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19 Cards in this Set
- Front
- Back
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is an abnormal sidebending accompanied by rotation
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scoliosis
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A scoliotic curve is always named for the direction of the
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convexity
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where can a scoliosis be located?
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thoracic, lumbar, thoracolumbar (T-12, L-1 junction)
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Flexible, and potentially reversible
Reducible with sidebending to the opposite side May progress into a structural scoliosis |
functional scoliosis
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Relatively fixed and inflexible.
Non-reducible with sidebending to the opposite side or lift therapy |
structural scoliosis
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what is a major cause of functional scoliosis
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short leg syndrome
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Vertical plum line should pass halfway between knees, along gluteal fold, through all spinous processes, & midline of head.
Observe for levelness of… Popliteal creases Greater trochanters Iliac crests Inferior angles of scapula Acromion processes Mastoid processes |
static postural exam
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“Hump” becomes apparent with forward bending
Functional Scoliosis Hump diminishes or disappears with patient side bending towards convexity (towards rib hump) Think… reducing the sidebending -> reducing rotation Structural Scoliosis: Hump does NOT reduce with patient side bending towards convexity (towards rib hump) |
adams test
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Mild: 5 – 15°
Moderate: 20 – 45° Severe: > 50° Impaired respiratory function: > 50° Impaired cardiovascular function: > 75° Important to identify curves likely to progress > 5° increase in 5 months –- significant progression |
cobb angles
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Angle > 40° may result in:
Increased lumbar lordosis and extension (sway back) Shearing forces on intervertebral discs Angle < 30° may result in: Decreased lumbar lordosis (flat back) Compressive forces on articular facets |
Lumbosacral Angle
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OMT
Exercise Work to correct muscular asymmetry Stretching the tight muscles Strengthening the weak muscles Accomplished through exercises like Schroth and Konstancin exercises, physical therapy, yoga, pilates, and bilateral movement! Consider heel lift therapy for those with short leg syndrome Yearly physician visits- Minimum Following the progression of an ailment over a period of time is paramount to all clinical decision-making! Patient and family education. |
Treatment for Mild Scoliosis
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same as mild plus…
Consider bracing |
Treatment for Moderate Scoliosis
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same as moderate plus…
Consider surgery if visceral compromise or rapidly progressive curve despite conservative management |
Treatment for Severe Scoliosis
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Restore mobility to areas of Somatic Dysfunction
Modality and dosing is patient specific Eg. Frail, elderly patient: use indirect techniques Treat any Type II’s If no Type II’s, treat the Type I curve Treat other somatic dysfunctions Ankle, knee, pelvis, sacrum, etc |
OMT Treatment
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Konstancin exercise
Important historically and important for boards Mobilization and postural strengthening Schroth exercise Physiotherapeutic rehabilitation popular in Europe Also focuses on rotational breathing exercises and integration of exercise in daily life |
Exercise Treatment
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hump that forms during adams test to determine a scoliosis
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rib hump
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Erect AP (Anterior to Posterior) postural radiographs
Posterior closer to capture film for clearer posterior structures Thoracic Lumbopelvic Erect Lateral Lumbopelvic Radiated from side to side |
Postural x-rays
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Erect AP postural radiograph
Line across top of superior vertebra Line across bottom of inferior vertebra Perpendicular lines off both lines Angle of intersection is the Cobb angle Used to measure degree of severity |
Cobb angle
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Leg length inequality is present in most adults, but can also be from acquired causes
Most common cause of Type I group curve mechanics Creates a functional scoliosis Rarely >10 degree curve Important to treat to balance asymmetry Sacrum and pelvis tilt towards the shorter leg Spine curves back in attempt to keep eyes level |
Short leg syndrome
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