Physical exercises in the treatment of idiopathic scoliosis at risk of brace treatment – SOSORT consensus paper 2005

As a baseline for developing a consensus for language and goals for proposed multicenter clinical studies, we developed questionnaires to examine current beliefs, before and after the meeting, regarding (1) the aims of physical exercises; (2) standards of treatment; and (3) the impact of such treatment performed by specialists in the field.The responses to the questionnaires show that, in principle, specialists in scoliosis physiotherapy do not disagree and that several features can be regarded, currently, as standard features in the rehabilitation of scoliosis patients. These features include autocorrection in 3D, training in ADL, stabilizing the corrected posture, and patient education.For treatment of all pediatric spinal deformities, the goal is to maintain function and prevent symptoms in the short- and long-term. In children with scoliosis, as summarized below, predictable signs and symptoms including pain and reduced pulmonary function begin early in life and worsen with age. Most curvatures still present at skeletal maturity also continue to worsen throughout life. For children with scoliosis, therefore, optimal treatment goals include reversing curvature magnitude and/or preventing curvature progression, pain, and pulmonary dysfunctionover a lifetime.Most clinical outcome surveys have revealed that, by early adulthood, the majority of scoliosis patients suffer from pain [1-15]. Only one large, controlled survey has been carried out, to date [16]. In that study, 1178 young adults, interviewed 10 years after diagnosis in adolescence, reported a significantly higher incidence of pain than 1217 control subjects. Of the scoliosis patients reporting pain, 23% (147/650) described it as 'horrible, excruciating, distressing' compared with 1% (6/416) of the control subjects who reported pain. Similar results were reported at >44 year followup [17]. Of a subset of 69 patients treated in adolescence (from an original population of 444), twice as many scoliosis patients