The RSC brace that your child will wear is just part of the intervention for scoliosis: a vital component of treatment is a form of Physiotherapy known as Schroth Therapy, named after, and devised originally by a German Physiotherapist called Katherina Schroth.
Each client is taught a series of exercises, which include stretches and muscle strengthening exercises designed specifically for the nature of the curve (a bit like the brace). Also, he or she will need to learn a new breathing technique which maximises the effectiveness of the brace. The Therapists that we work with are experienced practitioners who have attended a training course either in Germany or at the Barcelona Scoliosis Physical Therapy School, run by Dr Manuel Rigo, and whilst we work as a team, they are independent practitioners in their own right.
We also work with other accredited partners in the UK who are able to offer treatment and have an excellent relationship with practitioners in the Netherlands, for sharing of ideas and experiences. The programme can look quite daunting, but we have found that young people are highly adaptable and cope extremely well with the regime of changes to their lifestyle.
The commitment to such a programme must not be underestimated, as it involves a daily routine to ensure that the brace is utilised to it maximum effect.
Scoliosis is not only a physical pathology, but can also have significant psychological side-effects as well – examples are problems with body image, lack of self-confidence, withdrawal from social activities and sometimes depression. Whilst Cymortho does not offer counselling services, we work with each client in order to address such problems.
There are internationally agreed criteria and conditions for the level of intervention for scoliosis: these criteria are based upon a number of factors, which include your childs age, the Cobb angle, and the Risser sign which is used as a reliable indicator of skeletal maturity. The scale is from 1 to 5, where 5 indicates full growth has been reached. It is a useful and reliable indicator.
Your doctor will almost certainly discuss surgical options if he or she feels that this is appropriate. Cymortho is NOT in a position to say whether you should or should not consider surgery. However, you will want to research this as much as possible, and consider the risks and possible outcomes: remember, a surgical intervention using current methods is almost certainly irreversible, and your childs’ spine will be permanently fixed. Whilst this may well be necessary in some cases, we believe that RSC bracing allied with Schroth Therapy can significantly reduce the chance of needing surgical intervention by as much as 25%
In our experience, we have found that using RSC bracing, combined with specialist Therapy can be a very positive experience – there is a sense that you are taking control of your body. We are always surprised at the level of maturity of the young people, who often are highly motivated to do the daily exercises, reinforced by positive feelings of achievement when the curve is stabilised
Development of scoliosis
How a curve progresses can vary enormously, which is why research is so difficult: we have had cases where the parents have noticed a slight assymetry whilst on a summer holiday, such as uneven shoulder levels or one shoulder blade being more prominent than the other, and within a few months, the scoliosis has developed very rapidly, requiring immediate intervention. Alternatively, the progress will be very slow and then stop, requiring only 3, 6 or 12-monthly checks. There is no known method of predicting the behaviour of scoliosis, which is why careful monitoring is important.
This table at the end of the Links section has been devised by an international panel of experts to guide patients and clinicians in their approach. It is important to recognise this as guidelines only, and that each patient must be treated according to their age, growth rate, physical presentation and willingness to comply with treatment, but it is a useful tool to help formulate a treatment plan for your child.
The age at which the curve is most likely to change rapidly is at the onset of puberty – treatment leading up to and during this age will be the most effective.
One of the most frustrating aspects of our profession is that we often receive an approach from worried parents when the best time for bracing has passed. Remember, an assessment will not always lead to a brace being prescribed, as we will ONLY suggest orthotic intervention if we deem it to be appropriate – it is neither in your or our interest to provide a service which is not clinically justifiable. Whatever the outcome, too early is better than too late as we can always monitor any changes alongside other health professionals that are involved
Cymortho can offer you the best possible combination of Scoliosis Brace + Therapy, the only system personally sanctioned By Dr Manuel Rigo
To learn more or ask Hugh a question, please use the Contact Form in this page or email him on enquiries@cymortho.co.uk – he will get back to you as soon as possible