What is Scoliosis?
The basic definition is a side to side curvature of greater than ten degrees as measured by the Cobb angle. The Cobb angle is a lateral measurement between the upper and lower most ertebrae of the scoliosis curve.

Idiopathic means no known cause. Idiopathic scoliosis can be broken down into age groups, based upon onset of curvature.
Infantile: Age 0-4
Juvenile: Age 4-10
Adolescent: Age 10-18
Adults: over age 18

Adolescent Idiopathic Scoliosis (AIS) is the most prevalent scoliosis, and is the type most often treated using Schroth physical therapy. Patients with AIS can be treated while still adolescents or as adults.

Conservative therapy for scoliosis is directed at interrupting the "vicious cycle" that acts upon the spine. There is no exact way to predict which curve will worsen, and which will not. Growth is the number one variable that influences progression of curves: The more growth potential, the more curve progression is likely. The general rule is the greater the curve and the younger the patient at diagnosis (in age and skeletal maturity), the higher the chances the curve will progress. Almost all infantile and juvenile scoliosis curves will progress, and therefore require more aggressive treatment beyond physical therapy.

Summary of Schroth Method
Therapy is based on the principle that scoliosis has a postural component that can be improved by altering the forces that act on the spine. The belief is that children and adults are capable of understanding their scoliosis and are willing to become educated and play a proactive role in their own health. Curve-specific exercises are taught using principles of physics, anatomy, physiology, and kinesiology. Exercises are repetitively practiced in multiple positions to challenge the body.s strengths and weakness. When practicing corrective exercises, optimal postures, and proper mechanics, the body can adapt to a new and better position.
Goals of Schroth Therapy
Although prevention of curve progression is the primary goal of physical therapy, additional goals are also important to quality of life for patients with scoliosis:
  • improve posture and body mechanics
  • reduce pain (if present)
  • improve breathing capacity
  • improve strength and flexibility
  • optimize cosmetic appearance
  • prevent (or delay) surgery
  • enhance psychological outlook
History of Schroth Method
The Schroth method was developed in Germany during 1920.s by Katherina Schroth. Katherina was diagnosed with scoliosis as an adolescent and was told that she would need surgery. In order to avoid surgery, she diligently preformed self-made exercises to counteract the affects of scoliosis on her spine. The techniques have been perfected over decades with the help of her daughter, Christa Lehnert-Schroth, a physical therapist, and her grandson, Dr. Hans Rudolph Weiss, an orthopedic surgeon. The Schroth method has now been practiced in Europe almost 90 years.

The Schroth Clinic in Bad Sobernheim, Germany, is run by Katherina. Schroth.s grandson, Dr. Hans-Rudolph Weiss. (See www.skoliose.com) The program is designed as a Scoliosis Inpatient Rehabilitation. program (SIR). This involves a four- to six-week inpatient stay at the dormitory.based Schroth center. Patients learn and practice Schroth in groups and receive related services for four to six hours a day. Patients then follow up with one of the many Schroth therapists located throughout Europe. Dr. Weiss is respected worldwide, and has published many articles on the conservative management of scoliosis.

Who is a Candidate for Therapy?
In 2006, SOSORT published recommended admission criteria for rehabilitation. SOSORT is The Society on Scoliosis Orthopedic and Rehabilitation Treatment, - a multidisciplinary international society committed to research and practice of non-surgical scoliosis care. (See www.SOSORT.com).
SOSORT criteria for therapy include:
  • Curves 20-25 degrees of Cobb angle
  • Girls age 12, boys age 13
  • Risser sign under 4

According to SOSORT, the above criteria are only guidelines, and considerations for therapy admission should be made on individual cases. There have been discussions suggesting earlier admission for smaller curves when there are clear signs of structural vertebral deformity (as seen on x-ray), and when there is a strong family history of progressive scoliosis. In these cases, it may be appropriate to begin treatment for younger patients with curves at 10-15 degrees in order to prevent progression.

3 Steps of Schroth Scoliosis Program
Step One: Evaluation
Prior to initiation of therapy, patients undergo a thorough evaluation consisting of:
  • orthopedic examination
  • posture exam with digital photos
  • breathing assessment
  • x-ray review
  • curve classification
  • discussion of individual findings
The purpose of the evaluation is to gain the clinical information necessary for the patient, family and therapist to jointly determine the patient appropriateness for physical therapy, and to set individual therapy plans and goals. Patients and families will have time to ask questions specific to their individual cases.
Step Two: Treatment and Exercise Instruction
Following evaluation and orientation, each patient is scheduled based upon his or her individual treatment plan. Plans will range in content and progression according to individual findings. Some patients may require more hands-on therapy treatment as an adjunct to exercise, while others will be ready to begin exercise immediately. We tailor programs to meet individual needs to foster themost successful overall therapy experience.
Step Three: Follow-Up
Once trained in Schroth, patients continue exercises at home for 20 to 30 minutes per day, five days per week. The critical period for exercise consistency is through the growing years, but the exercises are designed for life-long use in order to maintain curve stability well into adulthood. Follow up therapy appointments will vary by individual patients.
The Website about Schroth Method from Germany
The Katharina Schroth Spinal Deformities Rehabilitation Center
National Scoliosis Foundation
Scoliosis: An online journal published by BioMed Central
Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT)
脊醫伍兆聰 Dr. Ng Siu Chung Nathan 專業資格
- 香港註冊脊醫 (Registered Chiropractor)
- 美國脊骨神經科醫學士學位 (Doctor of Chiropractic)

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