Physical Therapy for Adolescents with Idiopathic Scoliosis

Scoliosis is a three-dimensional deformity of the spine. In its most common form, idiopathic scoliosis (70% to 80% of cases), the causes are unknown (Rowe 2003). AIS is discovered at 10 years of age or older, and is defined as a curve of at least 10°, measured on a standing radiograph using the Cobb technique (Parent et al, 2005). While the prevalence of AIS is around 3% in the general population, almost 10% of those diagnosed with AIS will require some form of treatment; usually observation or scoliosis-specific exercises (SSE) for mild curves, braces for moderate curves and spinal surgery for severe curves (Cobb angle >500). Up to 0.1% of the population is at risk of requiring surgery (Lonstein, 2006). A severe form of AIS is more commonly found in females. Typically, AIS does not cause any health problems during growth (except for extreme cases). However, the resulting surface deformity frequently has a negative impact on adolescents` bodyimage and self-esteem that can give rise to quality of life (QoL) issues and in worst cases, psychological disturbances (Maclean et al, 1989). Adolescent patients are generally treated in an attempt to halt the progressive nature of the deformity. No treatments succeed in full correction to a normal spine, and even reduction of the deformity is difficult (Danielson and Nachemson, 2001). If scoliosis surpasses a critical threshold, usually considered to be 30o Cobb, at the end of growth, the risk of health and social problems in adulthood increases significantly (Negrini, 2005). Problems include reduced quality of life, disability, pain, increased cosmetic deformity, functional limitations, sometimes