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The effectiveness of a novel, integrated protocol for the treatment of adolescent idiopathic scoliosis: a case report

Mohammad Sheibanifar, Azadeh Hakakzadeh, Jennifer Parent-Nichols, Farshad Okhovatian*

Introduction: This case report introduces a novel, integrated treatment protocol for adolescent idiopathic scoliosis(AIS). The treatment approach was an integration of the Schroth method manual, pelvic floor exercises, and home care education. Case presentation: A 14-years-old girl was referred to our outpatient clinic with a diagnosis of AIS, specifically, kyphoscoliosis (18° left thoracic and 64° thoracic kyphosis). Outcome measures used for this patient included calculations of the Cobb angle for thoracic scoliosis, the kyphosis angle, the scoliometer angle for scoliosis, and visual analog scale for back pain. The Adam’s Forward Bend Test was also used. The Scoliosis Research Society 22r (SRS-22r) form was used to assess the quality of life. Outcomes for these measures following treatment included a 6-degree reduction in Cobb angle (18 to 12 degrees), a 14-degree reduction in kyphosis (64 to 50 degrees), a 38% reduction in scoliometer angle (1.85 to 1.15), 3 score decrease in VAS, and 23% improvement in quality of life (2.85 to 3.5 and minimum clinically important difference for SRS-22r is 0.4). Conclusion: the patient in this case report achieved improved outcomes following our new integrated protocol and her outcomes were better in comparison schorth method only. Home care exercises have been included with periodic guidance from the physical therapist. In this integrated protocol, both abdominal and pelvic areas were activated to improve the core stability which may result in three-dimensional correction of the spine. Despite the advantages of integrated therapy, it requires more time and effort in comparison with the schorth method alone. Further research will be needed to provide a more fundamental understanding of the impact of the integrated protocol proposed in this study in treating AIS. Adolescent idiopathic scoliosis is a lateral curvature of the spine of at least 10° Cobb's angle of unknown etiology. Some studies have found that patients with AIS have a Visual Verticality perception similar to healthy controls.