazanas Theodoros Spyropoulou Konstantina Zorba Kathy 1

Contents Definition Of Scoliosis Signs & Symptoms Causes of the disease Diagnosis Therapy Action that the PT can take Prognosis 2

I. DEFINITION OF SCOLIOSIS Scoliosis(comes from the Greek word σκολίωσις,which means bending) is a medical disorder in which someone’s spine is curved from side to side. Usually the spine looks like an “S” or a “C”.

I. DEFINITION (PT.2) Scoliosis is separated, based on the age of the patient, to: Infantile(0-3) Juvenile(3-10) Adolescent(10-skeletal maturity) And based on the area where the curve is presented to: Cervical Thoracic Lumbar NOTE: Although the most common situation is to have a curve on more than one areas of the spine with the most known condition of them being the thoracolumbar scoliosis.

Stages Of Scoliosis Over The Years

II. SIGNS & SYMPTOMS Patients with full skeletal maturity is rare to present a worsening case. Severe cases of Scoliosis can cause: Extra pressure to the heart Problems with physical activities Reduction of lung capacity The signs can be: Uneven muscles on the one side of the spine Uneven arms, hips or leg length (Sometimes)Slow nerve action A rib prominence and/or a prominent shoulder blade

III. CAUSES OF SCOLIOSIS In most cases (80%), the cause of scoliosis is idiopathic.5% is congenital(because of bones in the spine developing abnormally) and the other 15% of cases fall into two groups: Nonstructural (functional): This type is a temporary condition in which the spine is otherwise normal. Nonstructural scoliosis is caused by another problem of the body. For example a leg being shorter than the other. Structural: In this case the spine is not normal. The curvature is caused by other disease like muscular dystrophy, metabolic diseases or connective tissue disorders.

IV. DIAGNOSIS Most commonly the doctor will carry out a physical examination of the spine, ribs, hips and shoulders. In most cases the initial diagnosis is made by a GP (general practitioner) or school nurse, who will then refer the patient to an orthopaedic specialist (skeletal system and associated muscles, joints, and ligaments specialist doctor). The specialist will order an X-ray to confirm the diagnosis of scoliosis, as well as determining the shape, direction, location and angle of the curve.

IV. DIAGNOSIS(PT.2) During the physical examination, the following will be considered: The skin for café au lait spots, signs of neurofibromatosis The feet for cavovarus deformity Abdominal reflexes Muscle tone for spasticity

V. THERAPY The most common solution to scoliosis, from the age of 1 to the end of the puberty, is to use a Milwaukee or Boston scoliosis brace 24 hours per day until the skeletal maturity of the patient. If it doesn’t have any effect then we have to proceed to a surgical operation. In cases of scoliosis with less than 20 ° curve the usual therapy is to do posture exercises and correction exercises. Lots of times swimming is indicated with nothing until now certifying its help.

VI. ROLE OF THE PT The most common method used by PTs is the Scroth method witch concludes a number of different correction exercises. A few of them are: hanging sideways on wall bars widens the collapsed ribs below the rib hump)(pic.1) Hanging from a bar with the knees bending and the hands open wide apart will fix pelvis, bent knee position and hand position(pic.2) Putting the hand on the rib-hump side to grasp a bar one higher up in order to derotate the shoulder girdle(pic.3)

VII. PROGNOSIS In general, the severity of the scoliosis depends on the degree of the curvature and whether it threatens vital organs, specifically the lungs and heart. Mild Scoliosis (less than 20 degrees). Mild scoliosis is not serious and requires no treatment other than monitoring. Moderate Scoliosis (between 25 and 70 degrees). It is still not clear whether untreated moderate scoliosis causes significant health problems later on. Severe Scoliosis (over 70 degrees). If the curvature exceeds 70 degrees, the severe twisting of the spine that occurs in structural scoliosis can cause the ribs to press against the lungs, restrict breathing, and reduce oxygen levels. Very Severe Scoliosis (Over 100 degrees). Eventually, if the curve reaches over 100 degrees, both the lungs and heart can be injured.

BIBLIOGRAPHY http://en.wikipedia.org/wiki/Scoliosis http://www.umm.edu/patiented/articles/how_serious_scoliosis_000068_4.htm http://www.schrothmethod.com/index.php/about/scoliosis-exercises 1989-1999 Ορθοπεδική Κλινική Πανεπιστημίου Πατρών Καθηγητής Η.Ε. Λαμπίρης Ορθοπεδική & Τραυματολογία Εκδόσεις Πασχαλίδης