Schroth 3D Scoliosis Exercise Therapy Program

Schroth 3D Therapy Program Components

Our 6 day Schroth 3D Scoliosis Therapy Program comprise the following components:

• Part 1: Initial Assessment Consultation
• Part 2: Customised Scoliosis Exercise Therapy Sessions
• Part 3: Schroth Method Home Exercise Program Manual
• Part 4: Schroth Method Home Exercise Program Notes
• Part 5: Education in Activities in Daily Living

Part 1: Initial Assessment Consultation

The initial assessment consultation is an integral part of the program and includes 4 steps:

• X-Ray Review: Before commencing Schroth 3D scoliosis exercise therapy with a patient, existing x-rays and reports are reviewed. It is essential that the patient presents at our Centre with a current set of x-rays, radiologist and orthopaedic specialist reports, as well as any other relevant medical history. X-rays need to have been taken in weight bearing (Erect) position, showing a Posterior-Anterior (PA) view of the full spine, and a Lateral (sagittal) view. X-rays highlight the radiological characteristics of the scoliosis curve pattern, any associated spinal degeneration, and enable the degree of curvature to be measured by the Cobb Angle method.
• Photography Review: A Therapist in our Centre photographs the patient while standing from 4 positions, front and back, and both sides. The photographs provide evidence of the clinical characteristics (what we see), establishing the three dimensional clinical characteristics of the patient’s scoliosis curve pattern, and trunk distortion. The radiological and clinical characteristics should concur with one another to correctly diagnose the patient’s scoliosis curve pattern.
• Measurements: In addition to measuring the scoliosis curvature by the Cobb Angle method, the Angle of Trunk Rotation (ATR) is verified by the Therapist using a Scoliometer. The patient’s vital capacity is measured using a Spirometer. The patient’s height is recorded on initial presentation, and any loss of function noted due to scoliosis progression.
• Awareness: In preparing patients for their program of Schroth 3D scoliosis exercise therapy, patients are taught how to: describe their pattern of scoliotic posture in Schroth terminology; the need for postural awareness; how to make pelvic corrections relevant to their curve pattern; and how to stabilize corrected posture.

Part 2: Customised Scoliosis Exercise Therapy Sessions

A program of Schroth 3D scoliosis exercise therapy is customized for patients based on their Major Idiopathic Curvature Type.

Scoliosis specific therapy exercises in the treatment of adolescent idiopathic scoliosis must provide:

• Three dimensional (3D) auto postural correction
• Training in activities in daily living (ADL)
• Stabilization of corrected posture
• Patient education

Patients perform their therapeutic exercises during the twice daily two hour sessions with the assistance of mirrors, and tactile cueing and feedback from the Schroth Therapist. Once patients have achieved optimal corrected posture for a specific therapeutic exercise, the Therapist takes a photograph of the patient performing the exercise.

Photographs taken are included in Schroth 3D Home Exercise Program (HEP) notes, specifying the therapeutic goals of each exercise, and how to perform them.

The need for patients to be focused on positive corrective changes in postural alignment, made possible by each specific Schroth 3D therapeutic exercise, is reinforced throughout daily sessions. Exercise therapy sessions are the precursor to consciously adopting a long term symmetrical, more physiological posture in ordinary activities in daily living (ADL). The benefit of adopting a symmetrical posture is that it can help prevent curve progression.

The effectiveness of Schroth 3D scoliosis exercise therapy is largely dependent on the ability and commitment of patients, and in the case of juveniles and adolescents, their parents as caregivers, to carry out the prescribed Schroth 3D exercise program.

Parents accompanying their child/teenager patient to one our Patient-Parent Programs are also coached in the Schroth Method. Coaching enables parents to provide support for the prescribed Schroth 3D Home Exercise Program (HEP).

Part 3: Schroth Method Home Exercise Program Manual

The Schroth 3D Home Exercise Program (HEP) Manual given to each patient includes:

• Their Pattern of Scoliosis
• Schroth Terminology
• Postural Awareness
• Pelvic Corrections
• Schroth Corrective Breathing
• Home Program Weekly Schedule
• Schroth Method Home Exercise Program (HEP)

Part 4: Schroth Method Home Exercise Notes

The notes for each Schroth 3D Home Exercise is set out in the following manner and includes a photograph of the patient performing each exercise in an optimal corrected posture.

• Exercise Name - Helps facilitate the Schroth Method teaching process.
• Main Focus - Therapeutic goals of each specific exercise: postural alignment; muscle rebalance; endurance.
• Positioning - Basic 3D corrections for the whole body from the pelvis (including lower limbs) upwards. Positioning is different for each scoliosis pattern.
• Elongation - Active elongation of the spine upwards from the pelvis after achieving basic 3D corrections. Hold the corrections and exhale.
• Exercise - The ‘main part’ during which specific muscle tension and Schroth corrective breathing facilitate postural correction and 3D stabilization. After the initial exhale, continue Schroth corrective breathing cycles throughout each exercise.
• Sets and Repetitions - Exercises are repeated a number of times (sets). Each set includes a number of Schroth corrective breathing cycles (repetitions)
• Variations - In some instances, it’s possible to perform a specific Schroth 3D exercise with the same main focus, but with different positioning: standing, sitting or kneeling.

Part 5: Education in Activities in Daily Living

Introducing Schroth Method therapeutic elements into ordinary activities in daily lifving (ADL) helps a patient reduce the asymmetric loading on the main scoliosis curve and lessens the risk of further progression.

Gaining awareness of the differences in postural alignment, by engaging in Schroth therapeutic scoliosis exercises, a patient develops a consciousness about postural correction, which with practice, becomes intuitive.

Patients develop a consciousness about postural correction in ADL through their participation in a program of Schroth customised scoliosis exercise therapy sessions. Training in ADL begins from the outset, during the rest interval between sets of Schroth therapeutic scoliosis exercises.

How patients: stand; sit; lay down on their front, back or side; walk; shower or dress; and engage in dynamic recreational activities such as sport or dancing, requires a conscious postural correction, ultimately an intuitive correction!. ADL is an intuitive element of the Schroth Method of Scoliosis exercise therapy.