Ortopedická protetika Praha sro - Společnost pro pojivové tkáně

Introduction
Until the discovery of the etiology
of the so-called idiopathic scoliosis
(Karski 1995–2006) the rehabilitation treatment
was not successful. Children performed
exercises, wore the corset and many
of them were operated on. Nobody knew
which scoliosis is progressive and which
is non-progressive. The indication for “the
strengthening exercises” was the following
chain of thinking: *a sudden appearance
and development of scoliosis, *it means
that the paravertebral muscles are weak,
*so the child was in need to perform the
extension exercises. Unfortunately, after
such exercises the scoliosis: the curves and
the deformation of the trunk and rib hump
were bigger.
Material and Methods. Old and new
exercises for AIS
A. In our material we observed
629 children in three groups:
a. children who were never treated
through rehabilitation exercises before
our first examination, b. children
treated for a short time (3–6 months)
before our first examination, c. children
treated for a longer time (1–2–3
years) before our first examination.
We studied all “strengthening exercises”,
e.g. in the prone position raising
of the head and the trunk, the same
exercise with the additional weighting
of the arms, elevating of the whole
trunk in the prone position from the
rehabilitation table.
We prepared a physical-mathematical
formula (prof. Marek Malicki – Polish
Academy of Science) for the forces
acting on the sacro-lumbar junction,
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the lumbar and thoracic spine. It was
stated that these deforming forces
are four-five-six times bigger as the
weight of the body. They make scoliosis
only worse. The formula is as follows:
F(ro)=F(cor) x sinα x krg / r [full
information in tables and pictures].
Now the old exercises are in Poland
reject from the “conservative program
of treatment”. The observations of
authors and also of Malawski (Warsaw,
1994) and the latest of Kotwicki &
Dobosiewicz & Szulc & Rąpała (2003)
about the “harmful effects” of extension
and “strengthening exercises” were
confirmed in many orthopaedic centres
in Poland.
B. Our new rehabilitation exercises are:
– Exercises to remove the contractures
of the right hip – stretching
exercises, “post-isometric stretching
exercises” in prone position or on
side – easy to elaborate for every
orthopaedic surgeon, rehabilitation
doctor or parents. Additionally we
use termotherapy and hand massage.
– Flexion-extension asymmetric exercises
for spine – (two phases) a) flexion
for 5 – 10 second for stretching
of muscles, capsules and ligaments
and other contracted para-vertebral
soft tissues and than b) extension
– that means active exercises
for muscles. These are exercises to
remove the contractures of the concave
side of scoliosis (Lumbar curve
& Thoracic curve) – bending exercises
to the left foot for treatment of
lumbar scoliosis and bending to the
right foot for treatment of thoracic
scoliosis.
LOCOMOTOR SYSTEM vol. 14, 2007, No. 3+4